FEATURE: RUSSIAN FEDERATION – All eight federal districts in Russia providing abortions

Last week, we published a report that said abortion was available in only three of Moscow’s 44 public abortion clinics. We asked Campaign members from Russia what the situation is in the rest of the country. The following summarises reports from senior health policymakers and/or senior obstetrician-gynaecologists in all eight federal districts of the Russian Federation:

by Galina Dikke

Nationally, no one can provide pills for medical abortion using telemedicine in the Russian Federation, and the pills cannot be obtained in a pharmacy (with or without a prescription). This is legally prohibited.

Medical assistance to terminate an unwanted pregnancy in the context of the Covid-19 pandemic and under the regime of “self-isolation”, introduced from 2 March 2020, is provided in full accordance with the legislation of the Russian Federation. In their responses, regional leaders noted that abortion is a form of emergency medical care, even during Covid-19, not routine or planned care, which could have limited them, and were firm that the consequences of not having access to abortion would be unacceptable. Therefore, all abortions in those districts take place without delay, and in the usual manner. All abortions are provided by obstetrician-gynaecologists only. Methods include surgical (vacuum aspiration 40%, dilatation and curettage 60%) and medical (combination of mifepristone/misoprostol) methods.

The cancellation of abortions due to Covid-19 was not even considered. These were their reports:

Central Federal District

In the Moscow region, abortions are performed in women’s clinics as usual.

Northwestern Federal District

The Health Committee advised that any operation that cannot be re-scheduled because it would adversely affect a patient’s condition must be carried out. As regards abortion, they said the consequences of not providing abortion would be unacceptable. Therefore, all abortions are provided without delay.

Volga Federal District

(1) In the Perm District, abortions have been designated as a form of emergency care during Covid-19, and not as “planned medical care”, which would have led to them being restricted.

(2) In the Republic of Bashkortostan, the Minister said that if people need a planned operation, why wait until it turns into an emergency. Therefore, there have been no refusals or delays in performing abortions.

Southern Federal District

(1) In the Volgograd Region, we do abortions, we do not refuse, there is no delay, and there is no special order or order from the Regional Health Committee.

(2) In the Rostov-on-Don Region, several hospitals and gynaecology departments have been redesigned to provide medical care to patients with Covid-19; however, abortions are performed in other institutions that continue this work. There were no reports or complaints from patients regarding denial of abortion.

Ural Federal District

(1) In the Tyumen Region, medical assistance to women who request an abortion in this time of “high preparedness conditions” is provided in the usual manner and not delayed. Cancellation of abortions was not considered. Medical abortions are carried out on an outpatient basis; the hospital is not involved.

(2) In the Sverdlovsk Region, medical assistance to women who seek termination of pregnancy is provided in all medical institutions licensed to do so, including medical abortion, in compliance with all necessary anti-epidemic measures.

Siberian Federal District

(1) In the Krasnoyarsk Territory, all medical abortions and terminations for an anembryonic pregnancy are performed in relevant hospitals. The Ministry of Health of the Krasnoyarsk Territory sent a letter to say assistance in these situations should be carried out in full.

(2) In the Tomsk Region, we continue to carry out abortions free within the framework of compulsory medical insurance, both in a day hospital and in gynaecology up to 12 weeks. There were no specific instructions on abortion for the “high alert” period of the pandemic from the Department of Health.

North Caucasus Federal District

(1) In the Kabardino-Balkaria Republic, the number of gynaecological beds in two medical centres in the city of Nalchik was increased to provide planned gynaecological care. Abortions are carried out – depending on the duration of pregnancy – up to 6 weeks in antenatal clinics, more than 6 weeks and for miscarriages in the gynaecological department of the perinatal centre. Medical abortions are in antenatal clinic day care centres. No one is refused.

(2) In the Republic of Dagestan, only routine care has been suspended. Emergency abortions are provided for those with bleeding, anembryonic pregnancy, or fetal abnormalities. In April, there were only two abortions (perhaps due to the onset of fasting).

Far Eastern Federal District

(1) In the Chita Region, routine care has been discontinued, but abortions are performed as usual.

(2) In the the Republic of Buryatia, medical abortion assistance is provided in full.

Information gathered and translated into English by Galina Dikke, Professor, Academy of Medical Education named after F.I. Inozemtsev, St. Petersburg, Russian Federation, 3 May 2020. Please do not reprint without permission ; MAP