The Russian Ministry of Health is proposing to change the list of medical indications for which a woman can have an abortion at any stage of pregnancy. According to the new rules proposed by officials, late-term abortions will be allowed only in cases where there is an immediate threat to the woman’s health. In effect, women may lose the ability to decide for themselves whether they are willing to carry a fetus with serious congenital diseases.
The Russian service of the BBC studied the proposals of the Ministry of Health. “The new draft decree does not cancel the abortion at the request of the woman, but includes medical indications under which the abortion can be performed regardless of its duration,” the Ministry of Health said in response to criticism of the proposals.
Under current legislation, a woman can obtain an abortion up to 12 weeks of pregnancy in all cases and up to 22 weeks in cases of rape. Abortion may be performed at any stage of pregnancy on medical grounds. The current list of medical indications for abortion has been in effect since 2007. The list is about to be revised, taking into account “the development of medical science and changes in the approach to treating various pathologies during pregnancy,” according to the Ministry of Health of Russia, as reported by the BBC.
The recommendations both add diseases for which pregnancy can be interrupted and remove certain norms that were included in the 2007 document. For example, it is now proposed to allow abortion when a woman is in the fourth stage of HIV, has sickle cell anemia, various mental disorders, certain diseases of the nervous system (such as epilepsy), and other acute illnesses. At the same time, medical indications for abortion are diagnosed malignancies (if chemotherapy is not prescribed), drug-induced psychosis, depressive episodes, chromosomal disorders (such as Down’s, Patau’s, and Turner’s syndromes), and other diseases.
Also, according to current laws, a woman has the right to an abortion at any stage in the case of a congenital fetal abnormality with a “bleak prognosis for the life of the child”. The Ministry of Health is proposing to remove this provision and instead legalize the provision of “medical assistance to the mother in the case of established or suspected fetal anomalies and injuries. This can be interpreted to mean that if the fetal abnormality does not pose a threat to the life and health of the woman, she does not have the right to a late-term abortion. “This is biopolitics. This is how Oksana Pushkina characterized the state’s intervention in the biological life of citizens, a term coined by Michel Foucault in the late 1970s,” according to the new list of deputies. According to Pushkina, women’s associations, which listen to the advice of doctors, should have the final say in the discussion about women’s right to abortion. Pushkina is convinced that the decision to have an abortion is often motivated not by medical or ethical reasons, but by socio-economic factors – “the inability to provide everything necessary for the baby and to ensure its prospects in life”.
The number of offers should remain: Oksana Pushkina The Ministry of Health’s new list was called “the Polish way.” In the fall of 2020, Poland introduced a ban on abortions due to incurable fetal diseases. This indication accounted for 98% of all abortions in the country. This decision led to mass protests. Pushkin also fears that excluding some norms from the list will lead to an increase in the number of underground abortions. Reducing the list of indications for abortion may provoke corruption, warns obstetrician-gynecologist and WHO expert Lyubov Erofeeva. “If there is a missing comma and someone has to do something, and bureaucrats say, ‘No, you are not included in this group, it has been removed from the list,’ this is always an opportunity for corruption,” she believes.
How Poland is fighting the law banning abortion. She is also concerned that it will be difficult for women to obtain an abortion in cases of fetal developmental abnormalities. Erofeeva believes that this could increase the number of rejections of children born with severe diseases. “In other words, we will simply add to the state’s burden live children who are unable to develop and live independently,” the doctor believes. Several feminist online communities also opposed the new list. Several activists urged their followers to leave negative reviews of the Health Ministry’s proposal on the government information portal. The possible problems with the adoption of the new list by the Ministry of Health are being discussed mainly on feminist portals, while “ordinary people don’t even discuss it,” says Natalya Moskvitina, the head of the Women for Life Foundation, which works to prevent abortions. She is convinced that the list of indications for abortion should be regularly updated. She also notes that many women currently face strong pressure from doctors: “Women are told that they must have an abortion, but she believes that a child with a pathology can live.” In particular, Moskvitina argues that many people “fought against the system” by proving that they wanted to give birth to a child with a cleft lip or clubfoot. Although many fetal pathologies can be corrected immediately after birth, such as gastroschisis (defect of the front abdominal wall).
Anti-abortion campaign in Belgorod. Year 2016. Also, according to Moskvitina, the diagnosis can be wrong, and doctors tend to take precautions: “Sometimes, based on certain indications, it can be seen that it is a pathology, but after a week or two, the fetus changes, grows, and there was no pathology at all. This is a human being – something develops faster, something slower, something may not be visible on the machine. Pro-lifers believe that doctors often fear possible lawsuits from the parents of sick children and therefore advise abortion to protect themselves. “This is how it works: if there are pathologies, then there are risks, which means additional surgeries, which means the doctor may face a lawsuit. Everyone is afraid for themselves,” Moskvitina believes. According to her, pathologies in which a child is not viable after birth remain on the list of the Ministry of Health. Only operable pathologies and those that do not significantly affect the child’s life have been removed.