Since the 2010s, Russia has been constantly trying to restrict access to abortion by introducing a “week of silence”, banning advertising for abortion, displaying the visualization of an “embryo’s heartbeat”, etc., and public officials have been making radical statements about the necessity to further restrict access to abortion. However, for a long time, the authorities have not gone through with imposing severe restrictions; the Ministry of Health has been one of the primary opponents of the Russian Orthodox Church and the conservative public. In July 2023, everything changed: the head of the Ministry of Health, Mikhail Murashko proposed restricting the sales of chemical abortion drugs and including them into the category of controlled substances by the end of the year.
The initiative could result in a ban on over-the-counter sales of emergency contraception. Consequently, a grassroots group of feminist activists created an Emergency Contraception Storage Fund, which raises funds via donations. The drugs purchased will be distributed free of charge by the activists — as a mutual benefit fund.
— Statements on the necessity to restrict abortions in Russia have been made frequently. Currently, the authorities are planning to limit the sale of abortion medication. Why now?
— Practical obstacles are created before imposing any legal restrictions, certain things are demonized. Naturally, it began well before the military developments. Occasionally, there have been proposals to remove abortions from compulsory medical insurance and prohibit this medical procedure at private healthcare facilities. The initiatives have been voiced by either representatives of the Russian Orthodox Church or by conservative deputies. However, the stir on the matter reached its peak this summer. What is alarming here? First, the topic is raised more frequently. We see statements on the issue in one region or another almost daily. Second, Mikhail Murashko, [Minister of Health], is the one directly addressing the issue. Before, the Ministry of Health did not denounce abortion as women’s “depraved practice”.
It is clear that conservatism is on the rise in Russia. But let us consider other possible reasons for this, besides ideology. I think this is partially due to the discouraging demographic statistics in the past year. The data on abortions looks rather gratifying: the rate has been declining every year [1186.1 K in 2010, 553.5 K in 2020]. But the number of births has generally dropped. [In 2022, 1,304,087 people were born, which is 6.7% fewer than in 2021]. Back in December 2022, this issue started to be discussed. In addition, many women of reproductive age are from the small generation of the 1990s who generally cannot provide significant numbers of births, as there are fewer of them. COVID mortality and the deaths of young men also carry weight, along with the fact that many people left the country. Russian women cannot possibly compensate for all this. But [the authorities] would like to paint a rosy picture. They believe they have to do something, and the restriction of abortion rights seems to be the most obvious measure.
— How severe is the current measure to limit access to abortion medication?
— The measure seems strange. It was proposed to ban the sale of abortion medication in pharmacies. When we read this, it did not make any sense, as “abortion medication” is not sold in pharmacies anyway. It is only sold to healthcare providers. Then it turned out that the restriction applies to mifepristone medication [the mifepristone-based pharmaceuticals for medical abortion contain the same substance in a larger dose, whereas emergency contraception pills come in a smaller dose]. The Ministry of Health presented this in very vague wording, that’s why the media wrote that emergency and over-the-counter contraception would be banned altogether. It was also mentioned that women harm themselves by taking such pills. Actually, the idea of prescribing emergency contraception would not be bad if it were not for attempting to impede its availability in the first place. Emergency contraception pills have a low dose of mifepristone. Even 60 packs may not be enough to induce an abortion (depending on the pregnancy term), as it would be probably as effective as using folk medicine remedies. But it will cost about the same as an abortion in a private health clinic.
Then why choose this strange measure? It seems to me the Ministry of Health does not intend to severely restrict abortions, as there are experts who realize that this will not increase the birth rate by several million. The increase, if any, will be quite insignificant; but at the same time, child and maternal mortality will go up. Therefore, I believe an attempt to limit the sale [of medication] is nothing but publicity-seeking activity, a message for the conservative public and the Russian Orthodox Church to prove that something has been done. But still, the tendency is disturbing. If mifepristone medications are no longer available, might the government take the next step and limit access to all emergency contraceptives? In such a case, the medication will probably cost more.
— What social groups would be most affected by restrictions on emergency contraception?
First of all, the women in abusive relationships. In such relationships, the men are likely to sabotage the use of barrier contraception, and women often do not have money to buy oral contraceptive pills, insert an intrauterine device (IUD), or use alternative methods of birth control. In my [VK social media] group, I occasionally see the requests such as: “I have two children. My husband insists on having a third child, but I am sure I don’t want to have another one.” Typically, in such relationships, sexual intercourse is unprotected, which is essentially reproductive coercion. If someone can force a woman to get pregnant and give birth, they are likely to prevent her from going to the doctor, or not give her money [to buy medication], etc.
“I believe an attempt to limit the sale [of medication] is nothing but publicity-seeking activity, a message for the conservative public and the Russian Orthodox Church to prove that something has been done.”
The restriction would also affect young women who are short of money for contraception or those using it incorrectly. Vulnerable groups include women who experienced sexualized violence [outside relationships] and many others. Apparently, it will be the hardest for those who need it the most. However, any woman might need emergency contraception at some point.
— As a feminist activist and an admin of a public page on pregnancy, motherhood, and childbirth, you are constantly in touch with women from different regions of Russia. Are they currently experiencing any problems with access to medicine, before the actual restrictions?
— Yes, they are. Some pharmacists are playing it safe. There are different forms of prescriptions, for example some medications are labeled as “sold by prescription”. Before, pharmacists did not ask for a prescription (although it would be a good idea), whereas now prescriptions are occasionally asked for.
Emergency contraceptives are taken within 72 hours [after unprotected sexual intercourse]. The sooner, the better. As there might be only a few pharmacies in a small town, going to the doctor can take days, so valuable time can be lost.
— The Mordovia region was the first to outlaw “inducement to abortion” and introduce fines for such acts. How are things in this regard in other Russian regions?
— Things are different in different regions. Probably in certain regions, the authorities will try to push through the necessity of selling all emergency contraception on prescription only.
The term “inducement to abortion” used in Mordovia is quite peculiar. The “inducement” may be referred to as something illegal, i.e. an offense. The inducement to abortion as the medical procedure is absurd, the same as the inducement to, say, teeth whitening, or laser vision correction. It is complete and utter nonsense! The wording suggests that abortion is pure evil.
— Moreover, regional laws should not conflict with federal laws…
— As it happens, this one does. Moreover, it contravenes several articles of the Constitution. For instance, Article 29 [Everyone shall be guaranteed the freedom of ideas and speech…]; Article 41 [Everyone shall have the right to health protection and medical aid…]. The law also contradicts the fact that life commences only after birth. It also contravenes articles 124.1 of the Criminal Code of the Russian Federation [obstruction in the delivery of medical care] and 136 of the Criminal Code of the Russian Federation [violation of the equality of rights and freedoms of man and citizen]. It is not at all clear how the law is going to be implemented. It can be implemented in any way. Therefore, even mentioning the possibility of abortion can be interpreted as an inducement.
I hope that this law will be suspended, or, ideally, revoked. I hope the idea will not make its way to other regions. However, the deputy from the Rostov region [Yevgeny Fedyayev] already found the idea to be “cool”. The developments in Mordovia revealed things in our country are deteriorating.
— Due to the authorities’ intentions to further tighten reproductive policy, a group of feminist activists, yourself included, created an Emergency Contraception Storage Fund in Russia. How did it happen?
— We have a work chat that includes subscribers from our Telegram channel and social media groups. Chat members are mostly female lawyers, medical professionals, and feminist activists. When all this started to unfold, we were discussing in the chat what we could do. One activist from Novosibirsk shared that the community would chip in and buy contraception to stock up just in case. Then I thought that we can do the same in several cities — the residents of regions that were in a better situation could help those who were not. This was how the project got going.
From a legal point of view, it is not a violation to give away medication that is not on the list of strictly controlled substances. Mifepristone medications are not currently on the list. If things change, we will be distributing pharmaceuticals with a different active substance.
— You are approached by female activists who can keep medication at home or donate funds to the general money pool, so women who need medication can get it from you. How does it work?
— Our priority is to share the information about the initiative and do everything in our power for it to reach people. We began to share postings on social networks and instant messengers. Those who were willing to participate responded. Some buy medication, even one pack will do. We encourage donations. We share the effort: some can’t afford to donate, but are willing to store the medication. It has been working quite well: we managed to find people and the funds. We are operating both in small towns and large cities, [the activists have stockpiled medication in 63 locations]. We can share the information through crisis centers as well.
Legality and anonymity are two important aspects. So far we are acting within the law. Legal consequences can only occur if the medication we dispensed caused death or proven harm to health.
If we do not break the law, and do everything transparently and legally, then everything will be fine, provided that the laws do not change. The counter-actions of anti-abortion activists, however, are worrying us. They can contact us disguised as a girl who needs help, instead, Cossack pro-lifers [active opponents of abortion] will show up. That’s why we ruled out the idea of having a chat open for everyone — as this is a possible loophole for our opponents.
In every location, there should be some kind of buffer in communication between a person who needs help and activists. The first option of such a buffer is feminist communities [public pages on social networks], where we can create topics about help with emergency contraception. People make requests for help in a particular location, and we are in charge of contacting a local activist and passing on the request. The second option we are currently working on is a chatbot — a command is entered, a location is selected, and the chatbot forwards the information to an activist in that location.
Another issue is the dispensing of emergency contraception. There is a contactless way to do it. Ironically, the method is used by distributors of illegal substances.
— Do you mean to use secret stashes with emergency contraception, or something like that?
— Yes. The important thing here is to keep away from the places where they leave secret stashes with illegal drugs, as we do not want an activist to be mistaken for a drug dealer or for the pills to be stolen. The medication is legal, but I do not want anyone to get hurt by accident. Contactless dispensing is a way to maintain anonymity. Personally, I would be afraid to do it the other way.
— There is always a risk that the opposing party might track down activists. How can you keep them safe?
— No way is 100% safe. All we can do is minimize the risks. Sometimes a fake request can be detected by indirect signs. Someone who needs help normally needs only one pack, not ten. When you talk a lot with women in distress, you cannot help but notice when something is off. For example, we face teenage girls writing [in a VK social media group] allegedly in a situation of violence that turn out to be perverted men with an urge to share their fantasies. Once you dig deeper, the underlying motives will come to the surface. Those (from the feminist community) have an eye for these things.
Besides, pro-lifers have organized chats of their own with anonymous members. Periodically, they forward information [about initiatives like ours]. My group on VK social media has been causing outrage in those pro-lifers’ chats.
— So far, the dispensing scheme of pills has been a work in progress. For now, the pills are being collected for storage. Have you actually started passing them on?
— Our primary goal is to stockpile pills while they are available. It is the most important thing. We have organized the whole process: for people to get in touch; to find out to whom to send the money, to decide who will make purchases, and in what quantities, establish how many we should buy. A female pharmacist put together a manual on more economical pharmacy websites and web applications, where one can get better deals. By the way, female physicians who can write prescriptions have also joined the initiative. Naturally, there are fewer of them than there are activists, but they are available in some locations. While women themselves can buy the medication in most places, our main task is to have a plan B and prepare for the worst.
— Your initiative runs as a mutual benefit fund. What types of people mainly get engaged? Are men participating as well?
— By the way, I haven’t heard about mutual aid funds before. A woman wrote to me that such groups once existed in the USA. Except they paid membership fees instead of pooling their money.
As for men, yes, they also donate and are willing to participate. A transgender person who had had a passport of a female before once contacted me. We should be generally cautious of male activists as they might be spying on us. However, in some regions, it might be easier for a man to buy [contraceptives]. Unfortunately, men and women are treated differently: women’s needs are often ignored, whereas men are treated more compassionately. There was a case when a woman was refused a surgical procedure of a C-section until the husband showed up – then the doctors agreed to do it. Another case: a woman had her first birth alone, and she was treated in a completely different way the second time with the husband present. Therefore, I believe that we should not downplay the participation of men. It can be beneficial in some situations since some regions of Russia are more patriarchal.
Anyway, more than 90% of our activists are women. Men can participate on one condition: if they buy pills with their own money. That’s our way of testing them.
— Now the Fund is being operated with the worst-case scenario in mind. If severe restrictions are not imposed, what will happen to all the purchased medication?
— I doubt that things will not get worse in the current circumstances, but if they don’t, then we will be focusing on free distribution, helping out socially vulnerable groups: victims of violence, refugees who find it more difficult to navigate these issues in a foreign country, female students who lack funds, etc.
In Russia, there are many unprivileged people: a lot of women struggle to make a 300 rubles purchase. We might distribute emergency contraception through both crisis centers and organizations helping homeless women. The activists themselves and those who donated can also ask for help. In any case, the medication will not be wasted, as it has a storage period of several years. I’d like to believe that the worst-case scenario plan won’t be needed.
— If the sale of over-the-counter contraception is banned, then the setting for activists will change greatly. What will you do in this case?
— We cannot guarantee there will be no new restrictions, as things are changing every day. We will be monitoring the changes and adapting accordingly. The good news is that restrictions can’t be imposed in a single day. If things change, we will be distributing the medication faster. We will then face a more serious degree of responsibility. The primary thing for us is not to jeopardize activists. We don’t mean for anyone to be subject to repressive measures.
— According to sociologists, any abortion restrictions primarily affect the poor. What social consequences do you think restricting access to emergency contraception or, in the worst case, abortion will have?
First of all, restricted access to contraception is associated with an increase in the number of unwanted pregnancies. Women face the choice between unwanted birth and abortion. If abortions are restricted, illegal abortions will be on the rise. Socially vulnerable women struggle to find a doctor or bribe money for a therapeutic abortion. They can’t afford to have it in another country.
There is an ongoing concern that women may take mifepristone [for self-induced abortion], but if safe abortion is restricted, they will be taking some other substances to attempt it. Either way, self-induced abortion is inefficient and unsafe. Substances used for self-induced abortion can lead to serious health problems or death. The criminalization of abortions under Stalin’s rule [1936-1955] resulted in a slight increase in the birth rate only in the first and second years after the ban. Any increase in the following period was negligible. At the same time, maternal mortality increased, and some women sustained lifelong health problems. After a safe abortion, women could later give birth to three children, but instead, they gave birth to none and got debilitated for life.
Now if the mother is constantly trying to have a self-managed abortion, how will it affect pregnancy? Stress harms intrauterine development, and attempts to self-induce abortion will likely greatly affect the child’s health.
Second, it is associated with an increase in infant mortality and further growth of social disadvantages. The number of crimes against children is already rising. If a child is not wanted, adults do not seek means to provide for the child’s needs. It entails numerous implications during their life – health and education possibilities are worse for such children. As those children are more vulnerable they are more likely to become victims of violent crimes by strangers. There are severe and massive implications for entire generations.
The birth of unwanted children also negatively affects the children already born. These children will lack resources and attention. It is not uncommon for older children to take care of the younger ones, so they have less free time for studies and leisure, etc.
“If abortions are restricted, illegal abortions will be on the rise. Socially vulnerable women struggle to find a doctor or bribe money for a therapeutic abortion. They can’t afford to have it in another country.”
— The attitude toward women in childbirth does not seem to be improving. What are the risks associated with such restrictions?
Obstetricians tend to reproach mothers for not being prepared well enough for childbirth. If they learn that women wanted or tried to have an abortion, this will be an additional excuse for discrimination or violence against them.
All these factors add up. I wonder how one can fail to understand that nothing good will ever come of strict reproductive control.