I need an abortion

Should I Get An Abortion?

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Considering Abortion

What facts do I need to know about abortion?

Is abortion the right option for me?

Abortion is common, and people have abortions for many different reasons. Only you know what’s best for you, but good information and support can help you make the decision that's best for your own health and well-being.

Why do people decide to have an abortion?

If you’re thinking about having an abortion, you’re not alone. Millions of people face unplanned pregnancies every year, and about 4 out of 10 of them decide to get an abortion. Some people with planned pregnancies also get abortions because of health or safety reasons. Overall, about 1 in 4 women in the U.S. will have an abortion by the time they’re 45 years old.

Sometimes, the decision is simple. Other times, it’s complicated. But either way, the decision to have an abortion is personal, and you’re the only one who can make it.

Everyone has their own unique and valid reasons for having an abortion. Some of the many different reasons people decide to end a pregnancy include:

They want to be the best parent possible to the kids they already have.
They’re not ready to be a parent yet.
It’s not a good time in their life to have a baby.
They want to finish school, focus on work, or achieve other goals before having a baby.
They’re not in a relationship with someone they want to have a baby with.
They’re in an abusive relationship or were sexually assaulted.
The pregnancy is dangerous or bad for their health.
The fetus won’t survive the pregnancy or will suffer after birth.
They just don’t want to be a parent.

Deciding to have an abortion doesn’t mean you don’t want or love children. In fact, 6 out of 10 people who get abortions already have kids — and many of them decide to end their pregnancies so they can focus on the children they already have. And people who aren’t already parents when they get an abortion often go on to have a baby later, when they feel they're in a better position to be a good parent. The bottom line is, deciding if and when to have a baby is very personal, and only you know what’s best for you and your family.

What can I think about to help me decide?

Family, relationships, school, work, life goals, health, safety, and personal beliefs — people think carefully about these things before having an abortion. But you’re the only person walking in your shoes, and the only person who can decide whether to have an abortion.

Here are some things to consider if you are thinking about an abortion:

Am I ready to be a parent?
Would I consider adoption?
What would it mean for my future if I had a child now?
What would it mean for my family if I had a child now?
How would being a parent affect my career goals?
Do I have strong personal or religious beliefs about abortion?
Is anyone pressuring me to have or not have an abortion?
Would having a baby change my life in a way I do or don’t want?
Would having an abortion change my life in a way I do or don’t want?
What kind of support would I need and get if I decided to get an abortion?
What kind of support would I need and get if I decided to have a baby?

Decisions about your pregnancy are personal. There are lots of things to consider, and it’s totally normal to have many different feelings and thoughts when making this decision. That’s why it’s important to get factual, non-judgmental information about abortion. Support from family, friends, partners, and other people you trust can also be helpful. But the decision is 100% yours.

Who can I talk with about getting an abortion?

Lots of people lean on others to help them with their decision. It’s good to choose people who are understanding and supportive of you.

Your local Planned Parenthood health center has caring professionals that can answer any questions you may have. They'll give you expert care, accurate information about all your options, and non-judgmental support along the way — no matter what you decide about your pregnancy.

Other family planning centers, private doctors, and abortion providers may also talk with you about your decision. But when you’re looking for a reliable health center, beware of anti-abortion “crisis pregnancy centers. ” These are places that may seem like normal medical clinics and claim to offer information about pregnancy options and abortion, but they don't provide abortion or a full range of health care. They often give you false or misleading information about pregnancy, abortion, and birth control, and they usually don't have to follow privacy laws. Crisis pregnancy centers are often located very close to Planned Parenthood health centers or other real medical centers, and have similar names — they do this to confuse people and trick them into visiting them instead.

No one should pressure you into making any decision about your pregnancy, no matter what. So it’s important to get the info and support you need from people who give you the real facts and won’t judge you.

If you’re having a hard time finding someone in your life to talk with, check out:

All-Options: All-Options has a free hotline that gives you a confidential space to talk about making decisions about a pregnancy. They’ll give you judgment-free support at any point in your pregnancy experience, no matter what you decide to do or how you feel about it.
Abortions Welcome: Abortions Welcome has nonjudgmental written and interactive resources to support you in making your decision, including a clergy counseling line, where you can talk to compassionate clergy and religious counselors about spiritual concerns.

When do I have to make a decision?

It’s important to take the time you need to make the best decision for you. It’s also a good idea to talk to a nurse or doctor as soon as you can so you can get the best medical care possible. The staff at your nearest Planned Parenthood health center is always here to provide expert medical care and support, no matter what decision you make.

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The Abortion Pill | Get the Facts About Medication Abortion

In This Section

The Abortion Pill
How does the abortion pill work?
What can I expect after I take the abortion pill?
How do I use the abortion pill?

How safe is the abortion pill?
How do I get the abortion pill?
How much does the abortion pill cost?

The Abortion Pill | Planned Parenthood Video

What is the abortion pill?

Medication abortion — also called the abortion pill — is a safe and effective way to end an early pregnancy.

How does the abortion pill work?

“Abortion pill” is the common name for using two different medicines to end a pregnancy: mifepristone and misoprostol.

First, you take a pill called mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing.

Then you take the second medicine, misoprostol, either right away or up to 48 hours later. This medicine causes cramping and bleeding to empty your uterus. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. If you don’t have any bleeding within 24 hours after taking the second medicine, call your nurse or doctor.

Your doctor or nurse will give you both medicines at the health center. When and where you’ll take them depends on state laws and your health center's policies. Your doctor or nurse will give you detailed directions about where, when, and how to take the medicines. You may also get some antibiotics to prevent infection.

How effective is the abortion pill?

The abortion pill is very effective. The effectiveness depends on how far along you are in your pregnancy when you take the medicine.

For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. If you're given an extra dose of medicine, it works about 99 out of 100 times.
For people who are 10-11 weeks pregnant, it works about 87 out of 100 times. If you're given an extra dose of medicine, it works about 98 out of 100 times.

The abortion pill usually works, but if it doesn’t, you can take more medicine or have an in-clinic abortion to complete the abortion.

When can I take the abortion pill?

Depending on where you live, you may be able to get a medication abortion up to 77 days (11 weeks) after the first day of your last period. If it has been 78 days or more since the first day of your last period, you can have an in-clinic abortion to end your pregnancy.

Why do people choose the abortion pill?

Which kind of abortion you choose all depends on your personal preference and situation. With medication abortion, some people like that you don’t need to have a procedure in a doctor’s office. You can have your medication abortion at home or in another comfortable place that you choose. You get to decide who you want to be with during your abortion, or you can go it alone. Because medication abortion is similar to a miscarriage, many people feel like it’s more “natural” and less invasive.

Your doctor, nurse, or health center staff can help you decide which kind of abortion is best for you.

How Russian doctors discourage women from having abortions and what to do in such a situation

In 2018, about 35% of Russians did not approve of artificial termination of pregnancy, and reducing the number of abortions is included in the Concept of the demographic policy of the Russian Federation until 2025. Afisha Daily recorded the stories of three women whom doctors persistently persuaded to keep the pregnancy, and asked the lawyer what to do in such a situation.

Svetlana's story

“Why do I need this child? For me to associate him with his father?” nine0008

When I gave birth to my first daughter, I was eighteen years old. Despite such a young age, my husband (already ex) and I wanted a child, I became pregnant consciously.

About a year and a half after the birth of my daughter, I had a delay. We were protected by interruption of sexual intercourse, and everything was fine, but not this time. I immediately decided that I would have an abortion.

I just went to work then, my grandmother stayed to sit with her daughter. I began to feel like a person, because I began to earn money myself, I didn’t have to ask anyone and humiliate myself. Knowing that the difference between the children would be so small, and my husband was constantly spreading his arms, I decided not to give birth. Why do I need this child? For me to associate him with his father? nine0003

I told my husband that I might be pregnant. He did not believe that the child was from him, and beat me.

Mom didn’t know that my husband beat me — he didn’t beat me in the face, but in such a way that the bruises remained only on the body. I didn't tell anyone anything - I endured, waited for things to get better, to change. Little fool, I had to run right away. I called the police, they took him away for two hours, then he came even more angry and beat me much harder.

“You will feel guilty for the rest of your life”

I went to a gynecologist for a free women's consultation. She told the doctor: "I'm late for so many days, I did a test, two strips." She replied: "Get in the chair." The gynecologist confirmed the pregnancy and started filling out some paperwork without even asking anything. When she began to record me for an ultrasound, I said: "Stop-stop-stop, I'm going to terminate the pregnancy. " She was surprised: “Do you mean interrupt?” - "Well, in direct, this is my right." The doctor began to dissuade: "You are still young, why do you need this." I didn't even listen to her, I just left the office. nine0003

Mom was at home, I told her everything. She began to calm me down, saying that you need to go to such doctors with a cool head. Mom enrolled me in a paid clinic, where I quickly passed the tests. While I was running with them, my husband beat me again, bleeding started. And I still needed an ultrasound to check for an ectopic pregnancy. And so I went to do it with bleeding, I was in the fifth week of pregnancy.

On the ultrasound, the doctor began to put pressure on pity: “The child’s heart is already beating, the child feels that they don’t love him and want to kill him.” nine0003

Then she added: “You will have a feeling of guilt for the rest of your life, the child will dream, follow you around, you won’t be able to live with it.” I answered: “I came to you and paid money, why are you starting to interfere in your own business?” I didn’t even try to tell her about my life situation, because the doctor really didn’t care about me. She was constantly chirping, she was nervous, she talked to me like I don’t know who. Then she not only softened, she simply stopped dissuading me. nine0003

After visiting the doctor, I cried, considered myself somehow different, did not understand how I could even think about an abortion. Then my mother and grandmother supported me a lot. Nobody said I was a murderer or a leper. Grandmother told how she terminated the pregnancy herself, even before anesthesia was given. She recalled a girl who came for an abortion, they began to cut her alive, she cried, screamed, and she was told: “It doesn’t hurt to spread your legs in front of the peasants, but here it hurts!” She, poor thing, endured.

As a result, this gynecologist wrote a referral for medical abortion. First, I took a pill in the office, then the doctor ordered me to come the next day, take another one and stay in the hospital for some time. The next day I took the drug, went to the ward, where the nurses - friendly girls - offered tea and coffee. I had bed rest on my card: two hours after taking the pill. The gynecologist came and said: “No, I didn’t say that, everything is fine with her, let her get ready and go home.” The nurses replied: "No, bleeding can open." - "For people like her, nothing will open." Nobody argued with her. I heard it while behind the screen. nine0003

I packed up and went home by public transport, standing up. My stomach began to twist, and when I got home, bleeding began. I also had to come to this gynecologist for a control ultrasound, but she refused me: "You don't need any ultrasound, everything is fine anyway."

After the abortion, my husband beat me again: he shouted why I did it. I gathered my strength and filed for divorce.

“Why are you doing a second abortion?”

A few years later, we celebrated our daughter’s 4th birthday, and her ex-husband came to congratulate her: all so kind and handsome. We had sex with him, and I had my period. And again the same song - a delay. I didn't know that this happens. I called him, he said: "I don't know where you've been." Well, I decided that I would not prove anything. nine0003

The pregnancy test showed one line, but my cycle is like a clock, so if there is a delay, then something is wrong. I went to the antenatal clinic and again got to the same doctor. She examined me and said: “Nothing, it’s a failure. Take the test again in a week and come back." I did a test, and there were already two strips. I came again, the gynecologist didn’t even examine me: “Well, that means I’m pregnant.” And again she began to fill out the paperwork, almost a referral to the hospital. I didn't spray myself, I just got up and left. nine0003

I went to the paid clinic where I was last time, only to a different branch. I did tests and ultrasound. I was signed up for a vacuum abortion, because the medical abortion was no longer suitable for the deadline. Before the operation, the gynecologist filled out paperwork and said so displeasedly: “Why are you already doing the second abortion?” I answered: "Well, people do ten, what do I do now. " "It's bad for health." Although abortion cannot be compared with childbirth in this sense. I was already wiser and was able to rebuff her - I asked her not to interfere in her own business. Vacuum abortion was quick, without complications. nine0003

“You won’t be able to give birth, you won’t be able to get pregnant, your uterus will fall off”

When I had abortions, there was no such agitation for fertility. And now from every iron. Everyone attacks you, and if you ask for help, they say: "Give birth, you will get out, money will fall from the sky." They talk about all sorts of lawn bunnies.

Instead of supporting and helping, saying comforting words, doctors always answer: "You won't be able to give birth, you won't be able to get pregnant, your uterus will fall off." nine0017

Four years later, I had another child with my current husband. It was planned, we prepared for half a year, passed tests, we really wanted and waited for it. But I do not plan more children - never and not for any money. I hope it won’t come to pregnancy, but if anything, I would have an abortion again. And my husband understands everything, he helps a lot: he sees what a child is and that he consists not only of smiles, but also yells, cries, his stomach hurts and his teeth are cut. And after 35 years, I'm generally going to ligate the fallopian tubes. nine0003

If a girl is not sure [that she wants to give birth], knows that she won't pull it, she must understand that there will be no lawn bunnies, there will only be harsh everyday life, where she will have to carry the child on her. Let her not break her life, think with her head. This is only her life, let her dispose of it as she wants.

Alice's story

"I knew everything would be great"

I came to my hometown in the summer to work as a journalist at one of the enterprises. Due to the heavy schedule, I hardly slept or ate, I felt lonely. It was a bad period, and I tried to unwind somehow: I hung out a lot, started drinking. And it all happened at the next party. Got pregnant at 19years old.

I immediately realized that I was pregnant. There was some peace, the skin became super clear, although I usually get acne every [menstrual] cycle. I constantly felt nauseous at work: I went to hot shops, took interviews, and my head was spinning. There was no fear or horror. On the contrary, I became curious how to get out of all this now.

I myself do not plan to have children, although I love them very much. [By the time I got pregnant] I knew quite a lot about abortions and was aware that medical termination of pregnancy is included in the CHI policy, that is, it can be done for free. I was not afraid of negative consequences, although I read on the forums about any tin with health after an abortion. But I reasoned: if a girl has a bad abortion, she will go to the Internet and write about it, and there is no point in writing anything for thousands of girls whose procedure went smoothly. I knew that everything would be great for me, I felt it. nine0003

“I had to repeat all the time: “No, I will have an abortion”

When I came to the antenatal clinic, the gynecologist and her assistant immediately asked about my age. I expected some kind of condemnation, but the doctor, on the contrary, was delighted: “Oh, wonderful, you are already an adult, it’s time!”. She probably thought that I would be registered, and I said that I would have an abortion. Then the doctor’s assistant began to tell me about the advantages of being a young mother: “Imagine, I gave birth at 19, and now my daughter and I go to clubs together!” I answered: “I will give birth to a child, who, in fact, is for life, so that later I can go to clubs with him ?!” nine0003

At the reception, I behaved rather rudely - more to protect myself. But it didn't work, no one took me seriously. It was very humiliating that they were talking to me like a child, despite the fact that I immediately said that I was going to have an abortion. What other conversations can there be? After all, I didn’t ask anyone’s opinion. The doctor began to tell unnecessary details about unfortunate clients who, just as young, had an abortion, and now regret it because they cannot give birth to children. There were arguments that I was already working (yeah, for some pennies!), that my family would help. The gynecologists tried to convince me that I would give birth to a child and be happy. nine0003

Doctors think it's cool to doom someone to life with a young mother who didn't want him. They just need to save the child so that it exists, and what's next is indifferent to them.

As if not planning a pregnancy wasn't enough for my decision and I needed a reason to have an abortion. And in my opinion, you need a lot of reasons to have a baby. I had to repeat all the time: "No, I will have an abortion."

After a "nice" conversation, they started doing an ultrasound. The gynecologist said that nothing was really visible and offered to wait a week, but even the cheapest pregnancy test showed two strips. I suspect that they wanted to delay the moment, hoping that I would change my mind. However, I insisted on tests, and they issued me a referral. I passed the tests the very next day, and a few days later I got a second appointment with the same doctor. She confirmed the pregnancy, did a second ultrasound and referred me to a psychologist (Russian antenatal clinics provide for mandatory pre-abortion counseling with a psychologist. — Note ed. ).

“A real girl should give birth”

I was really preparing for the appointment with a psychologist, I was directly rehearsing at the mirror how I would talk to her, I was on edge. Even sedative, in my opinion, drank. I arrived, went into the office and saw a young girl there. I sat down and silently looked at her. She calmly took out some piece of paper and began to ask standard questions on the questionnaire. "Do you know about the consequences?" - "I know". "Does the child's father know?" - "Not". - "Why?" - "We do not talk". “Okay, I understand.” nine0003

The psychologist put plus signs in the questionnaire, smiled and wished a safe abortion. She handed over the certificate, and we peacefully said goodbye. I was euphoric, I literally found "a ray of light in a dark kingdom".

After the appointment, I again went to the antenatal clinic, showed the certificate, and the gynecologists stopped trying to convince me. If at first they tried to build trusting communication, talk about how I live, then when they realized that everything was pointless, they finally started doing their job and fell behind me. I was given a referral for a medical abortion, which I had two weeks later. nine0003

In the perinatal center where I came to get pills, there were icons and pro-life posters everywhere: “Save life”, “A real girl should give birth”.

This aroused wild anger in me: I just saw a raped girl who looks at all this and thinks how she will live on if she leaves an unwanted child.

I was afraid of some kind of moralizing from the doctor, but there were none, everything went quite calmly. I took one pill right at the doctor's, two more were given to me at home. I took them in the morning, the family did not suspect anything: my relatives thought that my stomach just hurt. nine0003

“In our country, the attitude towards children is consumeristic”

In the whole story, I cried the only time - the entire lunch break at work. I have increased empathy, and even when something bad happens to me, I imagine a weaker person in my place. I thought about my peer, who is less versed in the topic and who is pressured by parents and doctors, they scare her that she will no longer be able to give birth. I felt sad and hurt to tears.

I can't get past the discussion of abortion. I'm bored of arguing with people who have the mindset that abortion is a sin. But there are those who consider themselves progressive and argue in the spirit of: "We need to protect ourselves so as not to have abortions." Of course, protection is super important, but first of all, so as not to spread STDs. Abortion is not the worst thing that can happen if you don't use condoms.

When you choose to terminate a pregnancy, you make the choice only for yourself. When you choose to give birth, you make a choice for another person, whether he should exist and in what conditions to live. No one can guarantee the happiness of their child. To create a new person, assuming that something bad can happen to him, in my opinion, is cruel. In our country, the attitude towards children is consumerist. If you want to give someone life, take the child from the orphanage. He is real and needs you. nine0003

Tatyana's story

"What if the child looks like a rapist?"

I was born in the small town of Zavolzhye, at the age of 16 I went to Nizhny Novgorod to study at the university. When I turned 18, I went to a club and was raped in the toilet. After the rape, everything hurt, I cried for a long time. I usually call my mom every morning when I go to school, but then I didn’t. My mother called me herself, asked what happened, and I answered that my stomach hurts - probably poisoned. For another six months, I sat at the very end of the minibus, because I was afraid of people, and if there was even a little boy, even a teenager, I would step aside. I hardly went to the shops, I was afraid of men. I didn't tell anyone about the rape. Tried to live like nothing happened. nine0003

A month and a half later, I developed toxicosis — I felt sick all day long. I took a pregnancy test - there were two strips. I bought three more pieces, they all showed a positive result. I told my friend that I might be pregnant. A friend says: "Leave it, it's so great!" At first, I really wanted to leave the child, because I heard from everywhere that abortion is a sin, you have to give birth and raise a child, since you already have one. When I told my mother about the pregnancy and about the fact that I would probably leave him, my mother, a wonderful wise woman, replied: “You yourself are a child. You have no apartment, no money, what will you do after giving birth? nine0003

I imagined: what would happen if a child looked like a rapist? I will look at him and remember everything - you can just go crazy.

“The doctor started telling me how unlucky I am — I’m wandering around somewhere and with whom”

Mom took me to a family planning center, where they did an ultrasound and confirmed my pregnancy. And then the circus began. I was asked to leave the office to talk to my mother. Then they asked my mother to come out and asked me at what age I lost my virginity. I said that I had my first sex about a year ago, to which the doctor began to tell me how unlucky I am - I'm wandering around somewhere and with whom. It seems to me that she had an attitude in her head: "If she got pregnant, but there is no father, then she worked up." Then my mother was called back, and the doctor told her: “Such a young girl has nothing to do with an abortion, because if she has enough brains to fuck, then she has enough brains to educate.” This is a verbatim quote. Mom said that we were having an abortion, and the gynecologist replied: “She won’t have any more children, you will regret it all your life later. The child is already there and there is no getting away from him.” Mom stood her ground and asked me to sign me up for a paid abortion so that I wouldn't be in pain. nine0003

The fact is that such a wonderful thing is practiced in the Trans-Volga region: girls have an abortion without anesthesia at all, they are cut to death, and we were offered the same option. To which my mother replied: “No, what are you, these are children, this is not allowed.” The doctor said: “Let him at least think before spreading his legs in front of everyone. But she will be hurt, she will remember everything and will not do it again.” Mother asked for the address of a paid doctor who would give me anesthesia. The doctor did not give a number and said: "If you want to encourage her in such behavior so that your daughter becomes a prostitute, then take her to paid doctors yourself." nine0003

I was very hurt, I could hardly hold back my tears, but I did not dare to tell the gynecologist about the rape, because I did not want my mother to know about it. She was afraid that she would be hurt. We said goodbye to this gynecologist, and I told my mother that I myself would find a paid doctor who would see me in Nizhny Novgorod.

“After the abortion, I cried for another month, reproached myself”

Mom gave me some money - everything she had at that time. I found a private clinic, where they examined me and said that the term was already long, and if two more weeks were extended, an abortion would not be performed according to the law of the Russian Federation. The doctor in the private clinic no longer tried to dissuade me, he only asked if they understood what I was getting into, why I didn’t want a child, if he had a father. He said that there might be health problems and then I would need rehabilitation. I told this doctor about the rape. He reassured me, saying that I still had neither the opportunity, nor the place, nor the money to raise a child. I was offered an abortion on the very same day. I think if the doctor suggested in a day or two, I would wind myself up, and I would be scared. The doctor said: “Don’t worry, you will stay with us for the night, we will look after you, feed you, everything will be fine. But you need to do this now, while you do not evaluate all the risks, otherwise you will give birth later and you may regret it very much. And I agreed. nine0003

I had a surgical abortion under general anesthesia, I woke up already in the ward. I didn't stay overnight and called a taxi. She came home, lay down on the bed, curled up and started to cry. And I didn't fully understand why I was crying. I got a call from a friend who knew about rape and abortion and offered to come to him. He wrapped me up, fed me, and I went to bed.

After the abortion, I cried for another month, reproached myself for having done something terrible. And only after many years I realized that there was nothing wrong with my act. nine0003

What happened to me is not my fault. In realizing this, the program for girls who survived violence helped me a lot.

I was a volunteer psychologist on the phone of the Russian LGBT Network. From the network, I received a letter that there is such an organization from New York, Girl-Talk-Girl, and the director of the organization, Kristen, will come to St. Petersburg to recruit a group of girls who have experienced violence, where they will tell their story and be able to let her go. I was afraid to go there, but after I was told that they would not judge me, but would help me cope with what had happened, I agreed. nine0003

There, for the first time after the doctor and my friend, I told the story of rape and abortion to other people. Later, at Girl-Talk-Girl, they gave me the number of a psychologist to contact. When I told everything, I directly felt how a stone had fallen from my soul, and I was finally released. And in 2014, six years after the abortion, I told my mother about the rape. She supported and reassured me, but we never talked about this topic again.

Now I am married to that friend who was always there, we are doing well. There are no children, because after everything that happened, the doctors say that I may not be able to get pregnant. Now I am undergoing treatment. My beloved husband supports me in everything. nine0003

Previously, if a woman had an abortion, doctors checked her health and could terminate the pregnancy artificially on the same day. Now, when she comes to the antenatal clinic for the purpose of having an abortion, doctors are obliged (according to the order "On Approval of the Procedure for Providing Medical Care in the Obstetrics and Gynecology", Article 106. - Note ed. ) to show her an embryo during an ultrasound on the screen and his heartbeat. The woman is also given time to think - at least seven days. If deadlines are pressed, the time is reduced to 48 hours. nine0003

In addition, a woman must be sent (according to the same order, article 104. - Note ed. ) to the Center for Medical and Social Support for Pregnant Women in Difficult Life Situations to talk with a psychologist. How well it works, I can't say. It seems to me that such centers exist purely nominally. At least I don't know a single person who was helped there. Unfortunately, they dissuade us by manipulating a woman, and do not try to identify the real reason for such a decision and help her. nine0003

Women would be much less likely to take such a step if they knew that after the birth of a child they would receive real help: they would be protected from an aggressor-husband, children would be taken to kindergarten earlier than in two or three years, and women would be able to leave earlier to work or, for example, will receive additional benefits.

Often women have an abortion because of some internal experiences and problems, in such cases, medical institutions should find out whether she really made such a decision herself or, perhaps, her husband puts pressure on her and forces her to have an abortion. Either she found out about the betrayal and thus wants to take revenge - such actions are usually impulsive, and in this case, you need to help the woman realize this. nine0003

Unfortunately, now, if a woman can be dissuaded from terminating her pregnancy and she keeps the child, after giving birth no one helps her, and she is left alone with her problems.

Very interesting wording in the law: "A woman has the right to artificial termination of pregnancy with the woman's informed voluntary consent." Moreover, it is not entirely clear what is included in this information. Therefore, in addition to telling doctors how abortion will affect a woman’s health, she may be told that she is making a mistake that she will regret. nine0003

If a woman who wants to terminate a pregnancy begins to be pressured and tries to manipulate her, and they also unreasonably refuse to have an abortion, she needs to write a statement with a request to receive a written refusal from the doctor to carry out the procedures. As a rule, excuses stop after the woman tells the doctor about her intention to write such a statement, since it will be evidence of a violation of her right (Federal Law "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation", Article 56. - Note ed. ). For this, a gynecologist can be punished financially and administratively. In the case when the doctor says: “OK, write,” you must definitely do this, and in two copies. You give one to the doctor, keep the second for yourself, and you should put a mark on it that your appeal has been received. Then either you will be promptly contacted by the medical institution in which you were at the reception, and they will make concessions, or you will be able to file a complaint with higher authorities.

You can also call or write to specialized centers and institutions, such as ours, where you will be promptly advised or given contacts of relevant organizations and will help defend your rights. nine0003

“No one will give you an abortion. So it’s not destiny” — Such cases

“I’m sure that if a psychologist in some European country saw me in my terrible psychological state, he would send me for an abortion, not even recommending that I continue the pregnancy. We were told: “Don’t be sad, drink your vitamins””

At the end of October, Russian President Vladimir Putin instructed to assess and strengthen the effectiveness of medical institutions for the prevention of abortion. One of the proposed measures is to strengthen the “financial interest” of doctors. The topic is also widely discussed against the backdrop of mass protests in Poland, where on October 23 it was forbidden to terminate a pregnancy even because of an incurable disease of the fetus. nine0003

At the same time, some pregnant patients who decide to have an abortion still face psychological pressure from health workers. Women from different cities of Russia told Takie Dela about the obstacles they faced before undergoing the procedure in state medical institutions.

“The gynecologist said that there was no pregnancy”

26-year-old Margarita Gavrilova ( all the names of the heroines in the text have been changed at their request - note TD ) went to the antenatal clinic in Lipetsk in 2019year. Previously, the woman did all the necessary tests at her own expense - she had an ultrasound scan, pregnancy tests and the results of an hCG analysis on her hands.

“I am a health worker myself, so I know what's what. From the very first day of the delay, I did several tests that confirmed the positive result, then I took the hCG test privately and went for an ultrasound scan. It turned out that there really is a fetal egg aged three weeks. I went to the antenatal clinic with all the tests and analyzes so that they would refer me for a medical abortion. But the gynecologist stated that there was no pregnancy, that it was an endometrial cyst on the ovary, which did not need to be treated, and absolutely no drugs should be taken. She said that we need to wait two or two and a half months to see if the disease progresses, and then treat it, ”says Gavrilova. nine0003

Margarita clarified with the doctor why the tests were positive and the tests confirmed the pregnancy. The doctor, according to the woman, confidently stated that this happens because the cyst gives a hormonal failure, after which she ordered the patient to come in a few months and gave a referral to a psychologist.

“At this stage, a sports interest woke up in me, I decided to go to him and find out what kind of conspiracy this is. At the reception, the psychologist at first really told me not to worry and that such diseases were successfully treated. And then the brainwashing just started: children are happiness, it is necessary to give birth, people go for abortions, and this should never be done, because it is “sin and murder”. In general, a person works as a brainwasher to speak teeth to patients, ”Margarita notes. nine0003

The girl went to a private medical center where she was given abortion pills and a referral for an ultrasound scan, where she went a few days after taking the pills - everything was fine. According to her, no one exerted pressure, and the doctor immediately said that the termination of pregnancy was exclusively her business.

“Two months later I got a call from the same antenatal clinic asking why I didn't come. I replied that your doctor had deceived me and that if I had not had the sense to go to a private clinic, then I would now be at a time when it is no longer possible to have an abortion. They told me that I was a fool, that they gave me a chance to think about how I will live with this now. They began to scare me with the fact that I would not give birth and that abortion provoked oncology, and this would not pass without a trace for me. They also advised me to go to church,” recalls Gavrilova. nine0003

Margarita noted that everything is fine with her health now, she passed tests for hormones to make sure that the procedure did not affect the hormonal background.

“It turns out that they have moved to a new level of deception: people come in early pregnancy, and they just “hang” some non-existent sore for them so that they don’t do anything and reach the period of 12-13 weeks, when the abortion you can’t do it anymore, ”Margarita is indignant.

The possibility of Gavrilov's medical error excludes, in her opinion, this could be discussed if she came to the appointment without tests: then the doctor could possibly take the fetal egg for a cyst. nine0003

“But when I have all the tests confirming the pregnancy, there can no longer be any doubt that this is a hoax. And their call two months later with reproaches addressed to me confirms that this is a planned action. They probably think this way: a normal girl came, she doesn’t look like a homeless person and an alcoholic, so let her give birth, ”says Margarita.

Illustration: Anna Koltsova for TD

Gavrilova suspects that maternity hospitals keep records of the number of caesarean sections, as well as women who refused to have an abortion. “If there are more Caesareans than necessary, then they need to somehow explain this to higher authorities. And if they fulfill the plan, they receive quarterly bonuses. I don’t know how much they are paid, but there are incentives for, as they call it, “educational work,” Margarita believes. This, in her opinion, also applies to psychologists in antenatal clinics. nine0003

According to Margarita, some clinics refuse to perform abortions during the pandemic, including in order to reduce their number: “With the same logic, I could cancel all dental patients without acute pain, but our clinic did not, because people will then have more serious problems with their teeth if the process is delayed. There is a similar scheme here, but they deliberately delay the deadlines.”

“Oh, well, it's a pity”

Maria Savina from Yekaterinburg applied for an abortion at the seventh week of pregnancy, but the operation was performed only at the 12th week. Ultrasound had to be done at her own expense: there were no places in the district clinic, and the doctor ordered Maria to go for a consultation with a psychologist. nine0003

“I wanted to refuse a psychologist, but the doctor wouldn't let me. This psychologist received at the other end of the city, I had to skip couples and go. Also at the appointments, the doctor said that I would regret it, scared me with the consequences, and was generally dismissive. From other women who also wanted to have an abortion, I learned that this is in the order of things with almost all doctors.

At the consultation, the psychologist, according to Savina, said that the girl would become infertile after an abortion, that a young man would leave her, and that it was time to give birth at that age (the girl was then 18 years old). nine0003

“For two hours she found out everything about my life, my parents, my boyfriend. As a result, I came to the conclusion that it is better to give birth, that parents will help. Considering that I ran away from them to a rented apartment at the time, it was genius of her. Then she took my number and after a couple of weeks she wrote, asking what I decided. When she learned about the abortion, she answered something like: “Oh, well, it’s a pity.”

Oksana Sergeeva's child from Pikalevo, Leningrad Region, was only four months old when she found out that she was pregnant again. The question of maintaining the pregnancy was not even raised - it was obvious to everyone in the family that at the moment they would not pull another child. nine0003

“When I came to the antenatal clinic, they told me: “Everyone who can give a referral is on vacation, no one will abort you. Means no luck". I was at the manager's - it was useless, I said, they say, everyone gives birth in the weather, and you will give birth. I managed to do everything only in a paid clinic, I don’t regret anything, ”recalls Oksana.

Oksana considers the refusal of many clinics to perform abortions during the pandemic to be completely unjustified: “Now they just found a pseudo-reason to sabotage women, infringe on their right to independently decide the fate of their pregnancies.” nine0003

“Don't be sad, drink vitamins”

25-year-old Anna Merkulova from Tambov was registered for pregnancy in the winter of 2020, but then, due to an unstable psychological state, she changed her mind about giving birth. The girl was afraid that due to the fact that she was already registered, she might be denied termination of pregnancy. And the period was already quite long - about 11 weeks.

“Because I am a journalist, it was not difficult for me to contact the head of the consultation and ask if they would refuse my referral for an abortion. The manager got hysterical into the phone, promised to convene some kind of council, but said that I should come in the morning. Let me explain: in the city I am known as a slanderous, harmful person, complaining to everyone and pumping rights. That is why I also called the insurance company and said that the medical facility does not answer my specific question and does not interact with the patient. nine0003

Illustration: Anna Koltsova for Trade House

The next day Anna, taking her husband to support her, came for a referral. The gynecologist, according to the girl, tried to dissuade her, arguing that she was acting irresponsibly, and 25 years was the ideal age for having a baby. Merkulova had an abortion at the 12th week, but she is sure that she was able to achieve this solely with the help of connections and acquaintances in various instances.

“I am sure that if a psychologist in some European country saw me in my terrible psychological state, he would send me for an abortion, not even recommending that I continue the pregnancy. We were told: “Don’t be sad, drink vitamins,” says the girl. nine0003

Abortions during the pandemic

The problem of the availability of abortion under compulsory health insurance worsened in April 2020, when due to quarantine, many state medical institutions began to refuse to patients in elective surgeries, including abortions. This became known after the experts of the Violence.net center called 44 Moscow clinics, and only three of them agreed to have an abortion.

28-year-old Lidiya Myasnikova went to a public Moscow clinic in mid-April while she was eight weeks pregnant. The girl gave birth to her first child just a year ago, she and her husband were not ready for the appearance of a second child. The medical institution refused to have an abortion, referring to the decree of the Mayor of Moscow “On the introduction of a high alert regime” dated March 5, 2020, published in connection with the threat of the spread of coronavirus infection in the capital. nine0003

Another Moscow resident, Alexandra Gruzdeva, had an abortion under the CHI policy at the end of July. She noted that at the preliminary session with a psychologist, they tried to persuade her to keep the pregnancy, and the gynecologist insisted on the same. The operation itself went well - the clinic did not refuse her hospitalization and conduct.

According to Anna Rivina, director of the Violence.Net Center, they have no information that private clinics somehow restricted abortions during the coronavirus restrictions. At the same time, the center does not know how things are with planned operations in Moscow hospitals for September 2020. nine0003

See also The ministries of health of the two regions recommended that private clinics refuse abortions. The gender sociologist decided to find out: is this even legal?

At the end of September, the press service of the Moscow City Department told Takim Dela that initially hospitals were set up in the capital at 66 federal, city and private clinics to treat patients with COVID-19. At the same time, all Moscow hospitals that did not participate in providing assistance to patients with a new coronavirus infection have already returned to providing planned assistance. About 20 city hospitals, previously repurposed for coronavirus patients, returned to normal operation and accepted patients for treatment. nine0003

According to the department, despite the pandemic, termination of pregnancy at will or on indication is being carried out in all clinics providing assistance under the basic CHI program and licensed to provide medical care in obstetrics and gynecology. The exception is gynecological departments in hospitals repurposed to treat coronavirus patients.

"There should be a conversation with the patient, not an attempt to push your point of view"

In May of this year, Commissioner for Children's Rights Anna Kuznetsova proposed cutting funding for medical institutions that perform abortions: in her opinion, the more abortions a clinic performs, the less money it should receive from the state.

According to WHO, the cost of safe abortion is only one-tenth that of unsafe abortion. Representatives of the Russian Ministry of Health, in particular, the former head of the ministry Veronika Skvortsova and her deputy Tatyana Yakovleva spoke out against the ban on abortion in the country. At the same time, Skvortsova emphasized that the Ministry of Health, like the Russian Orthodox Church, does not encourage artificial termination of pregnancy. Yakovleva, in turn, noted that it is necessary to carry out explanatory work with medical personnel who would be interested in motivating a woman not to have an abortion. nine0003

The doctors themselves do not hide the fact that the Ministry of Health of the Russian Federation recommends that they dissuade patients from terminating a pregnancy. According to the doctor of one of the Chelyabinsk state clinics, Anastasia Guseva, it is normal practice to dissuade a patient from having a medical abortion in state clinics. Such recommendations are given by the Ministry of Health, whose main policy is to increase demographics in the country. At the same time, in her opinion, there is no talk of promoting childbearing among low-income parents or people with hereditary diseases. nine0003

“This is written in the regulatory documents and protocols. An obstetrician-gynecologist should invite a woman to think, weigh the pros and cons, because any abortion, including medical abortion, can lead to infertility, inflammatory diseases of the pelvic organs. I don’t have information about the restriction of abortions during the coronavirus, but if this is true, this is most likely due not to the doctor’s ban, but to the social restrictions that had to be introduced due to the pandemic, ”the doctor believes. nine0003

Guseva notes that, perhaps, the reception of patients was limited in medical institutions in order to prevent unnecessary contacts and isolate people from each other. But such measures, in her opinion, can lead to an increase in the number of criminal abortions, so it makes sense to introduce rules for admitting patients that allow them to receive full medical care even during a pandemic.

“Regarding intimidation and misinformation of patients, no one gives such recommendations to doctors. This only speaks of the low level of education and the lack of medical qualifications of the doctor [who had Margarita Gavrilova at her appointment],” the doctor says. nine0003

The safety of abortion also depends on the responsibility of the woman herself. If the medical abortion was successful, it is followed by a long recovery period (at least six months), which consists of anti-inflammatory, immunostimulating and hormonal therapy. “If a woman follows all the recommendations of the doctor, everything will be fine. But not all patients understand this,” says Guseva.

She points out that statistics on the number of abortions are indeed kept. If their number exceeds, for example, the figure for the previous year, then the clinic tries to figure out what it is connected with - the socio-economic aspect or the lack of promotion of pregnancy and abortion prevention. As the doctor notes, various measures can be taken - from advertising campaigns with a pharmaceutical company that produces birth control pills and condoms, to lectures on the dangers of abortion in schools and universities. nine0003

In a conversation with Taki Delhi, Oleg Pogodin, head of the gynecological department of the Republican Perinatal Center of Petrozavodsk, argues that any illegal refusal to terminate a pregnancy can lead to an increase in the frequency of illegal abortions.

“I hope there won't be such extraordinary situations [like the coronavirus epidemic] in the future,” says the doctor. - But when they arise, issues with abortion should be resolved, of course. I am convinced that any obstetrician-gynecologist should promote childbirth, not abortion. And the doctor can give arguments in favor of prolonging the pregnancy. But he must do it honestly, answering all the questions of the patient. If the story [of Margarita Gavrilova] that you cited as an example is true, then it is unethical. There should be a conversation with the patient, and not an attempt to push your point of view. nine0003

“Abortion is simply a means to realize one's unwillingness to have children. If abortions are banned or limited, there will be no desire for this, ”Alexander Sinelnikov, professor of the Department of Family and Demography at the Faculty of Sociology of Moscow State University, tells Izvestia.