In Tatarstan, private medicine is seeking to refuse abortion services

Children’s Ombudsman of Tatarstan Irina Volynets proposed to encourage private clinics to refuse to perform abortions. She considers it necessary to compensate them for the loss of income due to this. The Ministry of Health of the Republic told Kommersant-Kazan that a third of commercial clinics in the region have refused licenses to perform this procedure since the beginning of the year. According to Ms. Volynets, they “one by one” made this decision after officials spoke with their leadership at a special meeting. The Children’s Ombudsman expects that in the future all private medicine will stop performing artificial termination of pregnancy and only government institutions will deal with this, which will benefit the birth rate in the republic. Human rights activists fear that the restrictions will force women to resort to “harmful practices.”

As Kommersant-Kazan was told by the press service of the Ministry of Health of Tatarstan, by September 2023, a third of the republic’s private medical institutions refused to perform abortions, although they previously had the appropriate license. The ministry did not specify the number of such clinics, but explained that in 2022, 86 private clinics had the right to such activities. Thus, about 25–30 commercial establishments could refuse their license.

The Ministry of Health reminded that “according to federal law, a “week of silence” must be organized before an abortion.”

“The pregnant woman is sent to the psychological assistance office for counseling and motivational questioning. She has the opportunity to discuss problems with a psychologist, social worker, lawyer, and other specialists. The patient is told about possible complications after the procedure and ways to solve her problems,” the ministry said. They noted that such work is “organized in a state network,” but “in private clinics, cases of non-compliance with this procedure have been identified.”

The idea of ​​limiting abortions in private clinics is being promoted by the Commissioner for Children’s Rights in Tatarstan, Irina Volynets. As Kommersant-Kazan learned, she turned to the republic’s Minister of Health, Marcel Minnullin, with a proposal to “support commercial medical clinics” that refused to perform abortions. Mrs. Volynets believes that they, “who have made such a significant decision,” need “compensation for lost income… by providing the opportunity to provide other compulsory medical insurance services.” “This will facilitate the adoption of a similar decision by other private clinics and increase the birth rate in the republic,” said the children’s ombudsman.

Among the clinics that no longer provide abortion services are “AVA-Kazan”, “Mart-S”, “Otorhinolaryngology Clinic”, and the Aibolit medical center. According to Ms. Volynets, they renounced the license “voluntarily”, responding to an “appeal” from the authorities. At the beginning of August 2023, officials gathered the heads of medical institutions for a meeting “on the issue of carrying out abortions in commercial medical clinics in the republic.” “As a result of the meeting, clinics in the republic are one after another removing abortion from the list of services,” Irina Volynets previously said on social networks.

The Children’s Ombudsman of Tatarstan is seeking to have private clinics banned from performing abortions at the legislative level.

In May, she sent appeals to the State Duma Committees on Family Affairs, Women and Children and Health with a request “to develop a bill, according to which the procedure for artificial termination of pregnancy will be carried out only under the compulsory medical insurance system.” Then Irina Volynets said that “in order to increase income, private clinics promote abortion advertising.”

The head of the State Duma Committee on Family Affairs, Nina Ostanina, did not support this proposal. However, Vice-Speaker of the Lower House Anna Kuznetsova took up the initiative. Russian Health Minister Mikhail Murashko said that he is ready to discuss the idea of ​​carrying out abortions only in state medical institutions, excluding private clinics from the process. According to him, private institutions often ignore a period called the “week of silence,” during which a woman who applies for a service can change her mind and continue the pregnancy. He also spoke about the need to limit sales of abortion drugs.

According to the Ministry of Health, in 2022, 395 thousand cases of artificial termination of pregnancy were recorded in the country. This is 3.9% less than in 2021. And over the past 10 years, the number of abortions in the country has halved. Mikhail Murashko noted that “thanks to the work being done, 44 thousand women refused to terminate their pregnancies last year.”

In Tatarstan, according to the regional ministry, the absolute number of abortions over three years decreased by 10.2% and amounted to 11.3 thousand in 2022 (in 2020 there were 12.6 thousand). “The prevalence of abortions decreased by 7.2% and amounted to 12.8 per 1,000 women of fertile age,” the Republican Ministry of Health told Kommersant-Kazan.

Human rights activists have expressed concerns that restricting abortion in private clinics “could lead to restrictions on access to safe abortion.”

According to lawyer Marie Davtyan, “in the compulsory medical insurance system it is easier to delay the timing of abortions” and already today “women are faced with illegal restrictions on access to abortion, because there are unspoken instructions about the number of abortions allowed in a particular region.” “Now such women are forced to turn to private organizations. If such a law is adopted, they will not be able to do this and will be forced to either give birth to children or undertake some other practice that is dangerous to their health,” the human rights activist believes.

The Ministry of Health of Tatarstan emphasizes that “this is not about banning abortion.” “The question is to give a woman the opportunity to make an informed decision in a situation of reproductive choice. Regardless of the form of ownership, a medical organization must comply with the procedure for carrying out this procedure, including psychological counseling,” the ministry emphasized.

Kirill Antonov