Abortion: A matter of life and death; Russian abortion rates, still relatively high, are falling steadily

(Moscow News – themoscownews.com – Kristen Blyth – August 13, 2013) In the days of the Soviet Union, abortions were shockingly common. “My grandmother once told me that she had 12 abortions,” Dasha, a Muscovite in her late 20s, told The Moscow News. “My former landlady – she’s 67 now – and I once had a conversation about having children. She can’t remember exactly how many abortions she had, but she thinks it was somewhere around 18.”

Abortion was widely used as a form of birth control in the Soviet Union. The Health Ministry registered 5.5 million abortions, compared to just 2 million live births, in 1965. A study done in St. Petersburg just after the fall of the Soviet Union found that only 14 percent of women aged 15 to 65 had never had an abortion.

It’s not surprising that Russia developed a reputation, perpetuated by the dismal tales of its past, for fostering a rampant “abortion culture” – and that stereotype’s still around today. In “What To Expect When No One’s Expecting,” a book published in April, American author Jonathan Last wrote that Russia’s high abortion rate “might be the most grisly statistic the world has ever seen. It suggests a society that no longer has the will to live.”

Last, regrettably, based his analysis on abortion statistics from 2002.

Russia’s demographic picture today, in fact, is starkly different – even optimistic.

“Our abortion numbers are decreasing,” announced Yelena Baibarina, the director of the Department of Medical Care for Children and Obstetrics at the Health Ministry, in an interview with RIA Novosti in early August. “In 2008 there were 73.1 abortions for every 100 live births; in 2012 there were 49.7.”

The Health Ministry’s statistics are not complete, as they exclude abortions performed in private clinics. But even statistics from Rosstat (the State Statistics Service), which count operations done both in public and private healthcare facilities, show that the quantity of abortions here have halved since 2000 – from 2.1 million in 2000 to 1.1 million in 2011, Rosstat’s most recently published year.

Russia’s abortion rate is still comparatively quite high – more than double Western Europe’s average of about 22 abortions per 100 live births, from World Health Organization 2011 statistics. But demographic studies show that Russian abortion numbers are dropping steadily, even approaching levels comparable to those of the West.

What’s responsible for the turnaround?

Experts say – birth control.

“Perhaps the most important factor [in the abortion decrease] is the emergence of the market for contraceptives and information about them,” Viktoria Sakevich, a demographer at the Higher School of Economics, told The Moscow News.

In the Soviet Union, birth control was widely unavailable, low-quality condoms being the only accessible barrier against unwanted pregnancy. As more methods of contraception were brought to Russia, the rate of abortions decreased in turn.

“The [abortion] rate started a downward trend after the ’60s that increased after the wide introduction of IUDs [intrauterine devices] in the late ’80s,” Boris Denisov, a pro-choice activist and Moscow State University demographer, told The Moscow News. “It increased even more after the collapse of the Soviet Union, when the market of pharmaceuticals [and oral contraceptives] appeared.”

A contraceptive revolution

With the gradual advent of contraceptive awareness and availability, abortion ceased to function as a first-resort method of birth control. A study published jointly by Denisov and Sakevich in 2012 found that 77 percent of Russian women who have a regular sexual partner now actively use some form of pregnancy prevention.

“You may call it a contraceptive revolution,” Denisov said.

Instead, the bulk of abortions now happen as a result of conscious planning among women who already have one or two children, said Lyubov Yerofeyeva, the director of the Russian Association for Population and Development. “This means that women are attentive to such a complicated thing as abortion. The mother is not a flighty and silly girl, but a responsible woman, who realizes that another child is a burden on the family – for financial reasons, for example,” she said.

Men, too, have started to participate in family planning, lessening the onus on women to do it all themselves. “In the Soviet Union, pregnancy was a woman’s problem,” Yerofeyeva added. “But now the economic situation is improving, men work more with their partners, and married couples plan to have the number of children that they want.”

Sex education unlikely

The government, thus far, has taken a rather middle-of-the-road stance on the issue. Abortions during the first 12 weeks of pregnancy are still freely available in Russia – and cheap. Early-term termination procedures like vacuum aspiration – invented, coincidentally, by Russian scientists in the 1920s and now popularly known as “mini-abortions” – can be scheduled as a quick outpatient procedure for less than $100. Moscow’s Yevroklinik advertises mini-abortions on its website for 2,500 rubles.

Yet the government does not promote a policy of public sex education and family planning. The Orthodox Church has been instrumental in driving Russia’s anti-abortion lobby, which successfully tightened legal requirements for abortion and their advertisement in 2011, and blocked past bills for introduction of sexual health education in schools.

The church’s ongoing influence on politics leaves it unlikely that a more liberal stance is imminent, Sakevich, the HSE demographer, noted. “We don’t even dream about a favored policy on family planning with our current conservative leadership,” she said.

But continuing to lower the abortion rate – and increase Russia’s birthrate – while maintaining freedom of women’s choice requires additional education and government support. A reproductive health survey published in May, done by Rosstat in partnership with the United Nations Population Fund, found that a high proportion of women (13 percent) still use unreliable birth control methods like withdrawal, and many do not have access to professional counseling on family planning.

The lack of sex education and training in Russia leaves something to be desired, but the increasingly widespread use of effective birth control has regardless changed the face of Russian demographic trends.

“We have what we have,” Yerofeyeva said. “It is no longer possible to say that Russia has a culture of abortion.”