"School age girls come"

How a secret bank of pills against pregnancy was created in Russia

In recent months, the Russian authorities prohibit abortion in paid clinics of different regions and introduce fines for “declining” to them. New restrictions also affected a significant part of the drugs for emergency contraception, which women take immediately after sex at the risk of pregnancy. In response to this, the femoralists created a fund for storing such drugs: they buy tablets to share with those who are required. The “branches” of the Foundation are already in most large cities. "Cold" figured out how it works and who can help.

In order not to miss the main materials of the "cold", subscribe to our Instagram and telegram .

In the early December morning, hiding from snow at the exit of the Airport metro station, 18-year-old Olga ( name changed ) tried to find a curly girl in a gray coat among passers-by.

Olga lives in Solnechnogorsk near Moscow and almost every day comes to Moscow to college, but this morning she shook in a crowded train not because of classes for an hour and a half. Recently she had unprotected sex. In the morning, frightened by an unplanned pregnancy, she went to the pharmacy for an emergency contraceptive - “escapel”, but they refused to sell it without a prescription.

What is this drug

Escapel is one of the drugs for emergency contraception. This is the name of the drugs that prevent pregnancy, delaying ovulation. Such funds are taken after sexual intercourse - for example, if a condom has broken or it was not used. WHO notes that emergency contraception cannot terminate the pregnancy or harm the developing embryo. Therefore, such drugs should be taken no later than 72 hours after sex, before fertilization occurs, otherwise the tablets will be useless . Emergency contraceptive in the first 24 hours is most effective.

Olga was surprised: a year and a half ago, when she first took this drug, he was freely available. She knew that the Escapel should be drunk as soon as possible, and began to be nervous - she was worried about abortion prices. “I realized that I will no longer have time to sign up for a doctor to get a prescription, so I decided to seek help,” Olga recalls.

A few months before, she helped her girlfriend who studies a lawyer with her homework. The topic of work sounded like this: "Overcoming the demographic crisis." From there, Olga learned that Russia's legislative restrictions on abortion were discussing, and decided to read about it in Telegram.

“I subscribed to various news publics and, in search of words, watched that people write about all these restrictions,” says Olga. In one of the channels, she came across posts about the fund of emergency contraception. In early December 2023, when she herself was required, she remembered about him, wrote in a bot, and agreed with her about a meeting.

After 10 minutes of nervous expectation, an unfamiliar girl approached her. "Is that you?" She smiled at Olga, and then handed her a bag. The meeting lasted no more than 20 seconds and from the side resembled a regular deal using Avito. Olga thanked the stranger several times and went home. In the package there was a drug for emergency contraception. Less than 24 hours have passed from the moment of contacting the fund to transfer the pills. Olga describes her condition on this day briefly: "On the verge between anxiety and panic."

"Just complicate life for women"

The idea of ​​an emergency contraceptive fund was born at the end of July 2023 in one of the chats of Russian femo female femo -ghosts, after the Ministry of Health published a draft order in which he proposed to submit to the list of drugs (PKU) the Misoprostol and Mifepriston - these active substances are used for drug termination of pregnancy. Mifepristone in very small dosages (10 milligrams) is in many popular drugs for emergency contraception.

What is emergency contraception

In Russia, emergency contraception drugs are sold based on two active substances - mifepristone and levonorgestrel, explained the pharmacist Vladislav Romanenko. To prevent pregnancy, conventional contraceptives (combined oral contraceptives) with ethinyl estradiol and levonorgestrel, which women take daily, can also be used theoretically - they drink them in an increased dosage for emergency contraception. This method is called the Yuzpe method (in honor of the Canadian doctor Albert Yuzpe).

In addition, an urgent installation of an intrauterine spiral can be used as an emergency contraceptive method. However, both of these methods are associated with great inconvenience. For example, a spiral cannot be installed independently - you need to go to the gynecologist within 120 hours after unprotected intercourse. According to Romanenko, such a method "is suitable for women who already planned to put her [spiral]." And taking the usual contraceptives in increased dosage is less effective than taking pills based on mifepepristone or left -winging, and has more side effects.

“No one uses the Yuzpe method, nor the installation of a spiral now,” the obstetrician-gynecologist Julian Abaev tells the “cold”. - We have “Escapel”, “postinor” (drugs based on the Levonorgestrel. - Approx. “Cold”), there is - or there was, I don’t know what will happen now - “wife with mifepriston. - approx.“ Cold. ”). It is more convenient to drink one tablet than install a spiral or make large dosages of oral contraceptives, then reduce these dosages - here you can get confused. ” According to Abaeva, the main method of emergency contraception is the use of drugs with mifepristone or left -handed, while these drugs are “absolutely equivalent”.

“One of the girls threw the news into the chat, in response to which one of the activists living in Novosibirsk said that she wanted to buy as many emergency contraceptives as possible-while this can be done in Russia at all,” says one of the creators of the project, activist Irina Fainman. - Buy in order to then share them with women who want to warn an undesirable pregnancy. I then thought: after all, such an idea can be realized not only in one city, but throughout the country. ”

Feinman 31 years old. She lives in Petrozavodsk and for the past few years organized events in the local cultural space of Agriculture Club, created in 2015 by a journalist and blogger Natalya Ermolina. “We had an annual AgriFemFest Fedest, there were psychoactivist events and urban , sometimes arranged events related to domestic violence and bullying,” says Faynman. In 2022, on the founder of the project, Natalia Ermolin, a protocol on the “discrediting of the army” was drawn up, and she left Russia. Agriculture Club closed.

Irina Finman remained in Russia and switched to “online activism”: she leads a group on VKontakte dedicated to pregnancy and childbirth in Russia, a telegram channel about the Abuez and mental disorders and is working on scientific materials.

Without waiting for the final decision of the Ministry of Health, Fainman posted a post in social networks that she was collecting funds to buy emergency contraceptives. The publication was shaved by other activists. For three months, it was possible to collect 200 thousand rubles for the project. According to Fainman, people are sacrificed by people “from all over Russia and other countries”, including men. In addition, some women gave their reserves.

The initiative of the Ministry of Health was not supported by a most part of the trade university. As the doctors explained, these prohibitions will lead to an increase in criminal abortions, a surge in medical tourism and a large percentage of children's rejection. The Minister of Health Mikhail Murashko, in response, assured that emergency contraceptives containing mifepriston would not be included in the PKU list - allegedly, only restrictions will concern funds for abortion.

However, in October, the Ministry of Health issued a final order , which touched all the dosages of Mifepristone and Misoprostol. From September 1, 2024, it will be possible to buy funds containing any dose of these substances on recipes on strict reporting forms No. 148-1/U-88-such recipes are required to store three years after the sale of the medicine.

This can lead to the fact that doctors will simply stop prescribing recipes for emergency contraceptives with mifeperiston. “No one needs this, no one will bother,” the obstetrician-gynecologist Julian Abaev explains to the “cold”. - I do not think that in the antenatal clinic, for example, there are such forms [strict reporting]. Gynecologists do not prescribe drugs from this group [from the PKU list] in principle. We have ordinary prescription forms. ”

Even if there is a strict recipe, a drug with mifepristone can only be in pharmacies ready to work with drugs from the PKU list. As experts explained , there are not very many such pharmacies. In addition, toughening the rules will probably force many pharmacies to simply refuse to sell emergency contraceptives with mifeperiston. According to experts, this will lead to the fact that the availability of funds for emergency contraception will decrease in principle, and the price will increase.

“It makes no sense to comment on this nonsense [introducing mifepriston into the PKU list],” says the obstetrician-gynecologist Julian Abaev. - Mifepriston in a small dosage was also used in the treatment of uterine fibroids. To carry out pharmaceuticals, you need 600 milligrams of mifepristone - three tablets of 200 milligrams. And Mifepriston in such a dosage could only be acquired by a medical center or some kind of medical institution that has a pharmaceutical license. That is, no one could just go and buy these three tablets of 200 milligrams just in a pharmacy - not according to the recipe, nothing. They [the Ministry of Health] have nothing to do, they are engaged in some kind of garbage. For many years, we [in the country] have been reduced by the number of abortion, so what they are fighting there, I do not understand. They simply complicate the life of women. ”

As an alternative to the means with Mifepriston, the Ministry of Health proposed emergency contraceptives with the left -winged, combined oral contraceptives and intrauterine spirals. However, both levonorgestrel-based preparations, and combined oral contraceptives are sold in Russian online recipe-albeit strict, written out on a normal recipe form. Such drugs cannot be ordered to house - you can arrange only pickup from the pharmacy. This means that before taking the drug, the girl needs to go to the doctor - and this can not always be done quickly.

At the same time, what rules are guided by offline apects when dispensing emergency contraceptives is not clear. So, according to the interlocutor of “Vistuka”, close to the Moscow Department of Health, in the capital's pharmacies you can’t buy no emergency contraceptives without a prescription - although the pharmacists looked “through their fingers” earlier at the lack of a prescription. According to Juliana Abaeva, for the recipe for emergency contraceptives, the girl turned to her infrequently: “Emergency contraception requires speed. Therefore, the girls themselves bought drugs without coming to us. ”

"There are activists in all millionaire cities"

Having collected money, activists began to distribute it by the regions - the project participants began to purchase emergency contraception funds in local pharmacies. “In the beginning, we did not set the goal of covering specific cities,” Faynman describes the geography of the project. - There was no confidence that there would be many cities at all. As it became clear where activists respond more, where less, I began to write separately in posts that I would like to find a person in the Far East or, for example, in Nizhny Novgorod. Now we have activists in all million-plus cities. Most activists responded in St. Petersburg and Novosibirsk. In Kaliningrad, a lot for a small city. There is a Stavropol Territory, Rostov region is well covered. In the more southern regions - Chechnya, Dagestan - unfortunately, so far no one is. The Far East is smaller than the European part of the country and the Urals. ”

Now 150 volunteers from 75 cities of Russia are involved in the project, Faynman says. According to her, both residents of regional centers and activists from "very small cities, almost with a population of a couple of tens of thousands of people, joined the project.

“I began to write women from the district centers:“ I live in a small city. I don’t know if my proposal will be relevant, but I would like to participate too. ” And why not. In the end, emergency contraception may need someone whom she personally knows, ”explains Faynman. Based on the size of the city and the number of respondent activists, the project participants decided what amount of contraceptives to buy in the field and how much money to send them for their purchase.

The project is expanding with the help of "sundress radio": the new participants will learn about it from the media and from their friends.

“I joined the project when I saw an interview with the founder [Irina Fynman],” says Sofia Rubin, an activist of the fund from St. Petersburg. - I understand that it is highly likely that the officials in our country will move on all the boundaries of violations of human freedoms and will make attempts to dispose of the bodies and fate of women against their will. It would be madness not to have a plan of B. I feel the joy and pride that we have such a project for women that there are people who do not care who are ready to rally and provide each other's support. ”

In offline apels in the regions, according to Finman, emergency contraceptives can still be bought without a prescription: “Somewhere they ask for a recipe, somewhere not. In one city, they can ask in one pharmacy, but they will not ask the neighboring one. ”

Because of this, doctors who were ready to help women with receiving recipes-not strict, but at least ordinary ones also joined the project. “In fact, this is just such a piece of paper with the seal and signature of the doctor,” says Faynman. - It does not need to be taken to the pharmacy, they do not sign it in a pharmacy, it is simply shown by buyers. And now several doctors from different cities who offered their help responded - they say, if there are activists to buy emergency contraceptives and they will not be sold without a prescription, it will be possible to approach them, and they will write out the recipe. ”

"We expect an influx in September"

Activists formulate the goal of the project as follows: to return to women free access to emergency contraception. As experts emphasized , toughening the rules for the sale of drugs with mifeprostone will lead to the fact that in pharmacies it will be possible to buy only contraceptives based on the left -winged. According to Faynman, primarily minors, migrants, refugees and homeless people will suffer from this. Indirect confirmation of this can be, for example, that most often, according to Faynman, to meet with activists, girls of “approximately school age” come for drugs.

As shown by graphs of prices for drugs with a levonorgestrel on Yandex Market, until their value has practically changed. For example, in July, when the Ministry of Health only spoke about the tightening of control over the vacation of drugs based on mifeperiston, the prices of the “postinor” containing the left -winged -hearthstrel began from 510 rubles. Now the prices for the drug start from 580 rubles.

Activists purchase both means with mifepriston and contraceptives based on the levonorgestrel. Project participants are stored at home. “There are no special conditions there,” explains Faynman. - You can keep in an ordinary locker in the room. We try to choose drugs with a shelf life longer. I am leading a single table where I write down in each city, how many emergency contraception packages are, the name of the drugs and their expiration date. ”

One of the activists created a chat boot of the project-for those who are looking for emergency contraceptives. Immediately after activation, this bot asks clarifying questions: how many hours have passed since sexual intercourse, which day of the cycle, how many days the cycle usually lasts and whether it is always regular. This information, according to Fainman, is necessary for activists to choose the right drug.

According to the obstetrician-gynecologist Juliana Abaeva, when selecting emergency contraceptives, “only the hourly interval matters”: “The sooner the patient drinks the tablet, the better. The instructions say that you can drink within 72 hours - but it is quite risky. It is better to do this on the first day. ” However, Abaeva emphasizes that “activists should not deal with these issues [selection of the drug]:“ the doctor should deal with all the appointments of any drugs. ”

Is emergency contraception dangerous?

WHO notes that taking emergency contraceptives can cause side effects: nausea and vomiting, bleeding and fatigue. At the same time, as stated on the portal, they arise infrequently and usually pass without any additional drug treatment.

“We write in the bot and when transmitting the drug we must say that we need to read the instructions to know about possible side effects, about drug compatibility,” says Faynman.

После того как заявка попадает в бот, ее получают Файнман и все активистки города, указанного города. Затем девушки обсуждают, кто сможет передать таблетки, и через бот договариваются о месте встречи. Препарат участницы проекта отдают бесплатно.

Пока активистки передали экстренные контрацептивы только девяти девушкам: «Это именно те, с кем дошло до передачи. ‎Обратившихся было больше — бывало, что человек обращался, а через несколько часов писал, что все-таки получилось самостоятельно купить. Мы ожидаем наплыв тех, кому будет нужна помощь, с сентября 2024 года, когда уже будет строгий учет контрацепции с мифепристоном. Мы хотим к этому моменту подготовиться максимально, обкатать всю систему передачи».

Пока активистки передают препарат из рук в руки, но в дальнейшем хотят «‎делать передачу препарата бесконтактно». «‎Ну, условно, конечно, не совсем так, как закладчики делают, потому что с ними лучше не пересекаться и не заниматься подозрительной деятельностью, чтобы человека [полицейские] задержали, решив, что он наркотики распространяет. Мы будем еще консультироваться по этому поводу», — рассказывает Файнман.

По словам юриста Константина Бойкова, пока активисткам за их деятельность максимум может грозить административная ответственность по статье 14.4.2. КоАП РФ (нарушение законодательства об обращении лекарственных средств), но скоро ситуация может поменяться.

«‎Можно посмотреть по аналогии с другими веществами, которые попадали в список ПКУ, — объясняет Бойков. — Было какое-то вещество, которое продавалось без рецепта — или по рецепту, но в список ПКУ оно включено не было. Потом государство вносило вещество в список — а дальше либо принимало закон, предусматривающий уголовную ответственность за оборот данного вещества, либо нет. Например, оборот этилового спирта, который внесен в список ПКУ, наказывается [по статье 171.3 УК РФ] лишением свободы сроком до трех лет. А есть в этом списке вещества, которые просто убрали из свободного оборота, — но ими не пользуются, допустим, наркозависимые, и уголовная ответственность за оборот таких веществ не предусмотрена».

По словам Бойкова, в случае с экстренными контрацептивами с мифепристоном введение уголовной ответственности за их оборот «‎не будет удивительным»: «‎Я вижу, как все идет, насколько рьяно [власти] взялись за борьбу за рождаемость и как это лоббируют депутаты и православная церковь. Честно говоря, этого следует ожидать». Бойков уверен, что это приведет «‎только к росту подпольных абортов, числа отказов от детей, числа женщин, которые будут делать аборты в других странах и к увеличению числа убийств новорожденных».

«Думают, что мы уничтожаем будущее России»

Сама Файнман не считает средства экстренной контрацепции панацеей. Она не сторонница гормональной контрацепции в принципе. Но ограничения Минздрава она считает «‎абсолютно безнравственными»: «‎Экстренная контрацепция — единственно возможный способ защитить себя от нежелательной беременности в случае сексуализированного насилия или полового акта, происходящего без согласия женщины. What remains? Экстренная контрацепция, аборт или роды. Однако аборт в России тоже не всегда легко сделать».

Например, в родной для Ирины Файнман Курской области четыре из пяти частных клиник, которые имеют лицензию на проведение медикаментозных абортов, в ноябре отказались от этой процедуры. При этом, по словам Файнман, хирургические аборты ни одна из этих клиник не проводит уже давно — то есть если женщина обнаружила беременность на сроке больше 10 недель, ей, чтобы сделать аборт, нужно ехать в Воронеж или Москву или идти в государственную клинику.

«‎Я часто слышу, что в России одно из самых либеральных законодательств в мире в отношении абортов, — говорит Файнман. — Да, де-юре до недавнего времени это было так. Но де-факто это совсем по-другому. Женщину могут отказаться записать на прием к гинекологу, или ее анализы вдруг станут “плохими”, или вообще великий пост наступил и никаких абортов. And what in the end? Рожать нежеланного ребенка тоже не лучший вариант. Поэтому здесь не стоит вопрос о том, чтобы найти наилучший вариант. Здесь мы выбираем меньшее из зол».

С аргументами активисток согласны не все. Против проекта выступили пролайф-активисты — так называют людей, выступающих против абортов. Челябинская пролайф-активистка Мария Мостинец в конце августа написала , что встречалась с вице-губернатором Челябинской области Ириной Гехт. На встрече, по ее словам, также присутствовали «‎два замминистра Минздрава, министр социальных отношений [Ирина Буторина] и начальник управления организации медпомощи детям и матерям при Минздраве [Людмила Подлубная]». На этой встрече пролайф-активистка рассказала чиновникам о фонде экстренной контрацепции: «‎‎Отдельно мной была озвучена проблема по неугомонным бабам, которые прямо сейчас по подложным рецептам собираются массово выкупать препараты для аборта и из них формировать склады в городе для раздачи всем подряд. Пришли к выводу, что за аптеками, в том числе интернет-аптеками, будет осуществляться особый контроль».

По словам Файнман, пролайферы атакуют активисток и в соцсетях. По их мнению, экстренные контрацептивы и препараты для медикаментозного аборта — это одно и то же, раз и там, и там содержится мифепристон.

«‎Они думают, что мы толкаем абортивные средства, что мы уничтожаем будущее России через ее детей. Но это абсурд», — говорит Файнман.