Russia sees shift on abortion

Physician Marina Chechneva remembers the old-style Russian gynecologists who worked in state hospitals and churned out back-to-back abortions like Soviet factory workers. She remembers the women who “used to use abortion as a kind of vacation, because in the U.S.S.R., they got three days off from work.”

Chechneva, head researcher at the Moscow region’s Institute of Gynecology and Obstetrics, performs abortions as part of her medical practice. These days, she is writing magazine articles about fetus development in hope of raising public opposition to abortion. After years of handling fetuses, she explains, she has come to feel a responsibility toward them.

The women “should realize that what they’re doing is already a murder,” she said.

A fledgling antiabortion movement is beginning to stir in Russia. Driven by a growing discussion of abortion as a moral issue and, most of all, by a government worried about demographics, doctors and politicians are quietly struggling to lower what is believed to be one of the world’s highest abortion rates.

“The attitude has changed,” said Alexander Medvedev, a gynecologist who performs the procedures. “Even in community clinics, doctors are trying to dissuade patients from abortion. Now teenagers come to see us with already two or three abortions, and it’s horrible.”

It’s an uphill struggle. Doctors say contraceptive use remains unpopular and that many Russian women rely on abortion for birth control.

The government is desperate to persuade citizens to bear more children. Russians are dying faster than they’re being born, a trend that has emerged as one of the most serious challenges faced by this sprawling, scantily populated land.

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New restrictions

The discussion is devoid of terms such as “pro-life” or “pro-choice.” From doctors to patients to officials, nobody seems to consider seriously the possibility of outlawing abortion. But the government recently imposed new restrictions on the procedures after the 12th week of pregnancy, and toughened the language of a waiver women must sign before terminating a pregnancy.

Late-term abortions used to be easily accessible on “social” grounds: A woman merely had to visit a social worker, complain that she wouldn’t be able to raise a child, and she could collect a stamped waiver. These days, exceptions are available only for extreme circumstances, such as the sudden death of a husband or a medical emergency.

In 2007, for the first time in decades, Russia’s Federal State Statistics Service counted slightly more live births than abortions in Russia. But doctors say those statistics are flawed because of the growing number of women who opt for undocumented abortions in private clinics.

Many gynecologists have launched their own small efforts to persuade patients to go through with their pregnancies. Although law requires parental consent only for girls younger than 16, many doctors boast that they involve the parents of any patient younger than 19.

“This is the decision of a lifetime,” gynecologist Natalia Smirnova said. “It’s very important for me to show them the ultrasound picture of their fetuses. This stops most of them.”

Speaking in her private clinic while women in their 20s filled the waiting room outside, Smirnova pointed to pictures of fetuses taped to her office walls and described the conversation she holds with a would-be abortion patient.

“I ask her to please explain to me and give me the reasons why she can’t preserve her pregnancy. I’m not satisfied with, ‘I’m afraid.’ I want to hear the whole story. ‘What did the father-to-be tell you, what did your mother say?’ There were cases when I myself called her mother in another town. By appealing to her mother, her partner, the future father, you can often succeed in making her change her decision and preserve her pregnancy.”

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Repercussions

Women interviewed for this article spoke wistfully, even painfully -- but with an underlying grain of pragmatism -- about the decision to end their pregnancies. Mostly sheltered from public or political discussions of abortion, they tended to describe the procedure as a medical decision that had surprising personal aftershocks.

“You kill not only a child, a living being, but a part of yourself, something that was alive in you,” said Irina, a 25-year-old Muscovite who has had three abortions. The young women who were interviewed declined to give their last names. “There’s a trauma and a grief you suffer. You murder a child. It was much more difficult than I expected.”

Still, Irina repeatedly chose abortion when she felt she was without options -- unemployed despite her university degree in accounting, married to first one man and then another who didn’t want the babies. She never used birth control. She became pregnant, then went to the state clinic and waited in line for a no-cost abortion.

“It’s like a conveyor belt,” she said. “Women sit next to the abortion room in a line, and it happens very quickly.”

It shouldn’t be so casual, Russian lawmakers contend.

“The spiritual position,” said Natalia Karpovich, a leader of the State Duma committee focused on family, women and children, “should be that this is murder and the woman who does this commits a sin. Still, I want to stress it’s a woman’s choice.”

Karpovich is among lawmakers who’ve pushed for media messages casting abortion in a less neutral light. She also supports new measures meant to encourage childbirth by paying cash bonuses and opening new day-care centers across the country.

“Like on packs of cigarettes or bottles of alcohol, advertisements for abortion services should be obligated to warn about the consequences,” she said. “That they may result in infertility, that some bad changes may happen in the female organism.”

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Economic issues

Karpovich was holding court in an expensive cafe near the Kremlin, flitting from table to table in a series of quick meetings. Her fingers flashed with diamonds; her body was swathed in a Pucci-style dress. She herself, she pointed out, was expecting her fifth child.

“As a Russian woman and mother, I feel the presence of the state, that my child has a future, that my country needs me as a mother and needs my child,” she said, smiling serenely.

“The economic development of Russia has led us away from the priority of building a family and gave a serious boost to abortion.”

But working women, many of whom came of age during the financial mayhem of the 1990s, say that massive cash inflows generated by oil haven’t trickled down fast enough. They simply can’t afford to contemplate having a child, they say.

“It works like this: The first priority is to get a career, then an apartment, then a car,” said Yulia, a 21-year-old secretary at a sewage company and a dead ringer for Scarlett Johansson. “Then all of a sudden it’s too late to have children, and this is torturing you the whole time.”

Last year, Yulia found out during a routine physical that she was eight weeks pregnant. “The guy I was dating was totally against having children, and I didn’t want to have a child with him, specifically,” she said. “It’s so easy these days. You can just go do it, and nobody thinks about it.”

After the abortion, nothing changed. She stayed with her boyfriend, and off contraception. Six months later, she was pregnant again. That time, her doctor told her she couldn’t have another abortion so soon. So she found a private clinic and a doctor with fewer qualms.

“In the past, it was easier to raise kids. Despite all the shortages, everything was so cheap and there were a lot of free services,” she said ruefully, with a shrug.

“I know I have a duty before my country, but I think my duty to myself is stronger. You don’t give birth to a child just to continue the line.”

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megan.stack@latimes.com