Medical professionals engaging with women seeking abortion must refrain from intimidation, rudeness, or pressure. Instead, they are instructed to assist patients in making an `informed choice` by using specifically designed phrases aimed at fostering a `positive attitude` towards continuing the pregnancy. For instance, expressions such as «At your age, it`s time to be raising grandchildren, not having children» or «You are doing a bad thing» are explicitly prohibited. Conversely, if a woman decides to carry the pregnancy to term, she should be commended. These guidelines are part of new recommendations issued by the Ministry of Health for medical facilities.
These methodological guidelines, designed for counseling women facing a `reproductive choice,` were developed by the Ministry of Health at the President`s directive, following a meeting on increasing birth rates held on March 1, 2023. The document aims to standardize the work of obstetrician-gynecologists, paramedics, and psychologists with patients considering termination of pregnancy. The Ministry of Health clarified that the recommendations consolidate and systematize existing approaches to interacting with such patients.
From the moment a woman first contacts a medical facility, a `week of silence` begins — a period intended for making an informed decision. During this week, motivational and psychological counseling is provided, and available social and legal support measures for pregnant women are explained. Any form of pressure on the patient is strictly prohibited. Specialists should focus on informing women about their rights, taking into account each woman`s individual circumstances, such as lack of housing or unstable relationships with the child`s father.
During consultations, specific verbal modules are prescribed for use, aimed at fostering a positive mindset towards continuing the pregnancy.
Medical professionals are advised to initiate contact with women using the phrase: «Pregnancy is a wonderful and natural state for every woman. Experiencing doubt, fear, and anxiety in such a situation is completely normal.»
If a woman prioritizes career or education, the medical professional should respond: «A career can be built at any age, but the opportunity to have a child might become limited over time. Pregnancy is a crucial and natural stage in every woman`s development and life.»
If a patient is young (no specific age is mentioned) and states a desire to `live for herself,` she should be reminded that «young mothers generally recover more easily and quickly after childbirth, allowing them to return to their other plans and tasks sooner.»
At the end of the consultation, if the woman decides to keep the baby, the specialist is required to commend her for this `correct` choice.
However, if the patient still intends to proceed with an abortion, it is recommended to say: «Think it over again, don`t rush. I will refer you to a psychologist; discuss all your concerns with them, and then I will expect to see you again.»
Doctors are also instructed to inform women about the potential negative consequences of abortion, including the risk of infertility.
During conversations with patients, rudeness, intimidation, and insensitive remarks are unacceptable, for example, «At your age, it`s time to be raising grandchildren, not having children» or «You are doing a bad thing.»
In late 2024, President Vladimir Putin emphasized that governors must constantly focus on demographic issues. As a result, many regions have undertaken various initiatives to reduce the number of abortions. Most constituent entities of the federation are using approaches developed by the Ministry of Health. In some regions, even prayer services against abortions are held, and fines are introduced for individuals who attempt to persuade women to undergo an abortion.
The measures being implemented appear to be effective: by the end of 2024, the proportion of Russian women who, after seeking abortion services, ultimately decided against termination, increased to nearly 25%.
These figures were previously cited by Deputy Prime Minister Tatyana Golikova.
Alexey Chernikov, an obstetrician-gynecologist and chief physician at the `K Meditsina` clinic, emphasizes the significance of the initiatives proposed by the Ministry of Health. He notes that by introducing these recommendations, the ministry is not resorting to prohibitions but rather fostering a conscious approach. «The manner of information delivery is just as crucial as the information itself,» asserts Mr. Chernikov. He urges colleagues «to always put themselves in the patient`s shoes and act as they would wish to be treated. This will help avoid careless phrases, reproaches, and judgmental actions.»
Victoria Shustova, an obstetrician-gynecologist and reproductologist, believes that the proposed verbal modules will be a valuable support for doctors, especially young specialists. In her opinion, clearly formulated communication standards and the involvement of related specialists contribute to more accurate, respectful, and safe counseling for women. However, Shustova emphasizes that the medical professional`s goal should not be to «persuade» the patient against abortion. «The doctor`s role is to conduct examinations, make a diagnosis, explain the medical aspects of the issue, and support the woman regardless of her final decision,» explains Ms. Shustova. «The clearer the roles of all participants in the process—doctor, psychologist, social worker—the higher the quality and ethical standard of the assistance provided.»
How the Ministry of Health Recommends Communicating with Women Making Reproductive Choices
Examples of phrases for various reasons for pregnancy termination:
Young age for childbirth, desire to live for oneself, unpreparedness for motherhood:
«Pregnancy is a crucial and natural stage in every woman`s life. Sometimes it happens unexpectedly, catching one off guard, forcing a change of plans. But in return, a child provides an additional source of strength and self-belief. From the perspective of maternal and child health, youth is objectively the most favorable age for childbirth. Young age is a big advantage for you. Young mothers recover more easily and quickly after childbirth and return to addressing their other tasks. Children born to young parents are close to them, as they are almost from the same generation. Among successful people, there are many young parents who harmoniously balance their time and parental care resources.»
Presence of illnesses, fear of having a sick child:
«You can register for pregnancy care at a women`s clinic now, and from an early stage, professional medical monitoring and support will be provided for your health and your child`s health. You will receive timely medical assistance at any stage. You have the right to choose your doctor, women`s clinic, and maternity hospital. The modern level of medicine allows for early detection of pathological conditions in the child during pregnancy and treatment of many diseases identified in utero.»
Poor relationship with the child`s father:
«Do you need help communicating this news to the child`s father? For a man, the news of pregnancy can also come as a surprise. He needs time to get used to the idea of having a child. This pregnancy has already begun. It`s important to understand that deciding not to have the child can have severe and destructive psychological consequences for you and your relationships. If you want to save your child`s life, become a mother, and find family happiness, no one has the right to prevent you. If you need help/support for interacting with close relatives, please contact a support hotline. Our specialists will help you build an individual support plan for your current life situation.»
Priority of education and career:
«A career can be pursued at any age, but the opportunity to have a child might be limited later on. Pregnancy is a crucial and natural stage in every woman`s development and life. You can do everything in parallel: look at how many strong and successful women had children early, and it didn`t hinder their careers.»
Phrases for everyone regardless of the reason for pregnancy termination:
- Every pregnancy termination is detrimental to health and carries a risk of complications. Abortion is a frequent cause of infertility and miscarriage in the future;
- By postponing childbirth today, you might face difficulties conceiving in the future, as reproductive potential inevitably declines with age, pregnancy proceeds with more difficulty, and there is a risk of complications for both the mother and the child;
- The prevalence of infertility continues to rise. Sometimes even IVF does not help women in older reproductive age become mothers;
- The risk of giving birth to a child with pathology increases with age.
Phrases at the end of the consultation if the woman decides to keep the baby:
- «You have made the right decision.»
Phrases at the end of the consultation if the woman has not yet changed her decision:
- «Think it over, don`t rush. I will refer you to a psychologist; discuss all your concerns with them, and then I will expect to see you again.»
Examples of unacceptable dialogue with a pregnant woman (stop-words):
- «Will you keep or terminate the pregnancy?»
- «Will you give birth or not?»
Avoid such phrases as:
- «You are acting incorrectly;»
- «You are doing a bad thing;»
- «At your age, it`s time to be raising grandchildren, not having children.»
