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Russian doctors have been recruited to dissuade underage girls from terminating unwanted pregnancies

Татьяна Калинина, фем-активистка, основательница лесбийского сообщества Cheers Queers

A woman pushes her baby past pro-Kremlin street art in the Moscow region town of Pavlovsky Posad, Russia, 14 March 2025. Photo: EPA / MAXIM SHIPENKOV

Every year, thousands of teenagers in Russia get pregnant. According to research by To Be Precise, an open data platform that investigates social problems in Russia’s regions, around 11,000 girls under 18 become mothers each year, while approximately another 3,000 terminate their pregnancies. Though doctors and educators view these figures as a cause for concern, the state has begun to view them as quotas to be fulfilled.

In the central Russian regions of Kaluga and Oryol, the regional authorities have introduced official “plans” for the number of schoolgirls that are expected to give birth. Indeed, in the coming years, the state is counting on dozens of underage girls to have babies to stem Russia’s already serious depopulation, even offering teenage mothers cash incentives to do so.

Novaya Gazeta Europe has spoken to a number of women’s rights advocates and reproductive health specialists around the country to learn more about the challenges faced by pregnant schoolgirls in Russia, including the impact motherhood has on their wellbeing at such a young age, and how the taboos around contraception and pregnancy continue to shape their lives both at home and at school.

Couples kiss in Moscow on St. Valentine’s Day, 1998. Photo: Yury Kochetkov / EPA

Alone, together

According to figures provided by To Be Precise, the highest proportion of underage pregnancies can be seen in girls aged 16–17, though significant numbers get pregnant at 14–15. In 2023, there were 37 documented cases of girls aged 12–13 getting pregnant as well. 

According to data provided by Rosstat, Russia’s federal statistics service, while 97% of abortions carried out in 2023 were performed on women aged 18–45, some 1% of procedures were given to girls under 18. While that proportion is relatively small, it still represented 3,346 abortions in 2023.

Early pregnancy carries serious health risks, with women giving birth between the ages of 15 and 19 facing higher chances of complications, including eclampsia (the onset of seizures in a pregnant woman with the hypertensive disorder pre-eclampsia), infection and post-natal depression.

A third of Russian teenagers are ignorant of the basic facts of life, let alone the differences between various methods of contraception.

While the environmental and social factors leading to high rates of teen pregnancy are complex, the majority of teenage mothers in Russia come from deprived regions with low living standards. Despite the fact that, according to expert estimates, over half of Russian teenagers want to learn about contraceptive methods, sex education remains virtually non-existent in Russian schools. 

“Nobody speaks to children, not about periods, not about sex,” according to human rights activist Sofia Volkova, who told Novaya Gazeta Europe that one 13-year-old schoolgirl she had interviewed told her that she has first learned about menstruation from her aunt because she found it “impossible to talk about such things” with her own mother. The lack of sex education in Russian schools in general means that over a third of teenagers are ignorant of the basic facts of life, let alone the differences between various methods of contraception.

The WANEXPO festival for pregnant women and babies, Moscow, 2 June 2023. Photo: Alexander Avilov / Moskva photo agency

Gynaecologist Olga Baranova, who specialises in teenage reproductive health, says that though just three years ago she was seeing 200–250 pregnant minors on average each year, “by 2024 that number had risen to over 400”, though “only one in 10 carries the pregnancy to term, and usually not because she wants to, but because her parents insist: ‘Have the baby, we’ll help,’ or because her boyfriend puts pressure on her to keep it.”

According to Baranova, many pregnant schoolgirls in Russia attempt to disguise their pregnancies for as long as possible, and, in some cases, turn to medical professionals so late that an abortion is no longer possible. “It’s incredibly hard for them, both mentally and physically. They don’t want the baby, but in practice they have no other choice,” she says.

Teenage pregnancies in Russia often become traumatic experiences in which decisions are taken by everybody involved except the girl herself.

Faina Petrova, an activist from the banned Feminist Anti-War Resistance, adds that Russian teenagers are often reluctant to trust doctors. “They know that whatever they tell a doctor, their parents will find out. So they tend to stay silent and seek out information online instead.”

Another activist, Anastasia Kulikova, describes the challenges pregnant young women face similarly, noting that many simply have no idea to whom they should turn for advice, leaving them “alone with their fear, pressure from their family and the academic expectations of school”. In the end, teenage pregnancies in Russia often become traumatic experiences in which decisions are taken by everybody involved except the girl herself.

A baby crawls behind its mother as she watches Vladimir Putin take questions during his annual call-in show, in Moscow, 14 April 2016. Photo: EPA / SERGEI ILNITSKY

The illusion of choice

From the age of 15, teenagers in Russia have similar legal rights to medical care as adults, and are considered capable of giving informed consent to medical procedures, including abortions.

According to Russia’s Health Ministry, any girl aged 15 and over can decide to terminate a pregnancy without first obtaining parental consent. Indeed, medical facilities denying a girl aged 15 or over access to an abortion are acting unlawfully.

Clinics are required to disclose a girl’s medical history to her parents or legal guardians if they request it.

As Volkova notes, “objectively, the legislation in this area is fairly liberal”. However, the state has attempted to tighten the rules in recent years, with Deputy Prime Minister Tatyana Golikova instructing the Health Ministry to consider banning abortions for 15–17-year-olds who do not have parental consent for the procedure. However, no such amendments have been adopted to date.

At the same time, doctor–patient confidentiality for minors over 15 was abolished in Russia in 2020, meaning that clinics are required to disclose a girl’s medical history to her parents or legal guardians if they request it. As Petrova puts it, “teenagers have no real right to privacy.”

“On paper, a 15-year-old has the right to an abortion without parental consent. But in practice, parents will still find out if they ask for the records. For teenagers, that’s an enormous barrier and many are simply too afraid to go to a clinic.”

‘A lesser evil’

Emergency contraception such as the morning after pill is, of course, an effective solution in cases of unwanted teenage pregnancies. However, though a prescription hasn’t been required for the morning after pill since 2023, it’s in short supply in Russian pharmacies due to international sanctions.

Kulikova, a feminist activist focused on women’s reproductive rights, explains that “a teenager can technically walk into a pharmacy and buy the pill, the law doesn’t forbid it. In practice, however, many pharmacies will require a passport or simply refuse the sale.”

Most Russian teenagers are either unaware of emergency contraception or are too embarrassed to buy it.

Volunteers in various cities across Russia are working to ensure as many girls as possible can access the morning after pill anonymously and free of charge, Kulikova says, adding that they are not doing anything illegal as the medication is legal. Indeed, without their support, many teenagers would be left with no option other than to carry an unwanted pregnancy to term, Kulikova says, explaining that the approximately €10 pill would quite simply be too expensive for many young women.

Most Russian teenagers are either unaware of emergency contraception or are too embarrassed to buy it, Kulikova says, calling the morning after pill a “lesser evil”, as its potential side effects are typically limited to nausea and menstrual irregularities.

Kulikova also stresses the serious physical and psychological risks pregnancy carries for girls aged 16 and under. “Compared to what childbirth or an abortion at this age can do, especially with all the psychological consequences, emergency contraception is by far the safest option,” Kulikova insists.

The Moniiag medical centre in Moscow, 6 December 2019. Photo: Sofia Sandurskaya / Moskva photo agency

Statistical motherhood

In June 2023, Russia’s Health Ministry sent doctors a letter providing them with “scripted guidance" for consulting women who have decided to terminate a pregnancy. The document includes sections on “handling objections”. 

For instance, if a teenager is considering an abortion because of her “young age, desire to live without having to take care of a baby, or unreadiness for motherhood”, doctors are instructed to respond with arguments such as: “pregnancy is one of the most important and natural stages in a woman’s life.”

This guidance includes a list of promised social benefits for young mothers including “free meals and transport for schoolchildren, priority admission to kindergartens, loans at preferential rates and tax breaks,” all of which are presented as arguments for early motherhood.

It is now state policy that doctors are “expected to dissuade girls from having abortions”.

Baranova confirms that it is now state policy that doctors are “expected to dissuade girls from having abortions”. In addition, Petrova notes that doctors are supposed to take special “pre-abortion counselling” courses, where they are trained in psychological techniques to persuade young women to keep unwanted children. 

“They are told that the Virgin Mary became a mother at 15 and that she was the best mother there’s ever been. A doctor’s role is no longer to discuss the girl’s choice with her, but to persuade her to keep her baby at all costs.”

These “scripted guidance” manuals for doctors have already been distributed nationwide, according to an investigation by independent media outlet Verstka, which is to say that discouraging teenagers from having abortions is now state policy. Doctors are expected to make the specious arguments that “youth is an advantage”, “young mothers recover more quickly after childbirth” and that “children born to young parents are closer to them in spirit”.

A baby born at the Moniiag medical centre in Moscow, 6 December 2019. Photo: Sofia Sandurskaya / Moskva photo agency

Cash rewards are widely used as another lever of influence, and doctors in various regions of Russia now receive direct payments from the state for their role in so-called “salvaged pregnancies”. In the Arctic Komi Republic, for example, doctors are paid 5,000 roubles (€52) per case, while in the northwestern Vologda region, doctors receive a bonus payment of up to 25,000 (€261) once the child is born, as well as a one-off payment for talking a young woman out of a termination. 

In recent years, Russian demographic policy has extended into the nation’s classrooms. For example, in August, the authorities in the central Kaluga region officially approved a “plan for pregnant schoolgirls”, offering 100,000 rubles (€1,045) to each minor who carried her pregnancy to term. According to media outlet 7×7, state support for teenage pregnancies also exists in some 40 Russian regions.

A teenage girl facing an unwanted pregnancy is placed in a situation where she effectively has no choice.

The authorities in the central Oryol region have even calculated how many underage mothers it expects to give birth in the coming years, with 150 schoolgirls expected to give birth in 2025, 160 in 2026, and 180 in 2027. 

“This is not just demographic policy, it’s a way of putting pressure on the most vulnerable,” says Petrova, who explains that a teenage girl facing an unwanted pregnancy is placed in a situation where she effectively has no choice: her family and doctors urge her to give birth, her school promotes large families, and the state promises her financial incentives.

As Volkova puts it, “instead of supporting the teenager in her decision, the system uses her body as a resource for its own statistics.”

All names have been changed.