ASHGABAT -- Medical sources in Turkmenistan say officials continue to limit women’s access to abortion, threatening doctors who perform them and denying women a consultation to discuss their options for unwanted pregnancies.
Several health-care workers in Turkmenistan told RFE/RL on condition of anonymity that doctors were warned that performing an abortion will cost them their license, even if the procedure was carried out within the limits specified by law.
“After getting warnings from the Health Ministry and law enforcement agencies, doctors are immediately turning away women who come to inquire about an abortion. They are not even being given doctor’s appointments,” an Ashgabat physician said on August 20.
Health-care workers said doctors are only allowed to terminate a pregnancy when the fetus shows no signs of life inside the womb. Authorities also strictly control how doctors prescribe abortion pills to patients.
The medics said the clampdown on abortion is forcing women to resort to unsafe options, putting their lives at risk. It has also paved a way for bribery as some medics continue to carry out abortions secretly for large sums of money.
The sources spoke on condition of anonymity fearing reprisals by the authoritarian government.
RFE/RL cannot independently verify the claims. Turkmen officials did not respond to our requests for comment.
Turkmenistan unveiled a law in 2022 that permits terminating a pregnancy without a medical reason within the first five weeks. Previously, the period during which women were allowed to terminate an unwanted pregnancy without a health reason was 12 weeks.
The law on the Protection of Public Health also stipulates that terminating a pregnancy could be allowed at up to 22 weeks for “social” or “medical” grounds if the “medical advisory commission” concludes that such reasons are applicable.
The law doesn’t explain the “medical and social” reasons or the makeup of the advisory commission. After 22 weeks of gestation, the pregnancy can only be terminated for health reasons based on the decision of a specially established council of doctors, the law says.
In reality, however, “authorities don’t even take into consideration the exemptions that the law allows,” a Turkmen doctor told RFE/RL.
The law had sparked concern among medics who said the five-week deadline is too short because many women don’t even know at this point that they are pregnant.
The law was adopted in May 2015, but it was not made public or enforced until seven years later. Authorities have not publicly given any reason for their decision to limit abortions.
Dangerous Methods
The restrictions have triggered a spike in illegal abortions, bribery, and the use of unsafe methods by women desperate to end their unwanted pregnancies.
According to RFE/RL sources, some gynecologists in Ashgabat charge between $500 and $1,000 for a clandestine abortion. That is higher than the average monthly salary in Turkmenistan.
In the cities of Turkmenbashi and Balkanabat in Balkan Province, the amount of the bribe varies, depending on how advanced the pregnancy is.
“In the first two months, doctors charge [the equivalent of] $1,430. However, the termination of advanced pregnancies -- from three months and beyond -- can cost up to [the equivalent of] $14,300,” said a doctor from the Balkan region.
Although most secret abortions take place in hospitals, the patients are deprived of post-abortion care and cannot defend their rights or ask for any guarantees in case of complications.
The women who can’t afford bribes often risk exceptionally dangerous methods, said an obstetrician from Ashgabat.
“Some women use a potassium permanganate douche for several hours to try to end their pregnancy. This is extremely dangerous,” the doctor said. “There were cases that some pregnant women used high doses of medications that induce periods.”
'The Poor Suffer Most'
The Progres Foundation, a U.S.-based NGO that supports progressive initiatives in Turkmenistan, says impoverished women with limited resources and education suffer the most.
The foundation, which brings together activists and experts, has called for adequate access to safe abortions and post-abortion services in Turkmenistan.
The NGO also highlights a dire need in the country for women to have improved access to contraceptive pills, sexual and reproductive health services, and information including family planning, particularly in rural areas.
Only 47 percent of women of a fertile age in Turkmenistan have access to modern contraceptives, according to the group. It also raised concerns about a lack of training of Turkmen health workers on women’s sexual and reproductive health and rights.
The law on Protection of Public Health allows abortions only in state medical facilities, but according to 2022 official statistics, there were only 95 reproductive health offices and 76 licensed gynecologists to provide abortions in the country, where the number of women of reproductive age is estimated to be about 1.6 million.
According to the country’s Criminal Code, doctors who carry out abortions outside state hospitals or without a legal ground to do so face up to two years of correctional labor. The law also provides for up to two years in prison if the person performing an abortion does not have a license.
