Termination of pregnancy

The procedure for terminating a pregnancy varies depending on how far the pregnancy is.

Starting from 1 September 2023, women can decide to have an abortion up until the end of the twelfth week of pregnancy (12+0 weeks of pregnancy) without having to state the reason or grounds for it. This means that pregnancy can be terminated solely based on the pregnant woman’s request and the physician cannot refuse an abortion or request the pregnant woman to state the grounds for her decision.

As part of the care and treatment, the physician fills in the AB 1 form, but that is not permission to terminate the pregnancy. As a result of the amendments, legislation no longer requires that two physicians participate in the abortion process (previously, approval from two physicians was required).

If the pregnancy has lasted for more than 12 weeks but less than 20 weeks (12+1–20+0 weeks of pregnancy), permission to terminate the pregnancy must be sought from the National Supervisory Authority for Welfare and Health (Valvira).

When seeking permission from Valvira, the legal grounds for having an abortion include:

• giving birth and caring for the child would be a considerable strain for the pregnant woman considering her or her family’s living conditions or other circumstances;
• one or both of the parents have an illness or there is another comparable reason that seriously limits their ability to care for the child;
• the pregnant person became pregnant in circumstances referred to in chapter 17, section 22 or chapter 20, section 1, 2 , 5, 12, 13 or 16 of the Criminal Code of Finland (39/1889) (sexual offence or incest);
• there is reason to assume that the child would have or develop a serious illness or physical abnormality;
• the pregnant woman was over 40 at the time of conception or has already given birth to four children; or
• the person was younger than 17 at the time of conception.

The application submitted to Valvira must also indicate and state the reasons why the pregnancy was detected at a later stage or why an abortion has been delayed. However, this does not apply to persons who were under 17 years of age when they became pregnant.

The person seeking permission from Valvira always needs to have an AB 1 form filled in by a physician. In addition, if an abortion is sought on the grounds of a considerable strain, it is necessary to use an AB 2 form, and an AB 3 form when an abortion is sought on grounds related to the foetus. 

Permission for an abortion can also be sought from Valvira if the foetus is diagnosed with a serious illness or physical abnormality by means of an amniocentesis test or ultrasound scan, serological testing or other corresponding reliable examination and the pregnancy has lasted for more than 20 weeks but less than 24 weeks (20+1–24+0 weeks of pregnancy).  

After the twelfth week of pregnancy (from week 12+1 onwards), permission by two physicians is required to terminate the pregnancy if the continuation of the pregnancy or giving birth would endanger the life or health of the pregnant woman due to an illness, physical disability or weakness (abortion on grounds of risk to health). The AB 1 form must be filled in when terminating a pregnancy. There is no statutory time limit for an abortion. If the physician or physicians issue a negative decision, permission for termination may be sought from Valvira.

A physician may terminate a pregnancy without examining the statutory conditions and completing the forms for termination if the pregnancy must be terminated on the grounds of a health risk and the delay caused by following the statutory procedures could pose a serious risk to the health or life of the pregnant woman (emergency abortion). 

As a rule, the conditions and procedures for ending a pregnancy have not changed in cases where an abortion is performed after the twelfth week of pregnancy. Previously, the Act contained provisions on ‘special grounds’ on which Valvira could grant permission for termination. In the amended Act, these provisions have been replaced with the above-described provision, which is actually similar to the practice used by Valvira and according to which the application must indicate and state the reasons why the pregnancy was detected at a later stage or why the termination of pregnancy has been delayed. 

In future, the provision stating that, before making a decision on the termination of pregnancy, the father of the unborn child must be given an opportunity to express his opinion on the matter if this is deemed necessary, will only apply to the termination of pregnancies that have lasted for more than 12 weeks.

Certain changes have also been made to the division of responsibilities between healthcare professionals, but these changes are discussed below under a separate question. Previously, the Act stated that, if an abortion was sought on the grounds that the pregnancy resulted from certain sexual offences, the pregnancy could not be terminated, unless charges had been brought, the offence had been reported for prosecution or it was evident from the police investigation carried out in the case that the offence had been committed. This condition was repealed on 1 January 2023 as part of the reform of the legislation on sexual offences. 

If the person seeking an abortion is not capable of making a valid request for abortion because of her mental illness, other mental disorder or intellectual disability, the application may, in certain cases, be submitted by her legal representative. 

Healthcare services make a separate register notification (AB 4 form) of every abortion performed to the Finnish Institute for Health and Welfare.  

More information on the application procedure is available on the Valvira website.

The forms AB 1–AB 4 (including the forms ST 1 and ST 2 concerning sterilisation) have been updated, and they must be used from now on. The updated forms and information on them are available on the website of the Finnish Institute for Health and Welfare.
 

The updated forms are available in Finnish and Swedish on the website of the Finnish Institute for Health and Welfare:

• Forms (THL)

In some patient information systems, the forms have been integrated into the system. If this is not the case with the patient information system in question or the system has not yet been updated to comply with the legislative amendments, it is possible to use the above-mentioned PDF forms that are available on the website of the Finnish Institute for Health and Welfare. The AB 4 form that must be submitted to the Finnish Institute for Health and Welfare can also be filled in online.

The healthcare unit specific links to this form are available from the Finnish Institute for Health and Welfare.

The Institute has also issued instructions on how to fill in the forms on its website. The previous instructions issued by the Ministry of Social Affairs and Health on how to fill in the forms (Reports of the Ministry of Social Affairs and Health: 2008:43) are outdated and will cease to  apply.

Termination of pregnancy continues to require an appointment with a physician. Under the Act on Health Care Professionals (559/1994), a licensed physician decides on the medical examination, diagnosis and appropriate treatment of a patient. Only a physician can prescribe the medicinal products used in an abortion. The physician completes and signs the AB 1 form that is used in all abortions. 

Under the Abortion Act, the person requesting an abortion must be given an account of what having an abortion means and what its effects are before the pregnancy is terminated. People who have had their pregnancy terminated must be provided with advice on birth control.

The legislative reform changed the regulation as to who can give the above-mentioned account and provide advice on birth control. Previously, only a physician could give this account and provide advice on birth control.

As a result of the legislative amendments, not only physicians but also other licensed healthcare professionals who have sufficient competence for performing the duties can provide the person requesting an abortion with this account and advice on birth control. Such other healthcare professionals include, in particular, public health nurses, midwifes, and nurses with sufficient competence.

However, the physician is ultimately responsible for ensuring that the patient is provided, as part of the treatment, with information essential to her medical care. The physician must provide the account and advice themselves if this is necessary due to the patient’s health or the special circumstances of the pregnancy.

However, if the termination of pregnancy is requested or sought on the grounds of a suspected or diagnosed foetal abnormality, the account must be given by a medical specialist with expertise in foetal abnormalities, irrespective of the length of the pregnancy. 

If the pregnancy has lasted for more than 12 weeks (>12+0 weeks of pregnancy) and permission to end the pregnancy is sought from Valvira on the grounds of a considerable strain caused by the pregnant woman’s or her family’s living conditions or other comparable circumstances (section 1, subsection 3, paragraph 1 of the Act), the AB 2 form that is used for the above-mentioned account must be signed by a social worker, nurse or a comparable healthcare and social welfare professional (preferably other than the physician who submits an opinion to Valvira). The AB 3 form must be filled in by a physician.

By reading the guiding texts on the forms, it becomes clear who can fill in the forms for terminating a pregnancy and when each section on the form must be filled in. 

Previously, physicians working in the private healthcare sector needed approval from Valvira to act as a physician issuing an opinion on the termination of pregnancy. Valvira also granted approval to hospitals to perform abortions. Physicians employed by such hospitals were allowed to terminate pregnancies.

This regulation was repealed on 1 September 2023, meaning that such special approvals are no longer required from Valvira. A licenced physician can complete the forms and issue the opinions needed for the termination of pregnancy and perform the procedure.

Those wishing to practise private healthcare are required to have a licence in accordance with the Private Healthcare Act (152/1990) (as from 1 January 2024, registration in accordance with the Act on the Supervision of Healthcare and Social Welfare Services (741/2023)).

Under the Health Care Act (1326/2010), the wellbeing services counties must organise guidance and advice that is provided in connection with healthcare services, including the termination of pregnancy, in respect of factors that help to maintain or stand to compromise mental health, and, if necessary, psychological support for individuals, families and other people close to them and the coordination of this support.

The Social Welfare Act also stipulates that mental health services that are provided by the wellbeing services counties in connection with social work include necessary psychosocial support for individuals and families regarding factors that help to maintain or stand to compromise mental health, and the coordination of psychosocial support for individuals and communities.

The legislative amendments that entered into force on 1 September 2023 specify these obligations. This means that the Abortion Act lays down separate provisions stating that those requesting or considering an abortion and the other parent have the right to receive the psychosocial support they need.

The Abortion Act also applies to private healthcare. Under the Act on the Status and Rights of Patients (785/1992), patients have the right to receive good-quality healthcare and medical care. Their care must be organised and they must be treated in a manner that their dignity is not violated and their conviction and privacy are respected.

The Act on the Status and Rights of Patients also applies to private healthcare. This means that patients must also be provided with sufficient opportunities for discussion and advice when they have their pregnancy terminated in the private sector. The wellbeing services counties also provide, as necessary, psychosocial support to patients who will have or had their pregnancy terminated in the private sector as well as support to the other parent.