Fighting abortion attitudes in Russia


Poverty means many Russian women are opting to have abortions

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Changing society

A different approach

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By Jill Dougherty, CNN Moscow Bureau Chief

MOSCOW, Russia (CNN) -- The operating room is silent, the doctor’s eyes serious and focused. The young woman lies on the table, unconscious, her legs bent at the knee. The procedure is over in no more than 10 minutes. The patient is wheeled from the room and another woman is wheeled in.

In the Soviet Union, this was virtually the only family-planning method women had, other than abstinence: abortion.

Ten years ago, nearly four million abortions were performed per year, 2.2 abortions for every live birth.

But this is not the Soviet Union. This is Russia today and Zhanna has just terminated her pregnancy.

The anaesthesia has worn off and she lies in a bed, the cold winter sun streaming in through the window.

“I made the decision with my husband,” she says. “He’s taking it really hard. We wanted to have a little girl but we already have two children and we can’t afford another.”

Poverty is pushing Zhanna and other Russian women toward abortion. She is unemployed. Her husband scrapes by on a tiny salary. Abortion is free.

Zhanna, however, had a choice her mother did not -- birth control.

In contrast to Soviet days when it was virtually impossible to find contraceptives, Russian pharmacies, in big cities at least, now stock a number of different pills and devices. But some women can not afford them.

The pharmacist at one Moscow drug store shows us a dozen brands of hormonal contraceptives, most of them manufactured in Eastern Europe. A month’s supply costs from $1.50 to $10. But that’s a lot of money if your monthly salary is just $20.

There is another factor that keeps Russian women from using birth control.

“Many women are afraid to use hormonal birth control pills, even though we talk with them every day,” says one Moscow doctor who performs abortions.

Abortion, she says, can have serious side effects. In Russia, it accounts for 10 to 15% of secondary infertility. Many women, she says, are not aware of those side effects but still remember the high-dosage contraceptives introduced 20 years ago, pills that had serious side effects of their own.

Fear is often the product of ignorance. Just ask some of the young women students at Moscow State University. “Many young girls don’t know anything about condoms or whatever,” says Julia. “They prefer to do an abortion if something happens.”

Changing society

But Russian women, and their society, are changing.

Under Communism, the moral aspect of abortion officially played no role in a woman’s decision to end a pregnancy. Russia’s policy on abortion changed several times. After the Russian Revolution in 1917, the Bolsheviks legalised abortion. In 1939 Stalin outlawed it. It was legalised again in 1957.


Russia's abortion rate is the second highest in Europe

Now, the Russian Orthodox Church is speaking out on abortion, calling it morally wrong, and some women agree.

Olga, a Moscow university student, says: “Abortion is murder and no matter what happens I’d never have an abortion.” Tanya, another student studying in the library said: “Abortion is wrong and I’m against it. I think it should be forbidden.”

Russia’s abortion rate, although somewhat declining, is still the second highest in Europe, after Romania, and is three times that of the U.S. rate.

Ironically, abortion is widely practiced, even as Russia is experiencing a severe population crisis. The country’s death rate is now higher than the birth rate. Ten years ago, there were 13.5 newborns per thousand population. Today, there are just 8.5.

Would outlawing abortion resolve this? Dr. Vladimir Kulakov of the Russian Medical Academy, says no. “Restrictions are useless,” he says. “Women will simply find some doctor who will do an underground abortion….we need to improve living conditions, salaries, promote a healthy way of life and family planning.”

During the mid 1990’s, Russia began setting up family planning centres and funding them. But the Parliament did an about-face three years ago.

“Starting from the end of 1997, all the federal financial support for these initiatives was closed,” says Dr Lyubov Yerofeeva of the National Population Fund.

“It was closed with the pressure of groups of members of parliament, mostly communists, who, as I am saying, 'aborted' family planning.”

Now, family planning centres have to rely on local government funding which, most often, is very limited.

A different approach

There are places in Russia, however, where the abortion rate is falling significantly, such as in Dubna where a community-based scheme is changing women’s attitudes about abortion.

The waiting room at the Women’s Wellness Centre in Dubna is painted a cheery pink. Each doctor has a private examination room where women can discuss their concerns and be examined by the doctor of their choice -- something almost unheard of in the old Soviet medical system.

Here, an initial consultation with a doctor can last 30 to 40 minutes. Women get information on the most reliable contraceptives for their individual circumstances.

At the Dubna centre, the price of contraceptives is not the issue. Women are offered two years’ of free contraceptives if they cannot afford them.

The original funding seven years ago came from a partnership with the American city of La Crosse, Wisconsin. It was administered by the American International Health Alliance and paid for by the U.S. Agency for International Development.

Free birth control was just the first step. Doctors also launched an intensive campaign to educate.

“We begin with the school children”, says Dr Galina Kamkina, the centre’s first administrator. “We tell them that abortion isn’t good. Then the women who come here to the centre for checkups -- we tell them too. We urge them to use contraceptives after they give birth…and we even talk with women after they’ve had abortions.”

The abortion rate in Dubna is now 1.2 abortions for every live birth -- almost half the Soviet rate.

Attitudes are changing. Natasha had an abortion several years ago. She then started using birth control, which she pays for herself. Now, she and her husband are planning to have another child. “In the last seven years we’ve been a lot more serious about planning our family,” she says.

There are now almost 300 family planning centres in Russia. Where they exist, the abortion rate is falling. And some women, like 21-year-old Julia, a student, say they will plan their families by using contraceptives, not abortion.

“Ideally,” she says, “I’d like to have three children. But, of course, they way things are in the country right now, that’s not likely.”