Time to read: 16 minutes(s)

Your body is the Russian Federation's business: that's how our authorities seem to think, especially when it comes to increasing the country's birth rate. Officials themselves admit that Russia is currently in the midst of a profound demographic crisis. But instead of stopping sending its citizens to the front as cannon fodder and ending the war unleashed in a neighboring state, the authorities are choosing to ban abortions and promote early motherhood. To «reproductive function» Don't let the citizens go.

We're covering all the latest government initiatives, recalling the consequences of the last abortion ban, and publishing the opinions of Russian obstetricians and gynecologists on the abortion ban.

In June, the 2022 Vladimir Putin call demographic situation in Russia «extremely complex» и He explainedthat there should be many more residents in the country: "If we look at the challenges, what are they? Demographics. That's the number one challenge. We need to have more people, and they need to be healthy.".

At the same time, Putin assured that in Russia «a whole range of issues must be considered, including the development of medicine»to perform these tasks. 

Officials, apparently, have decided to carry out their superiors' orders—quickly and decisively. Well... as best they can.

"The value system needs to be revised. We need to stop focusing girls on higher education,   считает Senator from the Chelyabinsk region Margaret Pavlova. "We need to stop producing young people who pursue higher education that ultimately leads them nowhere—they either start working in completely different fields or something else entirely. And this search for self-worth drags on for years, and as a result, the reproductive function is lost."

Last July, the Minister of Health Michael Goosebumps He proposed restricting the sale of medication abortion drugs. He also stated that "society has developed a false belief that a woman should first get an education, build a career, and secure her financial situation, and only then worry about having children."

The Ministry of Health issued a corresponding order back in October. According to it, from September 1, 2024, to September 1, 2030, medications containing misoprostol and mifepristone will be subject to quantitative control. These medications are used for abortions and are strictly prescribed by doctors. Zhenale, a medication containing mifepristone but in a lower dose and used for emergency contraception, is also now available with a prescription.

In addition, at least nine regions of Russia have already restricted abortions or introduced fines for allegedly inciting them. 

For example, in August Mordovia accepted A law on administrative penalties for coercion into abortion. Its authors explained that "ideological and psychological pressure on citizens leads to the imposition of a system of ideas and values ​​alien to the Russian people and destructive to Russian society, including the cultivation of egoism, permissiveness, immorality, and the denial of the natural continuation of life and the value of having many children."

Currently, doctors face only administrative liability for coercing women into abortions. How this will be monitored and regulated remains unclear.

Similar fines were introduced in early November Tverskaya areaThey are planning to Kaliningrad и Tambov, and so in The Republic Komi.

In May 2023, the Commissioner for Children's Rights in the Republic of Tatarstan Irina Volynets proposed to ban Private clinics are offering abortions. They allegedly don't discourage women from doing so, while public clinics will. By the end of the summer, a third of private clinics Tatarstan refused the relevant license.

According to the latest data, three medical institutions in the Chelyabinsk area, all private clinics of the annexed Crimea, four out of five private clinics in Kursk area. Yugra journalists also reported that some clinics Nizhnevartovsk и Khanty-Mansiysk no longer perform medical abortions due to "tightening licensing requirements and regulations for the procedure."

В Kemerovo area under the regional government have created A group to reduce the number of abortions. It includes officials and clergy who will "develop and implement measures aimed at increasing the birth rate and reducing the number of induced abortions."

Also at the end of October in the State Duma passed A roundtable discussion of the Health Committee was held. Termination of pregnancy was again discussed. Now, deputies want to ban abortions in private clinics nationwide and significantly limit women's access to the procedure altogether. 

The Russian Orthodox Church also did not stand aside:

 "We need more people; that's an obvious fact, recognized by everyone: politicians and sociologists alike. But for that to happen, someone has to actually work to increase the population. And population can be increased as easily as by magic." - said earlier patriarch Kyryll. - If we solve this problem, if we learn to dissuade women from having abortions, the statistics will immediately go up."

But historical experience shows that this actually works in the opposite direction. Prohibitions don't lead to anything good.

Abortion was considered a crime in the Russian Tsardom and the Russian Empire. In the 17th century, under Tsar Alexei Mikhailovich, induced abortion was equated with infanticide and punishable by death (even though Peter the Great later abolished this punishment, the crime allegedly remained a crime). In 1845, for the "criminal expulsion of a fetus," a doctor could be sentenced to hard labor for four to ten years, and a woman could be exiled or imprisoned for at least four years.

There are no precise statistics on how many people were executed, or how many were sent to hard labor or prison. However, it is known that between 1910 and 1914, only 139 sentences were handed down under the "abortion" statute. 

In 1920, Soviet Russia became the first country in the world to fully legalize abortion. The rationale was to combat "bourgeois vestiges." Historians believe this was part of a trend toward expanding women's rights and a shift in medical ethics away from religious beliefs about pregnancy. 

But this freedom didn't last long: from 1924 onward, abortions were restricted to cases of threat to the woman's health and life, as well as to cases of pregnancy resulting from rape. Each case was reviewed individually by a special commission.

And already on June 27, 1936, the Central Executive Committee and the Council of People's Commissars of the USSR issued a decree "On the prohibition of abortions, increasing financial assistance to women in labor, establishing state assistance to large families, expanding the network of maternity hospitals, nurseries and kindergartens, increasing criminal penalties for non-payment of alimony and certain changes to the legislation on divorce." 

By criminalizing abortion again, the authorities wanted to ameliorate the unfavorable demographic situation and increase the birth rate. But it backfired—it led to death. The practice of illegal (underground and criminal) abortions began to spread across the country. Only a quarter of those performing them were professional medical workers.

Because of this, in just five years, the annual mortality rate for women after abortions rose from 451 to 4000. And these are only official figures. The rate of infanticide also increased—by the late 1930s, it accounted for approximately a quarter of all homicides in the Soviet Union.

The People's Commissariat of Health of the USSR attempted to combat abortion through public awareness campaigns, but these measures proved ineffective. Soviet women only gained control over their own bodies in the 1950s.

After Stalin's death in 1953, some feedback mechanisms were reinstated in government administration. On August 5, 1954, the Presidium of the Supreme Soviet of the USSR issued a decree "On the abolition of criminal liability for pregnant women for performing abortions." And on November 23, 1955, the same body issued a decree "On the abolition of the ban on abortions."

Abortion remains a legal practice in Russia. This cannot be said, for example, about Andorra, Honduras, Nicaragua, Salvador, Malta и Philippines - there, termination of pregnancy is prohibited without exception. Afghanistan, Iraq, Iran, Lebanon, Libya, Syria And in a number of other countries, abortion is recognized as murder and prohibited in all cases, even when a woman's life is at stake. Incidentally, the same law is in effect in eight American states.

In Poland, since 2020, abortions have been legal only if there is a risk to the woman's life or health, or if the pregnancy is the result of rape. However, in practice, obtaining a legal abortion is virtually impossible. In Poland, there have been numerous happened mass protests against such government policies. 

"Restrictive abortion laws, such as those in Poland, are contrary to international and European human rights standards and public health guidelines. They threaten the freedom, dignity, health, and lives of women."   stated formerly leading global human rights organizations. 

Today, Russia is largely following the Soviet Union's course, returning to its most brutal practices, including those related to childbirth.

"I consider a complete or partial ban on abortion illogical, because it will cause nothing but harm, as Soviet practice has already demonstrated. A ban is certainly possible. But last time, it resulted in an explosion of illegal abortions and subsequent maternal mortality. Back then, maternal mortality was only counted from 28 weeks of pregnancy, and women who died before that weren't included in the statistics. I belong to the generation that has had to hear such stories from patients and also treat disabled women after 'secret' abortions. The mortality rate is high, the morbidity rate is high, and the benefit to the nation's reproductive health is questionable." – says the obstetrician-gynecologist of the highest category, doctor of medical sciences, director of the Tomsk “Center for Perinatal Health” Sergei Yuriev.

According to Yuryev, 90% of women who come to medical facilities seeking an abortion now end up having one. And once they've decided, there's no talking them out of it. Most have well-thought-out motivations. If you ban it legally, they'll start doing it illegally.

"The problem of increasing the number of healthy children born into families is a pressing one in every country. We are far from alone in this. There are no simple solutions or ready-made recipes. Analyzing the initiatives presented by the State Duma Committee on Health Protection at an expert roundtable on abortion, I don't think they will be well received by society or, formulated as they are, will yield positive results. Mandatory consent for an abortion from the spouse or one of the parents (guardians) of a minor pregnant woman? Imagine this: a woman has four children, and her husband is categorically against having children, but refuses to sign any consent forms and will beat her if he finds out she's pregnant again. The woman comes to the doctor in tears, asking for an abortion, and is told, "No, we're forbidden without my husband's consent." And if her husband beats her? Then get social services involved, the police, and so on..." But we understand how this will end. The police also have their own orders, their own algorithms... And time flies... Reducing the permissible timeframe for an abortion on a woman's request from 12 to 8 weeks? Theoretically, the proposal is aimed at reducing the number of surgical abortions, which often lead to complications, in favor of medical termination of pregnancy. But medical termination technologies up to 22 weeks for abnormally developing pregnancies have long been successfully used in Russia, and the woman in our first example will simply be refused because she is more than 8 weeks... The next proposal is to perform abortions no earlier than seven days from the time the woman applies to a medical facility (according to the current version of Article 56 of the Law "On Health Protection" – no earlier than two days!) And yet, not all women learn about their pregnancy at 3-4 weeks; many later." – Yuryev reasons.

Sergei Yuryev notes that his private clinic does not perform abortions at all—the center's goal is precisely the opposite: to treat miscarriages, infertility, and to manage high-risk pregnancies until delivery.

“Yes, I will not have abortions, but I will make an exception abortion in the services of private I consider the ban on private clinics to be an unreasonable measure. So, a private clinic can perform complex surgeries and assisted reproductive technologies, but no one trusts it to perform abortions? Are they afraid of an uncontrolled flood of abortions? I don't see the logic! All licensed clinics are required to comply with all licensing requirements. If they don't, their license is revoked (revoking a private clinic's license is a matter of minutes). But what if they are met, plus comfort and a higher level of psychological support are ensured? Roszdravnadzor's oversight of private clinics is not weaker, but stronger, than that of municipal institutions. I return to the idea that a ban can achieve nothing but criminalization.

There's another consideration: if the embryo isn't developing properly or the mother has serious illnesses that prevent her from carrying the pregnancy to term. There's a special regional perinatal consultation where the woman (usually a married couple) receives full information. We explain the details, and she, always alone, makes the decision whether to continue the pregnancy or terminate it. This is, in essence, a right of reproductive choice, which should always exist. Only the family should decide this.».

Sometimes a medical council recommends that a woman terminate a pregnancy when there is absolutely no hope of having a child without a severe, disabling illness. In this light, how would a proposal for administrative or criminal liability for inducing an induced abortion appear?

Yuryev believes that it doesn't matter at all whether the pregnancy is terminated in a private or public clinic. Ideally, it shouldn't even be necessary, and if the pregnancy does occur and the patient doesn't want to continue it, the most gentle method—medication—should be used.

"Technical issues will follow. For example, quantitative control and sales restrictions for mifepristone and misoprostol. These medications are unavailable in pharmacies anyway, and they are used not only for abortions but also in obstetrics—to ripen the cervix and prevent postpartum hemorrhage. We're not against this control, but don't burden us with unnecessary reporting! Why create new entities when every hospital's medical information system has the ability to personally track every pill and ampoule?"

Yuryev clarifies that the topic of abortion is very complex, and what he has outlined is only a small part of it.

"There's no doubt that abortion is evil. It causes persistent hormonal imbalances, future infertility, and miscarriage... But I think it's more logical to reduce the number of abortions not through bans, but through well-thought-out, systematic efforts: preventing unwanted pregnancies among minors, women who have had multiple births, and those who are seriously ill (the main risk group for maternal mortality) and motivating (read: social support) women of prime reproductive age to have multiple children. I believe the state's social policy should play a key role here," explains the obstetrician-gynecologist. "The responsibility of doctors and psychologists here is to inform and educate the population. This should be done in kindergartens, schools, and technical colleges, talking to children about health and contraception directly in the family, and also engaging in dialogue at every medical appointment, since women often lack knowledge even about the basics." The most "popular" method of contraception remains the completely unreliable interrupted sexual intercourse, which means that pregnancy will occur without proper preparation, due to illness, exposure to harmful factors, and the woman will try to get rid of it."

This is confirmed by an obstetrician-gynecologist, host of the podcast "Spread Your Legs," a sex educator, and the author of the book "All About Her: Gentle Gynecology." Olga Krumkach:

"The situation is much more serious than it seems. It's not just some old-timers sitting around thinking, 'Let's ban abortions,' but also a woman arriving in an ambulance and saying, 'I have a stomach ache.' The whole team laughs, 'But you're pregnant.' And she replies, 'You're stupid, I can't be pregnant. I haven't had my period for a year.' And she must have had some kind of cycle irregularity before, and then she got pregnant. Or—half of our women come to the gynecologist at 20 weeks because their baby is starting to move. No one monitors their periods! Or—I had a patient who came in for labor and delivery convinced she had a tumor."

Olga explains that abortions should not be glorified, but depriving women of this opportunity is also wrong. 

"For a very long time, abortion was considered a contraceptive method in Russia. But it's not! There are many things designed for this purpose. But our society is afraid of hormones and other things, and condoms are expensive for most of the population. And I'm not even talking about teenagers. I used to ask my patients in pediatric gynecology why they didn't use protection, and they would answer, 'My parents give me 500 rubles a month in pocket money, but a pack of condoms costs 100-600.'" – Krumkach recalls. “And I have no questions, I kind of understand everything.”

Olga notes that in her practice she has never encountered doctors who are against abortions, and also reminds that abortions are still not banned in Russia: «Yes, that fear is always there. Yes, no one thought they'd be banned in Poland again. No one thought they'd be banned in America again. We don't know for sure whether they'll be banned in Russia. I'm 28 years old, and this debate has been going on for the last 28 years." 

For her part, Olga Krumkach points out that abortions are performed at private clinics at a lower quality. There, women come in, receive pills, and go home. Meanwhile, at a municipal hospital, both those undergoing medical and surgical abortions are monitored in the hospital. «Because any abortion carries a risk of infectious complications and bleeding. Then, after visiting private clinics, these women come to a public hospital for treatment.», explains that complications arise in both cases, but people with bleeding don’t go to private doctors.

 "In our country, in Europe, and in America, every person is a human factor, with their own religion, culture, upbringing, traumas, and problems. No one can be responsible for the entire medical system or make decisions for the entire country. But if a person is psychologically unhealthy, if they have personal complexes, they will transfer them to others. It's the same as with the old women on the bench. Wherever there is communication with people and even the slightest risk of manipulation, it will happen. Abortion is a medical service. A patient comes to me and says she wants to terminate a pregnancy. Honestly, I don't care at all. I can only tell her whether it's okay for her, whether there are any contraindications, and whether there are any risks. No adequate modern doctor, who doesn't have a history of shifting their problems onto others, will ever persuade anyone to continue a pregnancy." 

Krumkach's position is that abortions are necessary and should not be banned. 

"It's more important to talk more about contraception, raise public awareness, and make contraception accessible. If you look at the statistics on abortions, they're much lower now. And not because abortion access is being tightened, but because people have started using contraception and planning their pregnancies wisely," Olga says. "Sex education needs to be discussed openly; it shouldn't be a taboo topic. And there shouldn't be so much church pressure on what's happening in medicine. This is something that's much more important to talk about now."