Out of around ******* abortions conducted in Russia in 2022, more than ******* were obtained by women aged 18 to 44 years. Furthermore, 45-to-49 year-old female Russians had over ***** abortions.

Abortions in the Soviet Union became much more accessible under the Khrushchev administration in 1953, and the USSR's abortion rate subsequently developed into the highest in the world. The Soviet government did not begin releasing official statistical data until the 1970s, however it is believed that around six or seven million abortions were carried out each year in the 1950s and 1960s; a figure that remained fairly consistent until the late 1980s**. This high rate was, in-part, due to rapid urbanization and a desire for smaller families, as well as the lack of quality contraceptives produced by the Soviet government, and the widespread belief that abortion was safer than the side-effects of hormonal regulation via the pill. Relative to population size, there were between 97 and 106 abortions carried out per 1,000 women aged between 15 and 49 in the given years, which is roughly equal to one in ten women of childbearing age having an abortion each year (estimates for Russia alone suggest that this number was one in six in the 1960s). There were however regional disparities across the Soviet Union, as abortions were much more accessible and common in the European part of the country, and less available or socially acceptable in the Muslim-majority and rural regions of Asia. Abortion in the U.S. In the U.S. during this time, the abortion rate was much lower due to previous legal restrictions and lack of access, societal attitudes, and better access to contraceptives. Prior to 1973, abortions were either banned outright or only available under specific circumstances in all-but-four states. The Supreme Court case Roe v. Wade then saw the removal of most federal restrictions relating to abortion in the first trimester of pregnancy. This granted women across the country greater access to legal abortions; in 1975 there were over one million legal abortions performed in the U.S., and between 1.5 and 1.6 million in the 1980s. Proportional to population size, this equated to 29 abortions per 1,000 women aged between 15 and 45 in 1980, which is roughly equal to one in 34 women of childbearing age having an abortion in this year. Legacy During the decline and dissolution of the Soviet Union, the government began to promote the use of contraceptives, however the poor quality and supply of these reinforced former perceptions that they were more harmful than abortions. Additionally, medical institutions received much higher sums from the government when abortions were performed (relative to income from contraceptives), and these incentives delayed the drop in Russian and other post-Soviet states' abortion rates. While it is now generally accepted that contraception is safer than abortion, and awareness of the risks of infertility and maternal death has become more widespread, today, Soviet successor states have some of the highest abortion rates in the world by a considerable margin.

In the U.S., following the peak of almost 30 abortions per 1,000 women aged 15 to 44 in the 1980s, the abortion rate has gradually fallen with each decade, even dropping below the 1973 level in 2017. Although this is a side effect of improvements in contraception and education, a large part of this decline can be attributed to restricted access to abortion, particularly in rural and southern regions. While the majority of U.S. adults support Roe v. Wade, the Supreme Court overturned the ruling in June 2022, granting states the right to determine their own abortion laws.

More than ******* abortions were performed in Russia in 2023. Starting from over *** millio* abortions recorded in the country in 2000, the number of terminated pregnancies has continuously decreased over time. The figures include induced abortions as well as miscarriages. The abortion rate in Russia stood at *** procedures per 1,000 live births in 2022. How is abortion regulated in Russia? Abortions are legal in Russia up to the 12th week of pregnancy and up to the 22nd week in cases of rape. They are conducted in state as well as private medical facilities. In 2022, approximately ********* of all pregnancy terminations in the country were conducted in commercial clinics. However, over the past decade, the laws regarding abortion have been tightened, allowing for fewer reasons for pregnancy termination. Moreover, there are proposals to ban abortions in private clinics. In a ranking of European policies by progressiveness and openness to abortion, Russia listed below most Western European countries. Contraception use in Russia Russia was one of the lowest-ranking countries in Europe by access to modern contraception. Approximately ** percent of Russian women aged 15 to 49 years used hormonal contraceptives, while ***** percent used an intrauterine device (IUD). In 2023, the country’s health ministry increased control over the sale and storage of mifepristone and misoprostol, medicines for pregnancy termination.

The 1997 the Kyrgyz Republic Demographic and Health Survey (KRDHS) is a nationally representative survey of 3,848 women age 15-49. Fieldwork was conducted from August to November 1997. The KRDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Research Institute of Obstetrics and Pediatrics implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program. The purpose of the KRDHS was to provide data to the MOH on factors which determine the health status of women and children such as fertility, contraception, induced abortion, maternal care, infant mortality, nutritional status, and anemia. Some statistics presented in this report are currently available to the MOH from other sources. For example, the MOH collects and regularly publishes information on fertility, contraception, induced abortion and infant mortality. However, the survey presents information on these indices in a manner which is not currently available, i.e., by population subgroups such as those defined by age, marital duration, education, and ethnicity. Additionally, the survey provides statistics on some issues not previously available in the Kyrgyz Republic: for example, breastfeeding practices and anemia status of women and children. When considered together, existing MOH data and the KRDHS data provide a more complete picture of the health conditions in the Kyrgyz Republic than was previously available. A secondary objective of the survey was to enhance the capabilities of institutions in the Kyrgyz Republic to collect, process, and analyze population and health data. MAIN FINDINGS FERTILITY Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of the Kyrgyz Republic of 3.4 children per woman. Fertility levels differ for different population groups. The TFR for women living in urban areas (2.3 children per woman) is substantially lower than for women living in rural areas (3.9). The TFR for Kyrgyz women (3.6 children per woman) is higher than for women of Russian ethnicity (1.5) but lower than Uzbek women (4.2). Among the regions of the Kyrgyz Republic, the TFR is lowest in Bishkek City (1.7 children per woman), and the highest in the East Region (4.3), and intermediate in the North and South Regions (3.1 and3.9, respectively). Time Trends. The KRDHS data show that fertility has declined in the Kyrgyz Republic in recent years. The decline in fertility from 5-9 to 0-4 years prior to the survey increases with age, from an 8 percent decline among 20-24 year olds to a 38 percent decline among 35-39 year olds. The declining trend in fertility can be seen by comparing the completed family size of women near the end of their childbearing years with the current TFR. Completed family size among women 40-49 is 4.6 children which is more than one child greater than the current TFR (3.4). Birth Intervals. Overall, 30 percent of births in the Kyrgyz Republic take place within 24 months of the previous birth. The median birth interval is 31.9 months. Age at Onset of Childbearing. The median age at which women in the Kyrgyz Republic begin childbearing has been holding steady over the past two decades at approximately 21.6 years. Most women have their first birth while in their early twenties, although about 20 percent of women give birth before age 20. Nearly half of married women in the Kyrgyz Republic (45 percent) do not want to have more children. Additional one-quarter of women (26 percent) want to delay their next birth by at least two years. These are the women who are potentially in need of some method of family planning. FAMILY PLANNING Ever Use. Among currently married women, 83 percent report having used a method of contraception at some time. The women most likely to have ever used a method of contraception are those age 30-44 (among both currently married and all women). Current Use. Overall, among currently married women, 60 percent report that they are currently using a contraceptive method. About half (49 percent) are using a modern method of contraception and another 11 percent are using a traditional method. The IUD is by far the most commonly used method; 38 percent of currently married women are using the IUD. Other modern methods of contraception account for only a small amount of use among currently married women: pills (2 percent), condoms (6 percent), and injectables and female sterilization (1 and 2 percent, respectively). Thus, the practice of family planning in the Kyrgyz Republic places high reliance on a single method, the IUD. Source of Methods. The vast majority of women obtain their contraceptives through the public sector (97 percent): 35 percent from a government hospital, and 36 percent from a women counseling center. The source of supply of the method depends on the method being used. For example, most women using IUDs obtain them at women counseling centers (42 percent) or hospitals (39 percent). Government pharmacies supply 46 percent of pill users and 75 percent of condom users. Pill users also obtain supplies from women counseling centers or (33 percent). Fertility Preferences. A majority of women in the Kyrgyz Republic (45 percent) indicated that they desire no more children. By age 25-29, 20 percent want no more children, and by age 30-34, nearly half (46 percent) want no more children. Thus, many women come to the preference to stop childbearing at relatively young ages-when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization. However, there is a deficiency of use of this method in the Kyrgyz Republic. In the interests of providing a broad range of safe and effective methods, information about and access to sterilization should be increased so that individual women can make informed decisions about using this method. INDUCED ABORTION Abortion Rates. From the KRDHS data, the total abortion rate (TAR)-the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rates-was calculated. For the Kyrgyz Republic, the TAR for the period from mid-1994 to mid-1997 is 1.6 abortions per woman. The TAR for the Kyrgyz Republic is lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakhstan (1.8), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively), but higher than for Uzbekistan (0.7). The TAR is higher in urban areas (2.1 abortions per woman) than in rural areas (1.3). The TAR in Bishkek City is 2.0 which is two times higher than in other regions of the Kyrgyz Republic. Additionally the TAR is substantially lower among ethnic Kyrgyz women (1.3) than among women of Uzbek and Russian ethnicities (1.9 and 2.2 percent, respectively). INFANT MORTALITY In the KRDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992). Mortality Rates. For the five-year period before the survey (i.e., approximately mid-1992 to mid1997), infant mortality in the Kyrgyz Republic is estimated at 61 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 32 and 30 per 1,000. The MOH publishes infant mortality rates annually but the definition of a live birth used by the MOH differs from that used in the survey. As is the case in most of the republics of the former Soviet Union, a pregnancy that terminates at less than 28 weeks of gestation is considered premature and is classified as a late miscarriage even if signs of life are present at the time of delivery. Thus, some events classified as late miscarriages in the MOH system would be classified as live births and infant deaths according to the definitions used in the KRDHS. Infant mortality rates based on the MOH data for the years 1983 through 1996 show a persistent declining trend throughout the period, starting at about 40 per 1,000 in the early 1980s and declining to 26 per 1,000 in 1996. This time trend is similar to that displayed by the rates estimated from the KRDHS. Thus, the estimates from both the KRDHS and the Ministry document a substantial decline in infant mortality; 25 percent over the period from 1982-87 to 1992-97 according to the KRDHS and 28 percent over the period from 1983-87 to 1993-96 according to the MOH estimates. This is strong evidence of improvements in infant survivorship in recent years in the Kyrgyz Republic. It should be noted that the rates from the survey are much higher than the MOH rates. For example, the KRDHS estimate of 61 per 1,000 for the period 1992-97 is twice the MOH estimate of 29 per 1,000 for 1993-96. Certainly, one factor leading to this difference are the differences in the definitions of a live birth and infant death in the KRDHS survey and in the MOH protocols. A thorough assessment of the difference between the two estimates would need to take into consideration the sampling variability of the survey's estimate. However, given the magnitude of the difference, it is likely that it arises from a combination of definitional and methodological differences between the survey and MOH registration system. MATERNAL AND CHILD HEALTH The Kyrgyz Republic has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women counseling centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout the rural areas. Delivery. Virtually all births in the Kyrgyz Republic (96 percent) are delivered at health facilities: 95 percent in delivery hospitals and another 1 percent in either general hospitals

The survey charted the reproductive health and family formation of women aged 18-44 living in St. Petersburg, Russia. Topics included dating and sexual behaviour, pregnancy and children, health care relating to pregnancies and giving birth, contraception, attitudes towards having children, and health and use of health services. Sexual relationships and sexuality were investigated. The respondents were asked how old they had been when they had started dating for the first time and when they had first had sexual intercourse, how old their partner had been, which contraceptive method they had used when they first had intercourse, how many sexual partners they had had within the previous year and in their life, and how long they had been in their current relationship. In addition, opinions were charted on how satisfied they were with their relationship, whether they had had extramarital sexual activity, when they had last had intercourse, whether they were sexually interested in the same sex, whether they had received money or paid for sex, and whether they had received sexual education. Relating to pregnancies and children, questions were asked about breast-feeding, ages of children, previous pregnancies, who took care of the child while R was at work, and who had taken care of R when they had been under school age. Pregnancy and delivery care was surveyed by asking the respondents what kind of health care institutions they had visited during their latest pregnancy, how many times a midwife had visited them after their last delivery, and whether they had had medical conditions or problems relating to pregnancy. The number of abortions, the reasons for having one, the place where the abortion was induced, and satisfaction with treatment received were queried. Childlessness and infertility experienced by the respondents was studied as well as medical examinations or treatment sought for it. One set of questions probed whether the respondents had had any sexually transmitted diseases and what they would have done if they had found out they had contracted one. Use of contraception was surveyed. The respondents were asked which contraceptive method they had used in their latest intercourse, who had decided on the use of contraception, whether they had used contraceptive pills, and whether they were satisfied with the contraceptive method they were using. Additionally, views were charted on whether the cost had affected the decisions to use contraception, satisfaction with health services related to contraception, reasons for which a woman could refuse sexual intercourse, and the role of men in contraception, childbirth, and abortion. Opinions were investigated on the ideal number of children, ideal age for having children, plans to have children in the future, and reasons for having or not having children. The respondents' chronic illnesses and conditions as well as their quality of life and satisfaction with health was charted. Height and weight were queried. The number of visits to a physician in the previous year and health examinations were surveyed as well as how often the respondents smoked and used alcohol. Finally, the respondents were asked whether they had been victims of threatening behaviour, violence, or sexual violence. The survey is part of the research project "Reproductive Health and Fertility Patterns in Russia - A Comparative Approach (REFER)". The researchers have translated the original Russian data into English. Background variables included the respondent's year of birth, marital status, education, income, nationality and economic activity.