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July 11, 2003
Contraception Catches On in Russia from Ezhenedel'ny Zhurnal
By Vakhim Ismailov. First published 10 June, 2003.
Translated by Kevin J. Krogmann.

During the 1980s in the Soviet Union, condoms were as hard to find as people who wanted to use one, and Hungarian and East German contraceptive pills collected dust on pharmacy shelves. When the pills were used, the entire package was swallowed at once (a primitive precursor to the modern RU-486) to trigger a miscarriage when a woman thought she might be pregnant.

Throughout the 1980s, the country accumulated mountains of contraceptives, but made no real effort to prevent pregnancies. […] Most people pursued pleasure somewhat recklessly, in denial--at least for a few minutes or hours--about the inevitable reckoning: the maternity ward, the wedding hall, abortion, venereal disease.

Condoms became plentiful as soon as imports were decentralized in 1992, but there was no correlating effect on abortion statistics. […] Families still usually didn't use protection, and abortion was not considered a disgrace for a married woman.

In 1993, Public Health Minister Eduard Nechaev ended the centralized distribution system of medication. The prescription drug business was transformed overnight to the free-market model: Pharmaceutical company representatives visited doctors, and drug development experts conducted lectures, training, and seminars. The same evolution occurred in the contraceptive field: The Moscow representative of the Dutch company Organon, for example, founded the Information Center on Human Reproduction, where doctors learned about contraceptive gynecology--a topic not taught in Soviet times.

Emboldened by new knowledge and plentiful availability, most Russians quickly forgot the frightening myths that once surrounded the use of the pill and sponge. It became accepted that contraceptives reduce the number of abortions and related deaths. A federal planned parenthood program was developed and a network of centers for family and reproductive planning were established. Work on developing a school program covering contraception also began.

All of this could not have been a better gift for communists and clerical factions. As soon as the tide began to turn toward mainstream acceptance of birth control, national patriots began to sound like conspiracy theorists, bleating that some evil force wanted to depopulate Russia and defile Russian children. The orders were coming from a "world conspiracy" that wanted to gain control over Russia's natural resources. Global pharmaceutical companies--the contraceptives manufacturers--were holding the reins, of course. They needed a captive market for their poison, which was apparently impossible to sell in decent, civilized countries. Apocalyptic articles appeared in the press (not only communist, but also liberal). In the mid-1990s, few television stations could resist broadcasting stories on the subject. Duma hearings resulted in a preemptory resolution: Family planning and "gender education" in schools was banned.

The Health Ministry was the first to abandon its plans. In April 1997, it halted work on a school-based sex education program. Soon afterward, the Duma cut funding from its 1998 budget for planned parenthood programs -- claiming it didn't want to "sponsor genocide." Duma deputy and medical doctor Ekaterina Lakhova had harsh words for her colleagues. "Cutting this line from the budget, you have planned the death of 148 mothers," she told them. "On average, exactly this number of women die every year in Russia from abortion and its aftermath." In response, her fellow lawmakers stamped their feet and shouted, "You have sold yourself to foreign companies and pedophiles!"

In the spring of 1998, a clerical group smeared black paint on billboards all over Moscow that featured a demurely dressed model stating that the secret to her success was oral contraceptives. On one of the signs someone wrote, "[Moscow Mayor Yury] Luzhkov, you're the mayor of Sodom." The most vehement opponents of contraception didn't believe the Health Ministry had actually stopped teaching sex education; they were convinced that students were being secretly taught to use birth control. In the spring of 1999, industrialist German Sterligov; the director of the "Do Not Kill" fund, Sergey Aristov; and the head of the "Life" center, Father Maksim Obukhov, instructed parents who suspected that schools were conducting so-called gender enlightenment classes to send a message to a pager (mobile phones were still a luxury at the time) to summon a "quick reaction group" created by the center that would suppress any such lessons.

Educated society was in shock. […] Sociologist and sexologist Igor Kon suggested to several journalists that while communists and the church understood that contraceptives lower the number of abortions and slow the spread of AIDS, a dramatic increase in both would serve their agenda by providing evidence of the malignancy of liberal ideas in Russia.

By the beginning of 2000 it seemed the anti-contraception forces had won. Mainstream sources of information were on their side, their opponents had been discredited, and federal sexual education programs had collapsed. Furthermore, the Moscow offices of contraceptive manufacturers had, almost simultaneously, laid off all their employees who had been working on family planning and school education projects. (It was said that the layoffs were the result of an unwritten dictate by the directors of AIRM, the association of foreign pharmaceutical companies in Russia. Apparently, they no longer wanted anything to do with the country's internal affairs; their business, they decided, was simply to sell pills. Drug companies began focusing all their efforts exclusively on doctors, there was no more flirting with the Duma and government, and all advertising money went toward women's periodicals.)

Then, astonishingly, just when the war seemed lost, contraceptive sales began to grow. Russia is still a long way from Holland, where 80 percent of girls and women "sit on the pill" from the age of 14 until they become pregnant with their first child. But according to data from the deputy health minister, Olga Sharapova, the number of Russians using birth control has almost doubled in the last decade. Now 7.8 percent of women of childbearing age use contraceptive pills, and 16.3 percent use sponges. Pills have continued to increase their market share in Russia--a trend that parallels the situation in most of Europe. Data from the media and marketing company KOMKON indicates that in cities with populations over 100,000, one out of every five women uses a pill for birth control.

Surveys also show that the majority of women learn about birth control from their doctors and women's magazines--which leaves little doubt that contraception has become a part of life for the middle class. But even by the most optimistic estimate, no more than 20 percent of all Russian households can be considered middle class. So the majority of Russian women don't see the advertisements in magazines or receive information from their gynecologists, whose offices they usually visit only when they need an abortion. Additional decreases in the number of abortions therefore can probably only be spurred by federal family planning programs and sexual education in schools. In regions where obstetrician-gynecologist services have effectively replaced the federal programs that were canceled, the benefits of outreach are clear: In the Samara region, 40 percent of women of childbearing age use modern means of contraception; in Altai, the figure is almost 50 percent.

While there is still a disproportionately high number of abortions in Russia, there is light at the end of the tunnel. The age at which Russian teenagers become sexually active has decreased and the age at which women marry and give birth for the first time has risen. Almost 10 years separates the average age when sexual activity begins and the average age at first birth--something that can only be attributed to the widespread use of contraception. It is solid proof that Russians are finally thinking ahead, not after.