Private clinics in the regions refuse to perform abortions

Over the weekend, Patriarch Kirill called for the adoption of a federal law banning “inducement to abortion.” According to the head of the Russian Orthodox Church, this must be done because doctors “sometimes, for various reasons, including commercial ones, persuade a woman to have an abortion.” At the same time, the number of regions in Russia is growing where private clinics themselves refuse to perform abortions. As a rule, this happens after conversations with regional officials, who strongly suggest that clinic managers “contribute to improving the demographic situation in the country.” Today, commercial organizations in Crimea and the Kursk region have completely abandoned the provision of abortions, and clinics in Mordovia, Tatarstan, and the Chelyabinsk region have partially refused to perform abortions. The introduction of a possible ban is being discussed in the Kaliningrad region and Primorsky Krai. Experts interviewed by Kommersant warn that this violates women’s constitutional rights and could lead to an increase in the number of criminal operations.

On Sunday, Patriarch Kirill of Moscow and All Rus’ spoke at the XI All-Church Congress on Social Ministry. “Unfortunately, the number of abortions still remains high,” said the head of the Russian Orthodox Church. “Thank God, individual initiatives aimed at reducing the number of abortions are appearing at the legislative level. Not so long ago in Mordovia, for example, a law was passed banning inducement to abortion. I hope that this initiative will be supported in other regions and at the federal level. Because sometimes, for various reasons, including commercial ones, doctors persuade a woman to have an abortion.”

Let us recall that in August the parliament of Mordovia adopted a regional law prohibiting inducement to artificial termination of pregnancy; The initiative was proposed by the Public Chamber of the Republic. The law understands “inducement” as “coercion through persuasion, proposals, bribery, deception, or making other demands.” For violation, fines are provided – up to 10 thousand rubles. for ordinary citizens and up to 200 thousand rubles. for legal entities. In November, a similar law was adopted by the Legislative Assembly of the Tver Region; the same initiative has been submitted to the Duma of the Tambov region.

Previously, Patriarch Kirill called for the exclusion of artificial abortion from the list of services provided by private clinics in Russia. According to the head of the Russian Orthodox Church, “commercial medicine often does not comply with the most important anti-abortion restrictions that have been adopted in recent years.” The Patriarch explained the need for such a ban by the importance of “preserving and protecting the reproductive health of the nation” and called for “a significant review of the issues of sovereignty of our reproductive potential.”

Locally they listened to the idea, say the Russian Orthodox Church. “Already in ten regions, governors and health ministers are gathering representatives of private clinics and offering to voluntarily surrender licenses for abortions. Recently such news came from Crimea. The main commercial clinics that exist there refused to carry out these actions,” said Priest Fyodor Lukyanov, chairman of the Patriarchal Commission on Family Issues, Protection of Motherhood and Childhood, in October.

However, in this case, the regions are more likely to pick up signals from secular authorities. At the end of June, State Duma Deputy Speaker Anna Kuznetsova (United Russia) suggested that governors think about limiting the issuance of licenses to private clinics to perform abortions. She pointed to the example of four regions of the country in which at that time there was not a single private clinic with a license for abortion—Karachay-Cherkessia, Ingushetia, Chukotka and Tuva. They are also among the 15 leaders in natural population growth.

In the summer, some private clinics in Mordovia began to refuse women abortions. And the head of the republic, Artem Zdunov, said: in state health care institutions the number of abortions is decreasing, but in private ones, on the contrary, it is growing, “because they don’t look at the moral component.”

Next were Tatarstan and the Chelyabinsk region. At the beginning of August in Kazan, heads of medical institutions and officials held a special meeting on the topic of abortion. As a result of the meeting, private clinics began to remove pregnancy termination from the list of services, said Children’s Ombudsman Irina Volynets. According to the Ministry of Health of the Republic, in 2022, 86 private clinics in Tatarstan had the right to perform abortions. By September 2023, about a third had abandoned this license.

Deputy Governor of the Chelyabinsk Region Irina Gekht said that in July officials held negotiations with each of the 59 medical centers that provide abortions. As a result, three institutions promised to stop performing surgical abortions; one clinic will conduct them only in a 24-hour hospital setting. Other centers will only provide drug interruption for short periods for medical reasons. And three institutions will introduce “motivational questioning” of pregnant women aimed at preventing abortions.

In the Kaliningrad region, a proposal to ban abortions in private clinics was made in September at a round table on ways to overcome the demographic crisis. Chairman of the regional legislative assembly Andrei Kropotkin said: a decision was made to develop regional legislative measures on the possibility of banning abortions in commercial medical institutions. In response, local residents created a petition demanding to stop the “misogynistic” actions of the authorities, which “will inevitably lead to the spread of illegal abortions.” To date, it has been signed by 27,498 people. The press service of the government of the Kaliningrad region told Kommersant: for now, instead of prohibitive measures, pre-abortion counseling is being introduced in the region.

On October 27, deputies of the Astrakhan region sent to State Duma Chairman Vyacheslav Volodin a bill providing for the rights of regions to ban abortions in private clinics. The Ministry of Health of the Rostov Region supported the initiative.

On November 9, the Minister of Health of Crimea, Konstantin Skorupsky, announced that artificial termination of pregnancy in the region will be carried out only in state medical organizations. According to him, the heads of private clinics were asked to “contribute to improving the demographic situation” and they “voluntarily refused to perform abortions.” On the same day, Deputy Governor of the Kursk Region Andrei Belostotsky announced a similar decision. He noted that in total, five clinics in the region have such licenses – four of them have already refused to perform abortions, and now approximately 92% of women who decide to terminate a pregnancy will be in public clinics, where “they are actively working with them “

The Ministry of Health of the Primorsky Territory told Kommersant that they do not receive all information about abortions and their consequences from commercial hospitals. Therefore, the department indicated, several solutions are possible in this matter, including the introduction of a specialized data system for non-governmental medical organizations on abortion procedures or a complete ban on their implementation in such structures.

However, the authorities of some regions claim that they are able to reduce the number of abortions without prohibitive or voluntary-compulsory initiatives. For example, Elvira Pinchuk, deputy chairman of the government of Udmurtia, explained the region’s position this way: “From year to year we register a stable decrease in the number of abortions. Obstetricians and gynecologists of Udmurtia are unanimous in their opinion that the prohibition of abortion in medical organizations can lead to illegal methods of performing abortions. And these are colossal risks for women – from loss of reproductive function to fatal septic complications.”

Obstetrician-gynecologist, public health and health specialist, WHO expert Lyubov Erofeeva shares the position of her colleagues from Udmurtia. In her opinion, a ban in the private sector will be followed by queues at state hospitals, which “will open the doors to mafia structures” to perform urgent or anonymous “criminal abortions.” “Private clinics received licenses, they were under control, they submitted reports. Not a single deputy was able to tell me specific violations on their part,” says Ms. Erofeeva. According to her, in Russia there are “usual average European figures” for abortions – in 2022 there were 395 thousand. Their causes should be combated, the doctor is sure – for example, it is necessary to launch a program of affordable contraception. For a number of socially vulnerable groups, Lyubov Erofeeva believes, it should be completely free.

Partner at the Pen & Paper Bar Association, Ekaterina Tyagai, says: having a license is the main requirement for an organization that can provide medical assistance to women undergoing abortion. That is, as a general rule, it does not matter whether it is a private or public organization. Private medical organizations enter into a public contract with patients, which means that in the absence of a corresponding legislative prohibition they cannot refuse to conclude a contract.

“In the event of these changes, there will be an artificial narrowing of the circle of subjects who have the right to carry out such medical manipulations,” the lawyer points out. “This may actually be an obstacle to such operations. And also significantly increase the period between the emergence of the need or desire to terminate the pregnancy and the time of the corresponding operation.” Ms. Tyagai notes that a woman’s right to an abortion ensures health protection and is guaranteed by relevant law. It should continue to be viewed as fundamental, the lawyer is sure.

Natalya Kostarnova; regional corset “Kommersant”