In 2020, the number of official abortions in Kyrgyzstan declined by 26 per cent as compared to previous years. According to experts, this is related to the restrictions imposed due to the coronavirus pandemic.
Starting in 2015, the number of artificially terminated pregnancies in Kyrgyzstan was within 20 thousand cases per year, according to the health ministry. However, in 2020, their number declined by one-fourth. It happened because of the lockdown announced due to the coronavirus pandemic and restrictions on travel.
In 2015, Kyrgyzstan adopted the law on reproductive rights of citizens and guarantees of their enforcement. It enables the Kyrgyzstanis to choose the number of children, when and how they want to become parents, and also ensures the right of women to abortion.
According to the law, the artificial termination of pregnancy may be performed up to 12 weeks of pregnancy at the woman’s discretion. The pregnancy may be terminated up to 22 weeks based on social indications, and at any gestational age on medical indications.
Baktygul Bozgorpoeva, expert in reproductive health, said that access to reproductive health services was restricted by more than 70 per cent during the lockdown. Some women could not get an abortion on time and they had to give birth.
“Before the pandemic, a survey was held, which said that state facilities performed one thousand abortions per year. However, this number decreased to 20-25 per cent during the lockdown. However, in private clinics, the number of such services increased by 80 per cent,” she said.
However, the official abortion statistics do not show the picture. According to Raisa Asylbasheva, chief specialist of the office for medical assistance organisation and drug policy of the health ministry, both state hospitals and private clinics must submit reports on the number of artificially terminated pregnancies. In fact, it does not always happen.
According to Baktygul Bozgorpoeva, doctors perform illegal abortions because of low salaries.
“If 10 abortions are performed daily, only 2-3 cases are reported. Payment for the rest goes unreported. The reports submitted by private clinics are inaccurate, as well. They have to pay taxes for every abortion, so they do not report some abortions,” the expert said.
World Health Organisation claims that abortions are safe if they are carried out by skilled providers or when they are carried out with a method that is recommended by WHO and that is appropriate to the pregnancy duration. However, according to the health ministry of Kyrgyzstan, many women have an abortion from pharmacists, ultrasonographers and vendors. And such cases go unreported, too. The number of such cases is estimated within 400-600 cases a year.
“Many women and girls do not want their friends to know about their pregnancy and they go to the people who do not even have specialised education. Sometimes, a girl terminates pregnancy at home by means of pills or other medications. Or doctors tell or advise how to perform an abortion by phone. 3-4 women die every year from illegal abortions,” Bozgorpoeva said.
According to WHO, 4.7 to 13.2 per cent of annual cases of maternal mortality in the world can be related to unsafe abortions.
Abortions vs. contraception
Aigul Ibragimova (not her real name) is 42 years old and she has had eight abortions. She got married when she was 19, but her family life turned out to be not what she imagined it to be. Misunderstanding by her husband and his relatives led to quarrels and conflicts. The woman hoped that their life would improve after she gives birth to their first baby, but nothing changed.
When their first child was two years old, Aigul had her first unplanned abortion under constraint of husband’s relatives and the husband. Afterwards, she had more abortions. Her mother-in-law was a gynaecologist and terminated pregnancies of her daughter-in-law. She was never registered with the official statistics.
According to Baktygul Bozgorpoeva, many families encounter unplanned pregnancies that end in abortion. The most frequent reason is the low income and inability to take care of children. Few families use contraceptives.
According to Aigul Ibraimova, they did not use contraceptives with husband because he used to be drunk and did not want to use condoms. Oral contraceptives had a bad impact on her health, and she could not use the IUD because of heavy menstrual bleeding.
According to obstetrician-gynaecologist of the Alliance for Reproductive Health public association, Yelizaveta Kan, not all doctors work to prevent repeated cases of unplanned pregnancy and select reliable types of contraceptives for their patients.
“The country lacks various contraceptives. Currently, as far as I know, the country has only pills as hormonal contraceptives. In the past, we used to have IUDs, as well. Also, we have condoms imported from various countries. They have different quality and different prices. That is all we have. Other countries have a wider selection of contraceptives,” the specialist said.
According to her, many couples who turn to specialists for termination of pregnancy do not use condoms. Or they think that abortion means contraception. According to doctors, every time a woman has an abortion, it affects her health because her endocrine profile suffers.
“We try to train many specialists, namely obstetrician-gynaecologists, so that they follow up the termination of pregnancy and deal with the consequences of incorrect methods of contraception. If the woman fails to practise safe sex at a later stage, we must understand that she would again have an abortion in two or three months,” said Yelizaveta Kan.
She added that if we compare young people today and of the last century, now young people can get information on the internet. It is not always reliable, but it is available to them.
Sex education under a ban
In Kyrgyzstan, just like throughout Central Asia, the topic of sex education in the family is a taboo subject or undesirable issue. However, experts think that sex education must go along with social processes that involve children and adolescents. First, this is the prevention of violence.
“We just need to see at what age we should place more emphasis on that. Maybe we should start talking about it using simple phrases at an early age. For example, we can say that mother and father loved each other and that’s why you were born. At an early age, we should not go into details. Afterwards, we should add information to the existing knowledge, depending on the age,” said obstetrician-gynaecologist Yelizaveta Kan.
The lack of this knowledge often leads to the fact that people are not always aware of the methods of contraception and do not undergo regular check-ups. As a result we have unwanted pregnancies, infection with HIV and sexually transmitted infections.
“As a specialist, I can say that one time sex is enough for pregnancy. Among our [patients], there were many patients who did not even think about it or did not get any knowledge about it. Therefore, we always say that we need to educate and provide more information,” the expert added.
Main photo: birthchoice.net
This article was prepared as part of the Giving Voice, Driving Change – from the Borderland to the Steppes Project.
This publication was produced as part of the mentorship programme under the Development of New Media and Digital Journalism in Central Asia project delivered by the Institute for War and Peace Reporting (IWPR) with support from the UK Government. It does not necessarily reflect the official views of IWPR or the UK Government