Victoria Sakevich, Boris Denisov (Moscow): Reproductive Health and Rights in Russia Comment: Alexander von Plato International Conference in Contemporary History Jena University Dornburg Castle, November 28‐29, 2013

1. Reproductive health and rights in Russia
“When the chemistry works... Gender relations and birth control
in the age of The Pill”
November 28-29, 2013
Friedrich Schiller University,
Jena, Germany
Victoria Sakevich (Institute of Demography, Higher School of Economics,
vsakevich@hse.ru)
Boris Denisov (Lab of population economics and demography, Department of
Economics, Moscow University, denisov@demography.ru)

2. outline:
• demographic look at reproductive health
• data availability
• historical and contemporary situations
• reproductive rights in a pronatalist state

3. metrics and components:
• infant and child mortality
• maternal mortality
• abortion
• contraception

4. RLMS-HSE data from the 10th (2001) and 19th (2010) rounds
median ages are: menarche (13), the 1st coitus (18-19), menopause (48-49)

5. demographic view:
• From menarche to menopause a healthy
•
•
woman is fertile
From age 15 to 49 a woman may have
(13x35) 455 cycles, i.e., 12740 days (pills)
In a modern society she makes 1-3 live
births, which make her infertile just for 1-4
years, remaining time she somehow avoids
an unwanted conception

6. births averted:
LB -- live births (not averted, but occured)
births averted due to:
DM -- delayed marriage (or other sexual abstinence)
BF -- postpartum lactational amenorrhea (breastfeeding)
IA -- induced abortions and miscarriages
CC -- contraception (might be detailed by method)
Bongaarts, John
A Framework for Analyzing the Proximate Determinants of Fertility
Population and Development Review, Vol. 4, No. 1 (Mar., 1978), pp. 105-132

7. data sources:
live births
vital statistics, censuses, sample surveys
marriage
vital statistics, censuses, sample surveys
breastfeeding
sample and special surveys
abortions
vital statistics, sample and special surveys
contraception
vital statistics, sample and special surveys

8. data quality:
live births
good
marriage
good
breastfeeding
unknown
abortions
under discussion
contraception
bad or at least scarce

9. what is under discussion?
• Medical community consider abortion
•
•
statistics in Russia incomplete, and provide
its own estimates = reported x2-x4-x?.
It also provides no evidence or a verifiable
argument to support this position.
Why do they do it?

10. early history:
• before 1917 -- abortion was illegal, natural contraception
• 1920 -- the first decriminalization of abortion
• 1936 -- abortion ban + item#2 from Bakovka
• 1955 -- the second decriminalization of abortion
main rule: 12 weeks (at a woman will)
(item#1 = gas mask)

11. medium history :
1974 – Ministry of Health letter on hormonal
contraception (harmful effects)

12. contemporary history:
•
•
•
•
•
•
1987 -- wider availability of options = up to 28 weeks under a range of
non-medical conditions, wide introduction of IUD
1993 -- Peak of abortion and contraception liberties
1998 -- political U-turn
2003 -- severe restriction of social indications (13->4)
2011 -- new (not so liberal to abortion) health law
2012 -- Putin decree (only rape for social abortions, 4->1)

13. abortions’ dynamics:

14. trends of abortions’ dynamics:

15. inputs and outputs:

16. are these data complete?
• There is evidence that abortion statistics is
•
good enough
for the opposite the evidence is anecdotal or
not transparent

17. evidence from the RLMS and other surveys:

18. Contraceptive revolution?
contraceptive prevalence: 47.8 per cent (Moscow, 1966), 59.4 (Russia, 2010), and
TAR: 2.6-3.5 per woman (Moscow, 1966), 5.7 (Russia, 1966), and 0.9 (Russia, 2010)

19. why do they do it?
We guess the rationale behind the position of
Russian medical community is as follows:
1. it believes that it rules the public health,
2. it does nothing to reduce abortion level -thus,
it does not believe in its reduction.

20. it is misleading
• Political parties use either
•
faked data, or
faith based goodwill speculations
to support their bills to restrict abortions.
Decision making became irrational

21. I was not a particularly welcome visitor
It is a remark, made by Margaret Sanger, a pioneer of
global birth control movement, sex educator, and
women's rights activist after her meeting with the officials
of the Soviet ministry of health in 1934.
The meeting revealed totally and strictly opposing views
of Sanger on one hand and Soviet government on the
other.
Sanger was a neo-Malthusianists and look at a
population problem from a human rights' perspective,
paying more attention to means a person has to avoid
unwanted pregnancy, on the contrary for the Soviet
government each pregnancy was in demand.
Over the past eighty years, this person-state opposition
in Russia remained mostly in the same place.

22. Reproductive and sexual rights are not
welcome in contemporary Russia
Since the end of the
1990s, the Russian
government switched to
archaic ideology in the
area of reproductive
health and rights, it
neglects evidencebased arguments.
An opposition is weak.

23. Resume:
• There is a demographic instrument capable of testing
data consistency
• There are data from various sources
• Together the above confirms dramatic true decline in
abortions, and thus improvement of reproductive health
• Despite this evidence medical community provides
government and society with wrong ideas, which are
partially responsible for the archaization of public health
policy

24. Acknowledgments
This study (research grant No 12-01-0076) was
supported by The National Research University – Higher
School of Economics’ Academic Fund Program in 2013 2014

25. Vielen Dank für Ihre Aufmerksamkeit
Thank you for your attention