Abortion and Birth Control Practices Differ in Russia, Belarus, and Ukraine
[This post was originally published in December 2012]
While in Western countries the issue of abortion concerns the legality of pregnancy termination (and it is more generally a women’s rights issue), in Eastern Europe the high rates of abortion present a bigger problem. But not all countries in the former Soviet bloc follow the same trends when it comes to birth control practices. A recent paper by one of our readers, demographer Boris Denisov and his colleagues Victoria I. Sakevich and Aiva Jasilioniene, published in PLoS ONE, shows that “the last decade witnessed growing differences in abortion dynamics in Belarus, Russia, and Ukraine despite demographic, social, and historical similarities of these nations”. Having analyzed official abortion and contraceptive use statistics, provided by national statistical agencies and respective laws from the three countries, the researchers found a growing gap in abortion rates in Belarus, Russia, and Ukraine.
According to official statistics, in 1990 all three countries had very high abortion rates. Over the subsequent two decades, Belarus, Russia, and Ukraine all achieved a significant decrease in the number of abortions. However, the speed of this improvement that was nearly equal in all the three countries during the 1990s started to diverge in the early 2000s, showing a steeper progress in Ukraine and especially in Belarus compared to Russia. In Belarus the annual speed of reduction in abortion rates accelerated from 8% to 11%, in Russia it slowed down to 5%, while in Ukraine it continued at the same annual pace of 6%. As a result, today Russia exhibits substantially higher abortion rates compared to Belarus and Ukraine, whose figures are comparable to those of the United States, England and Wales, Sweden, and France. Why such differences between Russia and its Slavic sister-countries?
In the former Soviet Union, the three republics were very much alike in terms of culture, economic development, and demographic patterns. In spite of the two decades of independent development, principal demographic characteristics of the three nations are still very similar: all three countries experience low total fertility rates of 1.3–1.5 and high prevalence of one-child families. After a brief period of above-replacement-level fertility rates in the 1980s, Belarus, Russia, and Ukraine all experienced a sharp fertility downturn during the times of political and economic turmoil of the 1990s, with a slight recovery in recent years. Also shared was the “abortion culture” during the Soviet times, that is frequent use of induced abortion as a means of birth control. Since the earlier ban on abortion was repealed in 1955, abortion on request has been legally permitted up to 12 weeks of pregnancy (later-term abortions were permitted for medical reasons only); in 1987 the Soviet Ministry of Health permitted abortions in later stages of pregnancy under additional circumstances, such as pregnancy resulting from a rape, or divorce or death of the father during pregnancy. In the post-Soviet period there have not been any principal changes in abortion laws of the three countries; abortion procedure and related services are included in the basic package of state-provided health care guarantees.
Since the discrepancies in abortion rates cannot be accounted for by differences in abortion legislation, Denisov and colleagues propose to look for an explanation in terms of contraceptive knowledge and practices. While there are no legal barriers to using contraception (except with sterilization, which is subject to legal restrictions), the three countries exhibit different rates of contraceptive use: in Belarus 41% of women used either hormonal contraceptives or IUDs in 2010, in Ukraine 32% of women did, while in Russia the corresponding figure was only 25%. The researchers also concluded that “governmental policies play an important role in shaping contraceptive practices as well as achieving the shift from abortion to contraception being used for family planning purposes”. It is in such governmental policies that differences between Russia, Belarus, and Ukraine are particularly prominent. The Russian government changed its position on family planning in the late 1990s–early 2000s. Under pressure from the segments of society holding traditionalist views, including the Orthodox Church, which seems to exert an especially strong influence in Russia, the government has adopted a strongly pro-natalist course, viewing birth control as synonymous with low fertility, which is in turn perceived as the root cause of Russia’s demographic problems. Abortion is often presented as both detrimental to a woman’s health and as morally unacceptable, but at the same time the promotion of contraceptive is very limited. Many of the centers for family planning created in the 1990s are gradually being closed due to lack of funding. If the present trends continue, or if additional legal measures are taken by Russian government to restrict birth control, the researchers predict that the abortion gap between Russia and neighboring Belarus and Ukraine will grow ever more significant.
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