[CivilSoc] Contraception Catches On in Russia

[Moderator]

The following article appeared on the EurasiaHealth list. The original
source was the Transitions Online wire of 11 July 2003.
Contraception Catches On in Russia
from Ezhenedel'ny Zhurnal
(Transitions Online / TOL Wire, 11 July 2003)
http://www.tol.cz/look/wire/article.tpl?IdLanguage=1&IdPublication=10&NrIssue=732&NrSection=1&NrArticle=10021
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.
By Vakhim Ismailov. First published 10 June, 2003. Translated by Kevin J.
Krogmann.