Traditional Christian Values and Women’s Reproductive Rights in Modern Russia—Is a Consensus Ever Possible?

Abstract

Recently in Russia, abortion rights have been attacked. For decades, Russian women could have an elective abortion up to week 12 of pregnancy; between 12 and 22 weeks, medical or social grounds were required for an abortion.

In mid 2011, a group of Parliamentarians teamed up with Russian Orthodox Church activists and announced their desire to ban abortions, and the new version of the health law with restricting amendments was introduced: a mandatory waiting period, physicians’ conscientious objection, and limiting the social indications for late-term abortion.

Evidence indicates that restricting legislative changes based on “traditional” values could significantly limit women’s reproductive choices (e.g., access to abortion), a setback to women’s rights to exert control over their bodies and their lives.

UNTIL RECENTLY, RUSSIAN law guaranteed women freedom in relation to reproduction and reproductive health. However, this right has been slowly but steadily undermined. The forces behind this trend are actively seeking to dramatically change current legislation.

In May 2006, in his annual address to the Federal Assembly, President Vladimir Putin made a passionate statement about the dire demographic situation in Russia. He identified Russia’s decreasing population as a possible national security threat and as the most acute issue now facing the country. With total fertility rates estimated to be approximately 1.3 to 1.4 and a rapidly growing aging population, Russia’s demographic trends are similar to those of other European countries. However, unlike other European countries, Russia has far higher mortality rates, particularly among the male population. In Russia, approximately 45% of males who reached age 15 years in 2009 are not expected to survive to age 60 years. The immediate outcome of these troubling trends has been a decline in the size of the population: by 2009, Russia’s population had declined to 143 million,¹ down from 148.6 million in 1993, a loss of 5.6 million people.

Other demographic, socioeconomic, and reproductive health indicators for Russia are as follows:

• Life expectancy at birth (2011): 75.61 for women, 64.04 for men²;

• Percentage of population younger than 15 years (2010): 15.08³;

• Population below income poverty line of US $1 per day: 13.3% of the population live below subsistence level (first quarter 2012)⁴;

• Health expenditure per capita per year (2010): US $998⁴;

• Main ethnic groups (2010): Russian (80.9%), Tatar (3.87%), Ukrainian (1.41%), Bashkir (1.15%), Chuvash (1.05%), Chechen (1.04%), other (< 1%; 10.58%)⁵;

• Main religions (2010): Russian Orthodox (41%), Atheist (12.9%), Muslim (6.5%), other than Orthodox Christians (4.1%)⁶;

• Main languages (2010): Russian (99.41%), many indigenous and minor groups (< 50 000 people) apart from Russian using their ethnic languages⁷;

• Maternal mortality odds ratio (per 100 000 live births; 2010) = 34 [95% confidence interval = 26, 42]⁸; and

• Abortion rates (2008): 32.2 per 1000; (2010): 28.1 per 1000.⁹

Many experts attribute the decline in the population to the devastating socioeconomic conditions accompanying the transition from socialism to a market economy. A different and significantly more popular explanation attributes low fertility rates to the legacy of Soviet policies that altered the population’s “normative need to have children.” Focusing on the moral obligations of members of the Russian society rather than on their economic hardships, this interpretation supported state policies aimed at strengthening family values to increase fertility rates. Reintroducing “the normative need for children” into women’s reproductive strategies and rewarding women for fulfilling their moral and social duties, conservative experts claim, would strengthen the importance of family as a valuable social institution and would change population dynamics regardless of people’s material conditions. The proponents of this argument state that new policy proposals and government attempts to alter current population dynamics significantly underestimate fundamental changes in fertility and marriage patterns taking place in contemporary Russian society.

Russian feminist activists emphasize gender inequalities as the main reason for population decline. These activists remain skeptical of current government attempts to address the demographic situation. They stress, instead, the importance of policies that promote more equal parenting roles and the improvement of the child care system. However, the opinions of Russian feminists are seldom acknowledged in Russia.

In 2007, following President Putin’s address to the nation, the Russian government launched its new, high-priority “Demographic Policy for the Russian Federation—Present to 2025.” This focused on providing incentives for women to have more children. The policy included monetary incentives for a second child and each child thereafter. That policy was almost exclusively built around a one-time monetary measure—“maternal capital,” a sum of 365 000 Russian Rubles (US$13 000), with a yearly inflation adjustment, paid to women who give birth to a second, or subsequent, child. Despite these new government incentives to drive up birth rates, the results have not been as promising as expected. Fertility rates have remained low, and a high rate of abortions is found among Russian women. The number is slowly decreasing, but it still totals nearly 1 million annually.

For many decades, the law on abortions in the Soviet Union, including Russia, was very liberal. Russian women could request an abortion until week 12 of pregnancy. Between weeks 12 and 22, an abortion could be done only on medical or so-called social grounds, as defined by the Ministry of Health. For the first time in 2003, the government dramatically limited the number of permissible grounds. For instance, it eliminated the right to a second-trimester abortion for reasons of social vulnerability (i.e., when the parents are unemployed or imprisoned or have limited financial means). In 2007, the government emphasized moral values and a pronatalist approach and has continued to attack abortion rights for medical and social reasons, although, in practice, the share of abortions made for those reasons has never represented more than two to three percent of all abortions.

In the past, it was not uncommon for some conservative politicians in the State Duma (Russian Parliament) to sponsor legislation further restricting women’s rights for abortion. On several occasions, it was proposed that married women should require explicit permission from their husbands. It was further proposed that abortions should be completely banned, except in life-threatening situations. There was even a proposal to recognize that human life begins from the moment of conception and that abortion should therefore be considered as homicide. None of these proposals has been adopted or even gone to a vote. All were rejected by the Health Care Committee of the Duma. However, in 2010 to 2011, the situation changed. A working group to explore restrictions on abortion was formed under the auspices of the State Duma’s Women, Family and Children Issues Committee. The head of this committee, together with a group of Parliamentarians, has teamed up with clerical groups, which are antiabortion, anti–sex education, and anti–birth control. Most are affiliated with the Russian Orthodox Church, which is highly politically influential in modern Russia. For 18 months, the working group has been focusing on measures to restrict women’s access to abortion. This included removing a woman’s existing rights and vesting them, instead, with her legal guardians (i.e., her husband and the government). Since its inception, individual members of the working group speaking at Christian events have publicly expressed their wish to completely ban abortions in Russia.

In mid 2011, the Duma started debating a revised health law. Dmitry Medvedev, the former president (2008–2012), expressed his full support for proposed new legislation, which was to be adopted by the end of 2011. Debates on abortion focused on antichoice proposals. Detractors pointed out that antichoice measures would do nothing to tackle Russia’s prevailing problems. The supporters of antiliberal measures typically proclaim themselves as defenders of traditional Christian values. Although they typically do nоt hesitate to accuse women seeking abortions of being murderers, absent from their rhetoric is any mention of sexual abuse. The proposals fail to recognize, or even discuss, the high incidence of rape in Russia and its implications. That the incidence of rape in Russia has never even been seriously researched is indicative of the nature of the problem. Note, also, that the government does nothing to ensure that Russian physicians comply with recommendations from the World Health Organization (WHO) for abortions, despite having access to modern methods and equipment. In the framework of “Strategic Assessment of the Quality of Care in Abortion and Contraception Services” project, a survey was conducted in 2009 by the WHO, the Russian Ministry of Health and Social Development (MOHSD), and the nongovernmental partners, such as Russian Association for Population and Development (RAPD). The assessment concluded that Russian physicians often make mistakes leading to completely unnecessary complications when performing established abortion procedures and lack knowledge about contraception counseling. Unfortunately, the survey results were not officially endorsed by the MOHSD and were not used for the development of further plans for improvements in contraception provision and abortion services.

On the contrary, it is of concern that authors of legislative amendments to the new health law have failed to include measures to prevent unwanted pregnancies or contraception. Numerous contributors to the draft legislation, especially from within the church, are strictly opposed to any modern methods of contraception, including all forms of hormonal contraception, emergency contraception, and intrauterine devices. Rigorous, well-conducted studies reported that providing information about, and access to, contraception is the best way to reduce unplanned pregnancies and abortions. The American College of Obstetricians and Gynecologists (in 2009) found that reducing unplanned pregnancies clearly contributes to lowering both the rates of unsafe abortion and the overall level of abortion.¹⁰ Despite this, in supporting their proposals with so-called facts, antichoice speakers are able to submit to the media misleading data and statements, whereas the opinions of genuine experts, whose views may run counter to government thinking, are not published by state-controlled mass media.

Conservatives who advocate stripping women of their rights claim that it will raise fertility rates, ignoring that demographers can prove that achieving this goal by restricting abortions is impossible. For instance, in 2009, a Guttmacher Institute survey of 197 countries found that restricting access to legal abortion does not reduce the number of women trying to end unwanted pregnancies.¹¹ Abortion rates are about equal when comparing world regions, regardless of legislation. In the countries where abortion is severely restricted, it often costs women their health and lives. Evidence from demographers who have conducted research in Romania indicates that restricting abortions does not increase birthrates or contribute to the general health of the population.

There is a high risk that bad examples from Russia could negatively influence neighboring countries. Antichoice proposals have already been noted in the Ukraine and in Central Asian countries. These could lead to changes in abortion laws; changes that have been inspired by a Russian example based on dubious moral and religious justifications rather than rational thinking based on sound scientific knowledge.

The members of the previously mentioned working group together with influential church groups and officials from MOHSD strongly objected to proposals made by the State Duma’s Health Care Committee. They were able to force the head of the committee, Olga Borzova, to change the Health Care Committee position twice to accommodate the demands of these lobbyists. Three meetings, held with the Russian Orthodox Church officials, led to the inclusion of several restricting changes into the draft legislation (e.g., a waiting period should be applied to all terminations of pregnancies, a psychological consultation should be obligatory, and a physician’s objections based on conscience will be permissible).

A group of pro-choice nongovernmental partners prepared an alternative set of evidence-based amendment proposals. These were aimed at addressing real, rather than imaginary, problems to help women rather than attack them. Women pro-choice advocates wished to expose falsehoods spread by those wishing to restrict women’s reproductive rights and to persuade the government not to adopt antichoice amendments. A public campaign was organized by grassroots pro-choice activists and feminist groups led by the pro-choice “Rowan Bunch” coalition. They mobilized expertise and human resources to counter the attack on women’s rights. Their proposed alternative amendments were rejected.

Proposed amendments restricting abortion rights were voted on in November 2011. They were accepted with the overwhelming support of Duma representatives. The new federal law on the Protection of the Health of the Citizens of Russian Federation was enacted in January 2012. Article 56 includes a mandatory waiting period before performing an abortion: a 48-hour waiting period is required during the 4th to 7th or 11th to 12th weeks of pregnancy, and a 7-day waiting period is required between weeks 8 and 11. The waiting period is deemed to run from the date the woman was referred to a medical facility and the termination itself.

According to the Abortion Toolkit developed by the International Planned Parenthood Federation,¹² it is a false assumption that women need time, after having received counseling, to make a well-reasoned decision about whether to terminate a pregnancy. In fact, mandatory delays are intended to discourage abortion rather than to address health issues. In general, a woman requesting abortion has already made up her mind. Further delays are obstacles for women because they may entail increased expense, travel difficulties, and medical risks.¹³

Evidence indicates that psychological counseling related to abortion is being used to force women to continue pregnancy to term against their will. For example, in 2009, the Guidelines on Psychological Pre-Abortion Counseling were published by the Ministry of Sports, Tourism, and Youth Policy of the Russian Federation, Federal Agency for Youth Affairs.¹⁴ In this publication, abortion is treated as “a murder of a living child.” A woman willing to undergo abortion is assessed here as being “mistaken and deluding herself,” whereas pregnancy and childbearing are treated as a woman’s destiny. The authors of the guidelines recommends that psychologists show patients graphic movies on abortion. In 2010, MOHSD issued an official letter recommending this publication to women’s health care facilities.¹⁵ It may have been helpful if the recently published and evidence-based document WHO Safe Abortion Guidance: Updates and Recommendations 2012 had been issued earlier. This publication recommends that women who have made a decision to have an abortion before seeking care should not be subjected to mandatory counseling.¹⁶ This may have influenced Russian Parliamentarians’ decision.

Although the law’s new rules adversely affect women seeking abortion, women from rural areas are faced with particularly difficult circumstances. The Heinrich Böll Foundation reported:

The introduction of the compulsory waiting period still is substantially harmful, especially for women living in small towns and rural areas, since an additional visit to the doctor means for them having to go to another or bigger city, and for working women who cannot easily get time off their jobs to visit the doctor multiple times on different days. Meanwhile, the access to women’s health clinics is in practice quite restricted because of their insufficient numbers: even in capitals such as Moscow and Saint-Petersburg, in some districts women have to sign up to see a gynecologist 2–4 weeks in advance. Given that, even though the additional 2 or 7 days of wait required by the new law may sound relatively innocent, they will unavoidably turn into weeks if not months.¹⁷

Apart from restrictions concerning abortion on request implemented at the beginning of 2012, the Russian government issued an order limiting acceptable social grounds for late-term abortion from four (if a woman was deprived or limited of parental rights; if a woman was incarcerated as a result of committing a crime; if a pregnancy occurred as a result of rape; and if she was married to a totally or partially disabled person, or if she was divorced or her husband died during the pregnancy)¹⁸ to just one (namely, if a pregnancy resulted from a crime stipulated by Article 131 of the Russian Criminal Code, i.e., rape).¹⁹ Even incest is not recognized as a social ground for late-term abortion.

Another new legal restriction on abortion allows for a physician’s conscientious objection. A physician may refuse to perform an artificial termination of pregnancy provided he or she puts his or her refusal in writing to an appropriate superior, such as the head of the medical facility in question. A suitable alternative physician can then be allocated to the case.

Evidence indicates that proposed legislative changes will significantly limit women’s access to abortion, may prevent the early termination of pregnancy, and will likely lead to a rise in instances of criminal abortion. Even under previous, less restrictive laws, these accounted for up to five percent of maternal deaths in Russia. Changes in legislation will compromise women’s autonomy. Restrictions will represent a major setback to women’s rights to exert control over their bodies and their lives. Unlike, for instance, the European Union, which has real support for families and laws to promote gender equality and equity, the demographic situation is not likely to magically change in Russia, given the prevailing restrictive politics.

It is in the intention of RAPD, the leader in the field of sexual and reproductive health and rights in Russia, to monitor the status of abortions in Russia. We look forward to the release of the new Order (Poryadok) by the Ministry of Health because this is supposed to include the newly endorsed WHO Recommendations on Abortion.¹⁶ This could help influence the provision of abortions in Russia, but it will not be able to counter recently promulgated legislative barriers.