Countries Abortion Profile

Russian Federation

1. Law related to Abortion

Brief history of the law

Soviet Russia became the first country in the world to legalize abortion.

On 16 November 1920 the Communist Party lifted the ban on abortion “in order to destroy the traditional family and religion, and create a new socialist basis for communist society”.

This law was repealed in 1936, mainly for pronatalist reasons.

In 1955 soviet government relegalized the procedure with a few restrictions.

The 1987 law extend the number of legal grounds for obtaining a second-trimester abortion through Order N1342. This order permitted a pregnancy termination to be performed for up to 28 weeks’ gestation on juridical, vital, and broad medical and social grounds after authorization by a commission of local physicians.

Social reasons for legal termination of pregnancy between 13 and 22 weeks’ gestation were defined in 1996. The 14 permissible medical grounds consist of a wide variety of physical diseases and handicaps and mental disorders as well (including various psychoses, chronic alcoholism, drug abuse, and mental retardation) and so called “physical conditions” (such as being a teenager  and being older than 40).

In 2003 the 13 social reasons had been reduced to four (the court deprived the woman of her parental rights or restricted her parental rights; the pregnancy is the result of rape; the woman is confined to prison; and the woman’s husband is severely disabled or died during the pregnancy). Since 2007 the number of social and medical ground for the late abortion have been reduced, the two social grounds (Rape and Incest) left, the medical ground have been halved as well.

More over the Informed Consent to an Abortion on Request has been introduced at the end of 2007.

Short summary of conditions within the law

  • To save the life of the woman – in any terms of abortion

  • To preserve physical health - medical reasons

  • To preserve mental health - medical reasons

  • Rape or incest – social grounds (up to 22 weeks’ gestation)

  • Foetal impairment – medical reason for interrupting of pregnancy

  • Economic or social reasons – only 2 reasons for social grounds

  • Available on request – in the first 12 weeks of pregnancy

2. Policy

Seems that at the moment there is a slight shift to the development of a pro-natalist policy in Russia.

3. Second Trimester Abortion

Six main indications – medical grounds (see above) and social grounds (see above)
Regulations – Orders of the Ministry of Health
Upper time limit for different indications/methods used – up to 22 weeks
Additional regulations related to medical abortion,
Location of services – only at the hospitals
Level of providers – only Ob&Gyns

4. Practice

The induced abortion is performed by the professional gynecologist at the in-patient department of the hospital.
Abortion on request and for medical reasons is covered by medical insurance.
There is neither a spousal consent requirement nor any mandatory counseling or waiting period. Parental consent is required for adolescents below the age of 15.

5. Reproductive Health Perspective

Signatory to ICPD, CEDAW: Yes.

6. Abortion Statistics

Total – 1 302 000 (without private clinic)
absolute number abortion in 2007 –
Induced abortion rate among women aged 15-44 years
Total abortion rate per woman                                                    
General abortion rate per 1,000 women – 33,3
Abortion ratio per 100 live births         - 81,9
Age specific abortion rate age 15-19 – total – 124 480 (9,6% 0f all age group abortions)
1st TM –1 219 040 (93,6%)
2nd TM (22-27 week of gestation) – 20 144 (1,55%) safe
unsafe – 1 351 (0,10%) plus 63 850 (4,90%) - undetermined
married women – have no statistic
unmarried women - have no statistic
adolescents – 125 273 (9,66%)
Septic abortions – statistic is available only as a complication\reason for MM.

7. Public sector

Abortion services available
1st Trimester – Yes, in all level of Health Care services
2nd Trimester – Yes, available only on the secondary level of HC services
Cost: De yuro (by law) – free of charge; De facto – from 200 $ USA to 700 $ USA (It depends from facility, anesthesia, wards, et c.t.)
In principle, abortion is free of charge in state facilities, but women pay for extra services, such as better ward, anesthesia and so on.
If the reason for abortion is medical or social, it be performed free of charge.

8. Private sector

Abortion services available only for 1st Trimester Abortion
Cost - It depends from clinic, abortions’ method, anesthesia, wards, et c.t. , may be from 300 $ USA to 700 $ USA
The number of private abortion clinics is not known, nor is the number of women undergoing abortions in such clinics.

9. Methods used

1st Trimester – EVA, MVA, MMA with Mife Miso, sharp curettage, D&C (12-16 weeks pregnancy) – in out-patient clinic and at the hospitals
Medical Abortion – up to 42 days LMP
2nd Trimester – Intracervical installation of prostaglandins, hypertonic saline, with Ethacridine lactate , MMA with Mife Miso, with Miso alone, Hysterotomy (the lists – according the rate of dissemination) – only in the hospitals.

10. Provider level allowed for surgical and medical abortion

Both of abortions’ type (surgical and medical) available only by Ob&Gyns 

11. Abortion related morbidity mortality statistics

Abortion related morbidity – don’t have statistics
Total Maternal Mortality / 100 000 life birth – 24,1
Abortion part in the structure of MD - 18,8% of all maternal deaths.

12. Manufacture and/or availability through import of abortion equipment (MVA syringes, EVA equipment)

Russian distributors get MVA syringes from IPAS (the price is 100 $).
EVA equipment is Russian “product”.

13. Manufacture/ import of Mifepristone, Misoprostol

There are many possibilities to get Mifepristone, Misoprostol. There are 2 russian manufactures which are produced these medicine. There are some export variants of these medicine.

14. Facility and provider certification norms in brief

Should be licensed by MoH authorities.

15. Information available in national service delivery standards

Russian Federation has no official standards on Abortion care.

16. Informal / illegal providers – if present who are they

No.

17. Population urban/ rural: Demography of the country, with an analysis of availability of abortion services ratio to population

Birth rate – 11,3/ 1000 population
Total mortality rate – 14,6/1000 population
Total population – 142,22 million
Women fertility age – 76,37 million (27,5%)
Abortion’ beds – 3 700 (total) or 0,94/ 10 000 women of FA; in villages – 12,0% of all abortion’ beds
The number of OB&Gyn – 39 200 (total) or 5,1/ 10 000 women of FA

18. Role of government

Supportive, enabling, creating barriers, provides adequate funding to run training and service delivery programmes.

19. Role of religion/ religious leaders

Russian Orthodox Church has negative attitude to the right for an abortion and other abortion’ issues, has a strong supporters at a State Duma and struggles for abortion indications’ limitation.

20. Local Ob Gyn societies

Supportive, conscientious objectors – Supportive, but do nothing to keep stable their position concern the abortion issues against Russian Orthodox Church and some organizations (similar Pro-life).

21. Current status and potential of research

In 2003-2004 abortion-related maternal mortality was the subject of previous study (Zhirova IA, Frolova OG, Astakhova TM, and Evert Ketting;
In 2001-2002 Post-abortion Care Operations Research “Increasing Effective Postabortion Contraceptive Use and Reducing Repeat Abortions in Perm, Russia” was conducted in Perm (50 medical providers and 1580 postabortion clients, Identify who has abortions and why, Review the socio-demographic profile of the study participants, their reproductive behavior and the consequences of abortion, Quality of postabortion care, Highlights lessons learned and recommendations for the future  were analyzed  P.David, I.Savelieva, N.Vartapetova)
In 2006 WHO project “Strategic approach to abortion care in Russia” was started, but not finished for the technical reasons.

22. Awareness amongst community members

Awareness on MVA/EVA, medical abortion (among women) - Don’t have
Awareness on MVA/EVA, medical abortion (among medical providers) - Don’t have

23. Role of member organization/ individual