No matter where you live in this world, all women need to have safe, non-judgmental and consistent access to family planning services including birth control, IUD, Plan B, Plan C and abortion.

If you live in Croatia and are a woman, you need to know your options preferably before you need those options. Considering the substantial influence of Catholicism, it can be difficult and uncomfortable asking questions here, especially if you don’t subscribe to the expected norm of getting married and popping out a fleet of children.

Here at Expat in Croatia, we don’t believe religion dictate our health.

In this post, we cover what you need to know about access to family planning services including availability of birth control, emergency contraception and abortion in Croatia.

Birth Control, IUD, Abortion, Plan B, and Plan C in Croatia

Birth Control

Birth control pills are available with a prescription from a gynecologist (called “ginekolog”), either private or public. Birth control pills are not covered by state health insurance. Some birth control pills are partially covered by dopunsko, depending on your policy. The cost for pills is usually between 80 and 120 kuna per month.

The Croatian name for birth control is “kontracepcijske tablete” or “kontracepcijske pilule”.

To get a prescription, you must go to a gynecologist for a gynecological examination. If the doctor says you’re in healthy condition, they will write a prescription. You can only get a prescription for 6 months at a time and you are limited to filling the prescription for 2 month’s worth at a time.

Available birth control options include:

• Bellune 35
• Cilest
• Diane 35
• Escapelle
• Evra
• Logest
• Novynette
• NuvaRing
• Qlaira
• Trinovium
• Triquilar
• Yaz
• Yasmin

IUD (intrauterine device)

Spirala (intrauterine device) is an effective contraception method available in Croatia that results in very few complications. Spirala is a small T-shaped cartridge placed in the uterus where it can stay approximately 5 years for the purpose of preventing pregnancy.

There are two types of Spirala:

#1 Bakrena spirala or Copper intrauterine device (Cu-IUD)

Bakrena spirala provokes inflammatory changes of the lining of the uterus and secretes cervical mucus to prevent pregnancy.

#2 Hormonska spirala or Hormonal intrauterine device (Mirena or LNG-IUD)

Hormonska spirala continuously releases the hormone levonorgestrel. This hormone thins the lining of the uterus, making periods less abundant and in some cases, eliminating them entirely. It can also be used to correct irregular and prolonged bleeding, myomas, adenomyosis, and endometrial hyperplasia.

The cost of intrauterine devices in Croatia vary from 600 to 2.000 kuna, depending on the type. They can be purchased at pharmacies or at gynecological practices. Regardless of where you purchase the IUD, you must have a gynecologist perform the implantation.

First, you must visit a gynecologist who will first perform a medical examination. If you are found healthy, a gynecologist will insert the IUD into your uterus.

Hormonska spirala is free of charge (i.e. HZZO covers its cost) for women with secondary anemia as a result of heavy periods and in cases of a thickened endometrium.

Plan B

Plan B, known as “the day after pill”, is called “pilula za dan poslije’’ in Croatian. It is not covered by health insurance and cannot be prescribed in hospitals.

This is not considered to be regular contraception but rather an ‘emergency measure’ which is taken within 24 hours after unprotected sex has taken place.

It prevents pregnancy in 95% of cases, if taken within 24 hours. If taken between 48 and 72 hours after intercourse, its effectiveness drops to 61%.

You can buy Plan B in pharmacies (called “ljekarna” in Croatia) without a prescription.

There are two legal versions:

• EllaOne (Cost: 228,48 Kuna)
• Escapelle (Cost: 195 Kuna)

While these are available to you without a prescription, do not be surprised if a pharmacist refuses to sell it to you on religious grounds. If you’ve experienced this, share the pharmacy with us in the comments.

Plan C

In 2019, Croatia approved the usage of Mifegyne 200, known as abortivna pilula (abortion pill). The pill blocks the effects of progesterone to the uterus, causing contraction and bleeding which leads to induced medical abortion.

Mifegyne can be used until the 10th week of pregnancy. To get it, a prescription from your doctor is needed. A pharmacy can get it in 24 to 48 hours after your order. The pill should be taken for 4 days and after that, a gynecological examination is needed.

This pill can also be used in case of fetal death (in combination with Mispregnol 400). This method gives women a less stressful and risky option that can be done at home. It eliminates the need for kiretaža (evacuation) process, which is very unpleasant and must be done at a medical facility.

Abortion

Before we dive into your options, let’s talk about the history.

History of abortion in Croatia

Abortion legislation went through a major breakthrough in 1952 when Croatia was still part of Yugoslavia. This was in response to a significant increase in illegal abortions. When Croatia became independent in 1991 and adopted a new Constitution, the law regulating abortion was not changed. Under a 1978 law, abortion is allowed on request only during the first 10 weeks of pregnancy.

During the last few years, some Croatian organizations have attempted to take away a woman’s access to legal abortion. For example, groups of people called “molitelji”, which means “prayers”, gather in front of state hospitals to pray against abortion and harass women who come for the procedure. Luckily, there are NGOs fighting for women’s rights through their own protests in an effort to show the community that tolerance, acceptance of our differences, and peace are the only way to build a healthy community.

Abortion after 10 weeks is allowed only in cases of sexual misconduct, potential birth defects or any mental/psychological complications and must be approved by a commission (called “Komisija prvog stupnja’’ in Croatian). This commission consists of a gynecologist, another physician, and a social worker or registered nurse. Considering all of these hurdles, it is still not a guaranteed option and it won’t be easy.

The abortion process

The woman must prove that she is determined to have an abortion and the physician must be convinced of her determination. Counseling is not required prior to the procedure. The procedure must be performed by a doctor under good medical conditions in a health care establishment. Just like pharmacists with Plan B, doctors have the right to conscientiously object to the procedure. If you have encountered a doctor that has refused to perform the procedure, please tell us in the comments so other women can avoid that doctor.

The abortion must be performed by a physician in a hospital within the department of gynecology or obstetrics or in another authorized healthcare facility.  If the woman is under age 16, the authorization of her parents or guardian and the guardianship authority is required.

The abortion procedure lasts between 30 and 40 minutes. It is usually performed early in the morning, but there is a chance that you could wait for several hours.

Is it necessary to bring these things with you to the hospital:

• Uložak (menstrual pad)
• Čista pidžama (clean pajamas)
• Donje rublje (underwear)

What an abortion costs in Croatia

Abortion is not covered by state health insurance. The average cost of the procedure is 2.125 kuna without anesthesia and 2.800 kuna with anesthesia according to AntenaZadar. Abortion in Croatia feels forbidden due to the prevalence of refusals from doctors based on religious grounds.

Approximate costs of an abortion procedure are:

• Gynecological examination – 300 kuna
• Blood test – 50-100 kuna
• Procedure without anesthesia – ~1500 kuna
• Procedure with anesthesia – ~2000 kuna

Where you can get an abortion in Croatia

In 2019 as part of “Open Data Day”, a female team from the organization Code for Croatia developed a map of all the facilities in Croatia that offer abortion procedures and their approximate cost. This map was created based on data collected by journalists Danka Derifaj and Mašenjka Bačić.

Mašenjka received the Balkan Scholarship Award for Journalistic Excellence for her work on the availability of a pregnancy termination services to Croatian women. A BIG thank you to both of them for helping women gain access to health care services.

View the map of medical facilities that offer abortion services here.

More information on abortion in Croatia is available here.

Some other facts about sex health in Croatia you should know

Croatia has the lowest rate of abortion in the EU, likely because it is difficult to procure and socially unacceptable.

Croatia does not have dedicated sex education in schools nor free contraception. Since 2012, sex education in Croatian schools has been integrated within existing school subjects such as biology and psychology. The topics include masturbation, menstruation, pornography, sexual diseases, and sexual orientation. Elementary school subjects cover 17 hours of sex education topics, while high school subjects cover only 13 hours.

“Young people in Croatia use birth contraception pills three times less than their peers in Western Europe,” said Dubravko Lepušić from KBC-Sisters of Mercy in Zagreb for Vox Feminae.

There is an increased risk of sexually transmitted diseases in Croatia because:

• There is no dedicated, state-mandated sexual education
• Doctors discourage patients from getting STD tests
• There are no free government-provided sex education resources or distribution of contraception

You can get FREE STD testing with your state health insurance. Read about it here.