"The birth of unwanted children is the worst thing that can happen to the child and mother." Doctors about the tightening of the turnover of drugs for abortion • The Insider • RIMA — Russian Independent Media Archive
"The birth of unwanted children is the worst thing that can happen to the child and mother." Doctors about the tightening of the turnover of drugs for abortion
"The birth of unwanted children is the worst thing that can happen to the child and mother." Doctors about the tightening of the turnover of drugs for abortion
The Ministry of Health tightened the turnover of drugs for termination of pregnancy. This issue has been discussed throughout 2023. Against the background of news about future prohibitions of the sale of abortive tablets in Russia, they have grown significantly. Obstetrician-gynecologists consider the measure to be wrong and harmful to patients. The inability to make a drug abortion at an early date will lead to a greater number of surgery, which can lead to severe consequences for the female body. According to doctors, if the state in this way wants to reduce the number of abortion, sexual education in schools and stories about effective methods of contraception would help more.
The published order of the department refers to the list of two drugs-Misoprostol and Mifeopristone in the list of subject-quality accounting. This combination is used mainly for termination of pregnancy, but in small dosages, mifepristone is also used for emergency contraception (for example, in the preparation "Wousel"). The sale of drugs with a high dosage, with the help of which it is possible to terminate pregnancy, even according to the prescription, is impossible - such tablets can be issued only by a doctor in the medical institution with subsequent observation of the patient.
The obstetrician-gynecologist Julianna Abaeva recalled that since 2012 new requirements for abortion have been in force in Russia. Now abortion on the day of circulation is considered illegal. Abortion is possible no earlier than after two days after the woman’s appeal in terms of 4 to 7 weeks and from 11 to 12 weeks, and no earlier than in a week ( “Week of silence” ) with a pregnancy period of 8-10 weeks. “Such requirements were introduced so that a woman could make a voluntary and deliberate decision on termination of pregnancy,” the doctor explains.
Medication of pregnancy has been practiced in the Russian Federation for more than 20 years. Pharmacobut can be carried out up to 63 days of amenorrhea, that is, up to 6-7 weeks of pregnancy. The smaller the size of the fetal egg, the more effective the abortion will be. According to Abaeva, in the municipal medical institution, all these principles are more difficult to withstand, since for this you need to make an appointment, take tests, get results and make an ultrasound. In addition, drug abortion is not included in the compulsory medical insurance system. “And given the current situation and priority expenses, not on the social sphere and health care, it is unlikely that the inclusion of pharmaceuticals in the compulsory medical insurance can be expected,” the specialist notes.
“I myself am against any abortion, but of two evils, drug abortion is smaller. It does not require surgical intervention, does not injure the mucous membrane of the uterus, and psychologically easier to transfer. Never in the Russian Federation, pharmaceutical preparations have been available for sale in a pharmacy, even according to the prescription. These drugs could only receive clinics that had a license to carry out pharmacobe, ”says Abaeva.
At the same time, Abaeva does not exclude that in the future in Russia a ban on effective contraception, including emergency, is possible. “It must be borne in mind that all these drugs are imported. I hope that it will not reach this, ”she said.
Obstetrician-gynecologist Anna Barkovskaya believes that a reduction in the turnover of drugs for drug abortion is an unreasonable measure that will lead to an increase in surgical abortion, which is even more traumatic for the body and can entail severe consequences:
“It is reasonable, on the contrary, to increase the circulation of these drugs, because it is both an economically verified model and a safer, sparing method of termination of pregnancy. We must also not forget about the group of women who are faced with a frozen pregnancy, that is, we are not always talking about drug abortion at will.
The reduction in the turnover of these drugs will most likely lead to the fact that the number of surgical interventions will increase, which is more traumatic, leads to adverse consequences and, moreover, is very expensive. If we transfer all this load on the compulsory medical insurance, it will be much more expensive than a drug termination of pregnancy. ”
Barkovskaya notes that it is better to achieve an abortion number of abortion and stories about effective methods of contraception. Also, in her opinion, an increase in the state support of pregnant women would help:
“We need to start with sex education in schools. Now it looks something like this-some incomprehensible gynecologist comes to 16-year-old teenagers, holds a meeting with girls, says something about menstruation and condoms. No one is listening and everything will be made, because at the age of 16 this is already late. It is better to conduct such lessons with charismatic speakers who know their job and burn it. They underwent additional training for the lecturer whom they will listen, and not just on a doctor who does not need all this in FIG. And they need to be invited to 10-12 years old, when for the first time in life, menstruation has for the first time in her life, because it is from this moment that she can become a mother. It is possible that it is during this period that she first thinks about making contact with the opposite sex and during this period it is necessary to tell her about contraception.
Our adult women know little about it, they are afraid of hormones. I have patients who say: “I want to defend myself only by condoms. I am uncomfortable, but I'm afraid to switch to pills because they are more unreliable.” Perle's index laughs at you. The tablets have a much lower perl index than condoms. From the point of view of protection from pregnancy, condoms are so -so a method, and girls often learn about this only at 25-30 years old. In this regard, it is necessary to promote precisely evidence using statistics. ”
Barkovskaya also draws attention to two opposite positions of the Ministry of Health. On the one hand, the authorities want to remove abortions from the assistance system in private clinics, and on the other hand, they want to remove them from the compulsory medical insurance system. The doctor admits that it is difficult to regulate the work of private clinics, in particular, they do not observe the “week of silence”.
“The clinic wants to earn and be patient -oriented, but in this matter, patient -orientation is to not only provide a service, but give a woman what she wants. Namely: truthful information about what will happen to it and what will be the consequences, as well as what abortion options are, whether it needs to be interrupted, what conditions will be for this, and so on. And these days of silence, which are laid by law, is a wonderful measure, because such an important solution should be balanced and thought out a thousand times. On the one hand, this brings additional suffering to women and I just want to get rid of an unwanted pregnancy. On the other hand, this is a really important issue that needs to be solved with a cold head, having slept with this thought several times and talking with a normal psychologist. ”
In addition, it resembles Barkovskaya, termination of pregnancy sometimes occurs according to medical reasons, for example, with a frozen pregnancy - this is approximately 15% of cases. “Carrying out abortions by a compulsory medical insurance system is a separate cring variety,” she notes. “But if you make these interruptions optimal in cost, this is not such a large load.”
“Departure from compulsory medical insurance in this matter will hit the most unprotected groups - students, adolescents, poor. Why is this necessary? The birth of unwanted children is the worst thing that can happen to both the child and with the mother. You have a welcome of your feelings for many years, but with unwanted ... It will not bring happiness to either mom or the child, ”the doctor explains.
According to Barkovskaya, drugs for termination of pregnancy have one big drawback: according to Russian law, they can only be taken until the 42nd day, although all over the world these drugs can be used up to almost 12 weeks. “This is much more reasonable and appropriate, because 42 days are very few. There are women who have an irregular cycle in principle, and they have an amenorrhea of 42 days without pregnancy. In the place of our government, I would be puzzled by this and would engage in the wider distribution of these drugs and the regulation of this problem. It would be great if someone had solved this problem once, ”she says.
Pyrlya index (pele index), failure coefficient - an index showing the effectiveness of the chosen method of contraception. The lower this indicator, the more reliable the method of contraception. The Perl index is named after the American biologist Reimond Perl (1879-1940).
It is believed that the “Week of Silence” provides a woman with the opportunity to think well and make a decision.
