In Soviet Russia, abortion was the only reliable method of fertility control. Women had multiple abortions because they needed to work under state socialism, which provided legal abortion but no modern contraceptives. Andrej Popov, the leading researcher of abortion in Russia in the 1980s and early 1990s, referred to this situation as “abortion culture” (107–8). In his view, the Soviet state normalized this culture, and it was harmful because it nurtured uncaring relationships between men and women as well as distrust among citizens, experts, and the state. Unmaking Russia’s Abortion Culture analyzes the efforts of Popov and other Soviet/Russian experts to introduce modern contraceptives to end abortion culture.
Historiographically, this book fills in a lacuna in the study of family planning in Russia. Historians have documented Soviet medical experts’ failed attempts to introduce modern contraception through the mid-1970s. Political scientists researched the period of the early 1990s when the family planning project became a part of the presidential program under the Boris Elʹtsin government. How to connect these two periods was previously not clear. The particular point of interest was whether the Russian family planning program came primarily from the west. This book convincingly demonstrates that it originated in Soviet Russia. Also, not surprisingly, the ideas that drove the development of Soviet family planning looked significantly different from western feminist ideas of women’s rights. Throughout the book, Michele Rivkin-Fish skillfully and effectively explicates these differences by comparing Russia and the west.
Rivkin-Fish is uniquely positioned to do this study because of her personal acquaintance with Popov. In 1991, he arrived at Princeton’s Office of Population Studies from Moscow to begin a postdoctoral fellowship. They met soon after Rivkin-Fish’s arrival as a PhD student in Anthropology, with Popov telling her in person about his views on abortion culture. Later, Popov introduced her to his Russian colleagues and friends, including the famous sexologist Igor Kon and prominent demographers Anatolii Vishnevskii and Sergei Zakharov. On the American side, she met the distinguished abortion researcher and women’s rights advocate, Henry David, who had brought Popov to Princeton and supported Popov’s successful grant application to the MacArthur Foundation. In 1994, the grant helped Popov establish a Moscow branch of David’s research institute to study contraceptive practice in Russia. This special network provided Rivkin-Fish with rare access to the world of liberal experts. Her detailed description of the formation of this network provides a rich ethnographic study of the fruitful intellectual exchanges between Russian and American experts in the early 1990s.
The first of the six book chapters analyzes the formation of Soviet abortion culture after the 1955 re-legalization of abortion. The main sources are two memoirs and five non-fiction accounts by female authors. They depict Soviet women’s dilemma of being expected to regulate their reproduction without ever being taught how to avoid pregnancies. Abortion was available, but often without anesthesia. Women tolerated both extreme pain and the uncaring attitudes of the medical personnel. Rivkin-Fish argues that Soviet women resented abortion because they saw it not as a liberating choice, but as a painful and dehumanizing necessity imposed on them by a state that failed to provide sufficient support for women to raise children. They also found their male partners uncaring when they allowed repeated unwanted pregnancies.
Chapter 2 examines the period between the 1955 re-legalization of abortion and Mikhail Gorbachev’s glasnost in the mid-1980s, when Soviet health experts came to a consensus on the benefits of contraceptives for reducing abortions. The majority of experts focused on fighting abortion by “enlightening” women about abortion’s harm and dissuading them from undertaking abortions.
This consensus took bureaucratic form in 1970 when the Health Ministry recommended the production and promotion of intra-uterine devices and hormonal contraception. This is a previously little-known, but interesting fact. However, the background story to the Ministry’s issuance of the 1974 practical ban on hormonal contraceptives, suddenly reversing the 1970 recommendation, is not yet clear.
Chapter 3 discusses the development of the ideas of liberal family planning experts, with particular attention to Popov. Inspired by his dissertation advisor, the medical demographer Mikhail Bednyi, Popov moved the expert discussions of fertility control away from how to dissuade women from undertaking abortions. Instead, Popov identified the key problems to be men’s lack of caring for women and the lack of safe, reliable, and convenient methods of fertility control that could enhance mutual pleasure. In 1990, Popov published a pamphlet, providing scientific facts and friendly advice with humorous illustrations. By rejecting the typical pedantic tone and pronatalist calls of most Soviet experts, Popov aimed to establish trusting relations with his readers. Rivkin-Fish called Popov’s approach “liberal humanism” (132). Yet, notably, this liberalism lacked the idea of women’s individual rights or empowerment.
Chapter 4 covers the organization of Russia’s family planning that began in the period of glasnost. Experts called for the end of the ban on oral contraception and the introduction of family planning. This led to the establishment by Soviet health experts of the first association for promoting contraceptives in 1989 and then the Russian Association of Family Planning (RAFP) in 1992. Right before the collapse of the Soviet Union, the Russian Health Ministry established the first nation-wide system of family planning centers in Russia.
This became the basis for the organization of the family planning program under the Elʹtsin government. Global organizations and pharmaceutical companies provided support. The experts and civil organizations welcomed them, but they typically did not share the western idea of women’s individual reproductive freedom. While western experts advocated for legal abortion, Russians held opposite, anti-abortion views as their goal was to obviate abortions by promoting family planning. Also, most Russian experts argued that family planning strengthened Russia’s fertility in order to counter the emerging conservative criticism that family planning was helping diminish the Russian nation.
Popov died tragically in an accident in 1995, but other liberal experts continued the effort to reduce abortions and reform the doctor-patient relationship. Chapter 5 features Viktor Samokhvalov, a psychotherapist at Yuventa, a St. Petersburg clinic providing patient-centered care and sex education for young girls, and Liubov Erofeeva, gynecologist and the second director of RAFP, who studied family planning in a London clinic with the support of the Dutch pharmaceutical company Organon. She learned from western practice about the benefits of centering patients’ rights for promoting the culture of family planning.
Starting in the late 1990s, as Russia’s birthrate plummeted, Orthodox activist campaigns against abortion and family planning intensified. Official funding for the family planning program ended in 1998. As restrictions began, civic activism emerged. Chapter 6 traces the efforts of this activism as Putin’s growing authoritarianism attacked what it considered foreign values. In 2011, family planning experts and feminist activists formed a coalition that organized Russia’s first public grassroots protest for abortion access, and succeeded in blocking key proposed restrictions with the slogan, “Fight Abortion, Not Women.” This was repeated in 2015. This striking anti-abortion language as the central theme for preserving abortion access decentered the idea of women’s rights. Instead, it underlined the view that women needed legal abortion because society had failed them.
There is a fascinating parallel between the strategic choices made by the post-Soviet feminists of the 2010s and by the only female Soviet Health Minister, Mariia Kovrigina, in 1955. Behind closed doors, Kovrigina and top health experts argued that abortion should be re-legalized because women have the right to abortion in order to regulate the timing of motherhood. However, she chose not to use the language of “a woman’s right” in her proposal to the Central Committee. Instead, she focused on re-legalization and its benefits for women’s health. Similarly, post-Soviet feminists decided not to make women’s rights the sole theme of the protest. This strategy worked again.
Was abortion culture unmade? The answer is mixed. The drastic fall in the abortion rate in post-Soviet Russia speaks for itself. However, the liberal experts did not simply wish for a reduction in the number of abortions. Their goal also included nurturing caring relationships. The extent of their success in this area is not clear.
On the issue of Soviet women’s negative views of abortion in Ch. 1, the discussion could have been more extensive. First, the argument is based on limited sources, written by well-educated women. In order to make a broader claim, other sources could have been consulted to assess how widespread this view was among Soviet women. Second, it would have been interesting to see if and how the early 1980s introduction of vacuum aspiration (VA), the so-called mini-abortion, influenced women’s views on abortion and contraception. As VA offered a less painful, outpatient alternative to the traditional curettage, which required hospitalization, it quickly became very popular. But these are small quibbles.
Theoretically sophisticated and empirically substantiated, this excellent book should be widely read by everyone who studies Russia. I also highly recommend this book to be used for courses in women, gender, and public health, both at the undergraduate and graduate levels.
