Russia proposes strict limits on abortions to boost population

Cite this as: BMJ 2011; 342:d3103

by Andrew Osborn (Moscow)

A bill has been introduced into the Russian parliament that would sharply curb the availability of abortions in an attempt to reverse the country’s chronic depopulation crisis.

In a controversial move backed by the Russian Orthodox church, the draft legislation proposes that the country’s public health service stop offering abortions altogether, forcing women who want an abortion to pay for one at a private clinic.

If passed, the same bill would limit advertising of abortion services to specialist magazines only and enshrine in law a doctor’s right to refuse to perform the procedure for a large number of reasons.

The most contentious part of the new bill, however, is a clause stipulating that a married woman wanting an abortion must obtain the written consent of her husband, while an underage girl must obtain her parents’ written permission.

“The bill aims to create the conditions for a pregnant woman to opt to give birth,” said Yelena Mizulina, head of the parliament’s committee for family, women, and children. “We have public support.”

Mrs Mizulina said that passing the bill was a matter of national survival. “According to the traditions of Russian society the decision of an Orthodox woman to have a baby is a spiritual and moral one,” she told reporters.

“Nobody should be surprised that the population of Russia is dying out. It’s not just a problem of women not giving birth. On top of that there is an unknown number of so called pharmaceutical abortions when a woman simply swallows a pill bought in a chemist.”

Existing legislation allows Russian women to abort a fetus on request up to 12 weeks’ gestation, up to 22 weeks “for social reasons,” and to abort at any point during the pregnancy for medical necessity (with the woman’s consent).

Government figures show that more than 1.5 million abortions are performed in Russia each year, a statistic that the United Nations says means that Russia has more abortions per capita than any other country in the world.

With the real figure thought to be much higher and easily outstripping the number of births, the country’s population has shrunk by 2.2 million in the past eight years and stands at roughly 143 million, down from 148.5 million in 1995. Experts say that alcohol and drug misuse and the fact that many Russian men die in their 50s are also to blame.

But the Kremlin has warned that the procreation problem is critical. It has pledged to spend the equivalent of £33bn (€38bn; $62bn) to raise the birth rate by a third within just five years.

Vladimir Putin, the prime minister, has revived the Soviet era practice of giving medals to women who bear many children, and in 2007 he introduced cash payments for women who have two children or more. Under the scheme Russian women who have two children are eligible for a one-off payment of about £8000, a lot of money in a society where the average monthly wage is less than £500.

Critics have warned that the new bill would force women to opt for dangerous backstreet abortions and have complained about the Russian Orthodox church’s “pernicious” influence in the debate.

BMJ 2011;342:d3103 follow the link to see the coment by prof Vlassov, correcting above info 
and an article on Russian abortion>>contraception transition