JRL NEWSWATCH: “Abortion in Russia: How Has the Situation Changed Since the Soviet Era? [Excerpt]” – PONARS Eurasia/ Victoria Sakevich, Maria Lipman
(PONARS Eurasia/ Victoria Sakevich, Maria Lipman – February 12, 2019)
Victoria Sakevich is a Senior Researcher at the Institute of Demography at the Higher School of Economics, Russia. She has been studying the demography of reproductive health for many years.
Soviet women commonly resorted to abortion as a way to end unwanted pregnancies. In the post-Soviet decades, the emergence of a market economy, the availability of modern contraceptive methods, and increased knowledge about contraception have all contributed to improving sexual culture. The number of abortions has decreased significantly and would have declined even more rapidly were it not for certain issues, among them the absence of a system of sex education. Victoria Sakevich, a Russian demographer, discusses the abortion dynamic in Russia in recent decades in an interview with Maria Lipman, comparing it with abortion rates in other countries.
Maria Lipman: Conservative initiatives related to abortion have become more vocal in Russia in recent years, and we will get to that. But let us begin by drawing a more general picture: what have been the main trends in abortion practices since the collapse of the Soviet Union? In particular, how has the ratio of births to abortions changed?
Victoria Sakevich: There have been substantial-and positive-changes in birth control in the post-Soviet period. Russia, like Western countries, has undergone a demographic transition: today, an average family wants to have two children, and this means that for many years women and couples have to be concerned about avoiding unintended pregnancies. To this end, couples can use various methods of contraception that help prevent pregnancy or use abortion in order to end it.
For decades during the Soviet period, induced abortion played a substantial role in the birth control practiced by Soviet families. In 1920, Russia became the first country in the world to legalize abortion as a woman’s choice. [From 1936 to 1955, abortion was banned; backstreet abortions became common, leading to grave health damage and a sharp rise in maternal deaths.] Since Soviet women did not have the alternative of reliable and secure contraception, they had to resort to abortion as a way to end unwanted pregnancies. The highest abortion rates were registered in the mid-1960s. 1964 set the record: 5.6 million abortions were performed that year-that is, 169 abortions per 1,000 women aged 15 to 49.
In the 1990s, the transition to a market economy gave rise to radical changes in many spheres, including birth control. Over the past 20 or 30 years, Russia has made significant progress toward more modern, civilized methods of birth control in which the focus is on preventing unwanted pregnancies, not ending them.
According to official statistics published by the State Statistical Committee (Rosstat), a steady decline in the number of abortions began in 1988; between that year and 2015, the absolute number of abortions registered on an annual basis has decreased 5.5 times, from 4.6 million to 0.8 million. During the same period, the abortion rate per 1,000 women aged 15 to 49 declined by 5.3 times (from 127 to 24). Whereas in the 1960s there were three abortions for every birth, today the number of births is twice as high as the number of abortions.
The total rate of abortions-which provides a more accurate measure, independent of the age structure of women-has gone down from an average of 3.39 registered abortions per one woman during her reproductive age in 1991 to 0.78 in 2015. In the 1960 and 1970s, this index reached an estimated 4-5 abortions per woman of reproductive age….
Lipman: What do you think of the government’s family planning policy? Which government agencies (besides the Ministry of Health) or non-government (including religious) organizations come up with initiatives in this sphere? Does the Ministry of Health consider decreasing the number of abortions an important task? Is the government more open to progressive or conservative initiatives related to abortion? Which measures-legislative or regulatory-have been adopted or rejected in recent years?
Sakevich: The government’s family planning policy has never been consistent. My colleagues and I have divided the post-Soviet period into three parts: before 1998, from 1998 to 2006, and after 2006.
The earliest period (before 1998) may be described as “auspicious for family planning.” It was associated with the adoption of the federal program of “Family Planning” that I mentioned earlier. The period from 1998 to 2006 was “moderately inauspicious.” Many initiatives were launched that would have tightened abortion legislation (in Russia it remains liberal), yet nearly all of them were rejected. The period after 2006 we define as “archaization and regress.” The lawmakers intensified their efforts to restrict reproductive rights; this also coincided with a new stage of “pro-natalist” policy in Russia, one that is aimed at boosting the birth rate. At this stage Russia’s leadership has chosen to reduce the incidence of abortion, yet not by promoting family planning, but by stimulating the birth rate and creating obstacles to induced abortions.
A few legislative amendments have been adopted that reduce access to abortion. For instance, in 2007 the list of medical indications for abortion was cut down. In 2012, the government reduced the list of social indications for abortion to just one: pregnancy as a result of rape. In the 1990s, this list included 13 social indications. In 2011 a so-called “week of silence,” or waiting period, was introduced: when a woman comes to a medical institution seeking an abortion, she is now told to wait for 48 hours or seven days, depending on the pregnancy term. During this time, the woman has to visit an office of medical and social counseling and listen to a psychologist’s or social worker’s advice. The main goal of this counseling is to persuade the woman to change her mind and decide to give birth instead of ending the unintended pregnancy.
And by the way, the Ministry of Health suggested a differentiation between “prevention of unwanted pregnancy” and “prevention of abortions,” even though they are essentially the same thing. The officials, however, propose that the former implies the use of contraception and the latter is aimed at persuading a woman not to end the unintended pregnancy. Today, the activity of the Ministry of Health and public organizations that specialize in anti-abortion topics is focused on such “abortion prevention.”
Since 2012, Russian doctors have had the right to refuse an abortion. Since 2014, it has been forbidden to advertise induced abortion as a medical service. In 2016, the Ministry of Health recommended that a woman seeking an abortion be encouraged to view an ultrasound image of the embryo and listen to its heartbeat. That same year, a new voluntary and informed consent form for induced abortion was introduced. A woman seeking a voluntary termination of pregnancy must sign this form, which now includes frightening information about the possible negative consequences of abortion, up to and including infertility. Meanwhile, the World Health Organization cites abortion as a safe medical intervention-if it is performed by a medical professional in appropriate conditions and by gentle techniques.
Exclusion of abortion from the basic plan of compulsory medical insurance has been also discussed. [The Russian Orthodox Church has repeatedly called for such an exclusion; most recently, this opinion was voiced by the Patriarch of the Russian Orthodox Church – ML.]
In recent years, the opponents of the right to abortion have added a new argument to their stance: they claim that abortion offends the feelings of religious believers. Many of the abortion-restricting amendments are similar to the recommendations of the Patriarch of the Russian Orthodox Church. I also believe that many Russian pro-life activists have borrowed ideas from their counterparts in the US.
It should be noted, however, that in 2018 the political debates on abortion grew less passionate. Several bills initiated by senator Elena Mizulina (an ardent proponent of social conservatism and the major anti-abortion fighter) were rejected by the State Duma.
The executive government does not support repressive measures aimed at encroaching on reproductive rights. Tatiana Golikova, deputy prime minister for social policy, recently spoke out in favor of informing teenagers about methods of contraception-which was unexpected, given the conservative trend of recent years.
Lipman: What is public opinion on abortion like today?
Sakevich: According to public opinion surveys, the Russian people do not approve of abortion. Abortion is generally not a decision that is taken lightly or easily. But if the question is whether abortion legislation should be less liberal, then public opinion is divided. More and more Russians believe that a woman’s right to choose abortion should be restricted. In 1998, 18 percent indicated this in a Levada Center poll, and in 2015 this number reached 35 percent. The highest share of abortion opponents is found among those groups for whom the issue of unintended pregnancy is not highly relevant: men, women past reproduction age, young women without the experience of family life. But among believers (or those who identify themselves as believers), there is no consensus on abortion. Fifty-two percent of Orthodox believers and 61 percent of Muslims disagreed that abortions were legal murder and impermissible under any circumstances. An overwhelming majority of adult Russians (78 percent), including believers, share the perception that families should plan childbirth using methods of contraception. Only 14 percent believe that a woman should give birth to and raise as many children as God gives. If Russia held a referendum on whether abortions should be legally restricted, such a measure would likely not be approved by a majority. Russians are generally in favor of policies such as an increase in living standards, sexual education, the development of family-planning services, and including contraceptives in compulsory medical insurance plans.
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