The recent implementation of conservative policies regarding abortion in Russia has caused public outcry.

The gathering at a bookstore in Kaliningrad, Russia’s westernmost city, was attended by approximately 60 individuals despite being arranged at the last minute. Many attendees expressed their anger towards a legislator’s attempt to prohibit abortions in private clinics in the area.

Dasha Yakovleva, one of the organizers, was pleasantly surprised and encouraged by the turnout on a weeknight, despite the recent restrictions on political activism enforced by President Vladimir Putin.

Currently, political activism is not possible in Russia. The only remaining space is our kitchens,” Yakovleva, co-founder of the Feminitive Community women’s group, stated to The Associated Press. “This was a well-known public space in Kaliningrad where everyone openly expressed their views on the measure and why they believe it to be unjustified and inappropriate.”

Despite the fact that abortion remains legal and easily accessible in Russia, recent efforts to limit it have sparked controversy within the growing conservative nation. Advocates are calling on followers to file formal grievances, sharing online petitions and organizing small demonstrations.

Although currently only a proposal in Kaliningrad, private clinics in other areas have already started to cease offering abortion services. The Health Ministry has developed talking points for doctors nationwide to dissuade women from seeking abortions, and upcoming regulations will greatly limit access to emergency contraceptives and potentially increase the cost of others.

According to Michele Rivkin-Fish, an anthropologist from the University of North Carolina at Chapel Hill, it is evident that there has been a gradual decline in abortion availability and rights in Russia, mirroring the situation in the United States.

The 2020 ruling by the U.S. Supreme Court that overturned a 50-year-old law protecting abortion rights has greatly impacted abortion policies in America, giving states more authority. Approximately 50% of states have implemented bans or significant limitations, but not all are currently being upheld due to ongoing legal disputes.

During the Soviet era, restrictions on abortion led to some women undergoing the procedure multiple times because of challenges in accessing birth control methods.

Following the disintegration of the USSR, officials and medical professionals advocated for family planning and contraception, resulting in a decrease in abortion rates. Additionally, legislation permitted women to have abortions up to 12 weeks without any restrictions and up to 22 weeks for various “social reasons,” such as divorce, unemployment, or financial stability.

During Putin’s leadership, there has been a shift towards a strong relationship between the Russian Orthodox Church and the government. This has been accompanied by a push for “traditional values” and an effort to increase the population. Mikhail Murashko, the Health Minister, has criticized women for placing a higher importance on education and career over having children.

From 1990 to 2021, there has been a significant decrease in the number of abortions in Russia, dropping from 4.1 million to 517,000.

In cases of rape, abortion is permitted by law between 12 and 22 weeks. In certain areas, there are designated “Days of Silence” where public clinics do not offer abortions. Women are required to wait 48 hours or sometimes up to a week after their initial appointment before undergoing the procedure, depending on the stage of their pregnancy. State guidelines, as examined by AP, include psychological counseling with the intention of dissuading women from getting abortions.

According to an anonymous state clinic gynecologist, health authorities have implemented an internet-based “motivational questionnaire” that outlines government assistance for women who choose to carry out their pregnancies. The gynecologist was not permitted to make a public statement.

She mentioned that the waiting periods were emotionally challenging for some of her patients. She explained, “During that time (of waiting), they may begin to feel nauseous and have other symptoms of pregnancy. They don’t comprehend the purpose.”

In a particular region, women seeking abortions were directed to consult with a priest at state clinics. While officials claimed that this consultation was optional, several women reported to the media that they were required to have a priest’s approval in order to proceed with the abortion.

The rise in anti-abortion efforts coincides with a decrease in Russian women’s desire to have more children due to the ongoing conflict in Ukraine and financial instability. According to Nikolay Bespalov, the development director of RNC Pharma analytical company, sales of abortion pills increased by 60% in 2022. However, they still remained 35% higher than pre-2022 levels. In contrast, sales of contraceptive medications have been on the rise in 2022-23.

A new ruling from the Health Ministry has limited the distribution of abortion pills, which are used to end pregnancies during the first three months. The ruling states that mifepristone and misoprostol, the components of these pills, must now be placed on a list of regulated substances that require meticulous tracking and safe storage.

According to Dr. Yekaterina Hivrich, head of gynecology at Lahta Clinic in St. Petersburg, the new policy will result in additional paperwork for hospitals and clinics where pills are typically distributed, but will not have a significant impact beyond that.

The implementation of this decree will have an impact on the accessibility of emergency contraceptives, also referred to as morning-after pills. These pills are taken shortly after unprotected sexual activity to prevent pregnancy. Out of the six brands currently available in Russia, three of them contain a smaller amount of mifepristone. As a result, these brands will face significant limitations once the decree is enforced on September 1, 2024.

According to Irina Fainman, an activist in the northern region of Karelia, accessing certain medications may require a unique prescription and not all pharmacies will have them in stock. This process can be time-consuming for women who urgently need the pills.

The Health Ministry has not provided a response to inquiries regarding the potential exclusion of morning-after pills from the decree. While officials had previously assured that these pills would not be affected, some pharmacies are now offering those containing mifepristone only with strict prescription requirements.

Following the announcement of restrictions, Fainman and fellow activists took the initiative to gather a supply of pills to distribute in case of potential shortages.

According to Bespalov, there was a 71% increase in the sales of emergency contraceptives between August 2022 and August 2023 compared to the previous year. Approximately half of these sales were for contraceptives containing mifepristone. It is expected that new regulations may cause the price of these medications to rise and potentially result in temporary shortages.

According to state statistics, a senior legislator named Pyotr Tolstoy announced that lawmakers will make efforts to pass a country-wide prohibition on abortion in private clinics by the spring. These clinics accounted for approximately 20% of all abortions in recent years.

Previous attempts by conservative legislators to implement this prohibition have been unsuccessful. However, the Health Ministry has expressed willingness to evaluate it now.

According to Irina Volynets, a supporter of banning abortion and an advocate for children’s rights in the Tatarstan area, the removal of this procedure from private clinics in the future brings hope. She also advocates for greater government assistance to women with children as a means of encouraging higher birth rates.

Attempts have been made by local governments to persuade private clinics to discontinue providing abortion services, with differing levels of achievement. The region of Kaliningrad is considering implementing a ban on a larger scale. According to officials, approximately one-third of private clinics in Tatarstan have ceased offering abortions. In the Urals’ Chelyabinsk region, three clinics have agreed to cease performing them.

Lina Zharin, a psychotherapist and activist in Kaliningrad, emphasized the importance of recognizing that the pressure on women will continue to increase even without a complete ban. She was involved in the planning of the recent bookstore gathering. An online petition opposing the ban in Kaliningrad has received almost 27,000 signatures.

The Health Ministry is implementing a pilot project in seven additional regions that involves gynecologists encouraging women to reconsider their decision to have an abortion.

According to a document obtained by AP and referenced by other media outlets, doctors are instructed to use specific language when discussing pregnancy and abortion. This includes describing pregnancy as “a beautiful and natural condition for every woman,” while labeling abortion as “detrimental to your health and potentially carrying risks of complications.”

Natalya Moskvitina, the creator of Women For Life, a program that supports women who choose not to have an abortion, stated that she played a role in creating the guidelines and is implementing similar protocols for doctors in various areas.

In August, Moskvitina gained attention when the region of Mordovia passed a law that she assisted in creating, which prohibits the “promotion” of abortions. Another region is also thinking about implementing a similar ban. According to Moskvitina and local authorities, her program has successfully reduced the abortion rate by 40% in Mordovia. The program involves doctors congratulating pregnant women and providing them with gifts and information on available support resources.

These discussions may assist women who are uncertain about having an abortion in reaching a choice, but for some, they may cause significant discomfort.

In 2020, Olga Mindolina was considering terminating her pregnancy due to a previous difficult experience. However, when she consulted a doctor at a state clinic in Voronezh, she was unsure of what to do. The doctor advised her to give birth in this situation.

A psychologist at the clinic informed her that women may experience feelings of regret after having an abortion, and suggested that she speak to her husband about it. Additionally, a lawyer informed her of potential state benefits she could receive if she decided to carry the pregnancy to term. After considering this information, Mindolina decided to continue with the pregnancy.

In 2020, a Muscovite named Anastasia shared that she had a negative experience when a doctor advised her against getting an abortion. She described the situation as “unpleasant.”

She informed AP that she does not desire to have children and requested that her last name not be disclosed for fear of retaliation.

Dr. Lyubov Yeroveyeva, a gynecologist who led initiatives for family planning in the 1990s, advocates for the prevention of unintended pregnancies through educating about birth control and ensuring widespread access to contraceptives.

The woman suggested that instead of persuading her against getting an abortion, authorities should take steps to prevent her from needing to consider it.