Our study1 indicated that the Central Eastern European countries and Baltic countries have high termination of pregnancy rates. The Bulgarian, Romanian and Estonian rates are over 20 per 1000 women aged 15–49 years, a figure that is nearly twice the European Union (EU) average. We thank Dr Grošelj2 for confirming our concerns with these high rates, which in part reflect attitudes and accessibility to effective contraception in previous decades. The registered rates in these countries have actually decreased significantly over the last two decades and are slowly approaching the EU average, as seen in figure 2 of our paper,1 showing the trends in termination rates by region.
Using effective contraception is preferable to termination of pregnancy, but more detailed studies are required to identify the real causes behind the observed regional trends. Furthermore, additional East–West comparisons could provide further information on how best to replace pregnancy terminations with contraception and how to reduce the use of unsafe termination methods. Data and statistics on terminations of pregnancy over time should be an essential part of the European Public Health Monitoring and Reporting System.