Abortion in Georgia: Legal but restricted

Author: Khatia Ghoghoberidze, Dina Oganova


Women in Georgia have the legal right to an abortion. But the increased influence of the Georgian Orthodox Church and the government’s anti-abortion stance are forcing them to use lies and subtafuge to find a doctor willing to handle the procedure. 

“The doctor warned me not to tell anyone that it was my first child. ‘Whoever asks you about it, say that it’s your second,’ she said. They did ask me about it when we entered the room. I lied and said that it was my second child and the first one was waiting for me at home. I laid down and lost consciousness due to the anesthesia. I remember they didn’t even close the door—I was lying on my side and couldn’t see anyone's face, but I knew that people were walking behind my back and some of them even entered the room. When I woke up, I was told to move on because another girl was waiting. The door was still open and they made me watch another abortion while I was trying to wake up from the anesthesia,” recalls Mariam (her name is changed), who was 20 when she had an abortion.

Patriarch-Ilia II of the Georgian Orthodox Church has called abortion "the worst sin" and said it is "equal to murder." He also said the responsibility for the act is "shared by all the people involved in it," including doctors.
The number of abortions gradually increased in Georgia from 2006 to 2012, when 39,000 abortions were officially reported. The number of recorded abortions has steadily dropped since then: there were 23,000 in 2018, according to official statistics. It is worth noting, however, that not all abortions are registered.
In her work with doctors and women on the stigma and availability of abortions, gender expert Gvantsa Kvinikadze has found that women often get bullied instead of receiving support or empathy at clinics.

Georgian law allows abortions until the 12th week of pregnancy. Abortions must be performed by a licensed gynecologist. But doctors can refuse to perform the service if it is against their moral or religious views.

A growing number of doctors and clinics are refusing to provide abortions due to their religious beliefs, according to the Georgian Public Defender’s Study of 2019 about Sexual and Reproductive Health and Rights.

"She didn’t name that other clinic and I realized she was just trying to hide this act from the authorities. Unfortunately, at that moment, I didn’t have the strength to argue with her,” – says Ana, 23, from Tbilisi, Georgia.
“I have changed many girls’ minds on the very first day. I don’t need five days to do that. I may have psychological influence when I tell them that this is their baby on the screen; that they are good people ... Sometimes I even get very unprofessional and tell them some lies like ‘your uterus is very thin’, or ‘the abortion may be dangerous for this organ’ and so on,” the Public Defender's report quotes a doctor in Batumi as saying.
Out of top 15 medical clinics in the capital, just four said they would provide an abortion when contacted by phone. Further inquiries established that just one doctor at one clinic was willing to perform an abortion.  

Doctors were also reluctant to speak on record about abortions. One, who spoke on the condidtion of anonymity, stressed women do have the right to an abortion in Georgia and doctors have a responsibility to respect that right—regardless of their personal beliefs.  

When given no other choice, "women who need to end an unwanted pregnancy take lots of different medicine, which is even worse for their health than a well-planned abortion," she says.
 "As for an induced abortion, women should have three to five days to think before making a final decision. If they do not change their mind, what else can I do? It is their right. If you [a doctor] refuse, that is not a solution, either, because she will go to another doctor or will do something by herself," notes the doctor. 

Maiko was 19 when a condom ripped during the sex with her partner and, as a result, she got pregnant. Maiko scoured the internet looking for information about safe abortion. That’s how she picked one of the most well-known clinics in Tbilisi and went there.

“After the visit and ultrasound, the doctor told me that the clinic was out of medication, but she had her own stock, which I could buy. I paid in cash and didn’t realize what she was actually doing. In fact, if there had been any complications with my abortion, I would not have even been able to appeal to the clinic because nothing had been registered about me,” she says.

“I was told I had five days to think. I said I had already made my decision. She made me sign a paper confirming that I was giving up the five days the doctor gave me to reconsider my decision. She filed that paper and told me to come the next day. I did so and paid her in cash. She gave me the pills and sent me home, warning me to remember that my abortion was registered at another clinic but I was using this one because it was closer to me," - remembers
 Ana, 23, from Tbilisi, Georgia.

Some women cannot afford an abortion at a health clinic, and they try to use pills without a doctor's oversight, which often leads to serious complications, notes the Public Defender's report. The report adds that some women resort to unorthodox methods, like intentionally falling on their stomachs or injuring themselves to end their pregnancy.
“The government does not intend to encourage abortions as we have chosen to favor life. So, our plan doesn't include funding this procedure. But we finance emergency abortions when a woman's health or life is in danger,” said the head of the health department at the health ministry, Marina Darakhvelidze.

Gender expert Kvinikadze notes that often women resort to simply asking friends or relatives for advice and end up taking pills that induce contractions, which can be dangerous. 

The five-day waiting period is another barrier for women, she says. 

“Women have to leave their villages to visit doctors. It's time-consuming and requires additional financial resources," Kvinikadze notes, adding that there are some doctors who try to help by falsifying the visit registration so it looks like the woman has already completed the five-day waiting period. 

The Public Defender's Office agrees that access to abortion services and information about the service remains a serious obstacle for women in Georgia. While there is at least one abortion provider in every municipality, that does not mean women have access to it, the Ombudsman's Office noted in its report. 

“We cannot say that abortion is inaccessible. However, there are obstacles. The first and the most serious concerns awareness. People do not know where to go to get service. Then come moral dilemmas for women,”notes Anna Iluridze, head of Gender Equality Department at the Office of the Public Defender of Georgia.

She adds that  it is also not easy to find a proper doctor. 

“The five-day waiting period before getting an abortion is another barrier for women. It is even proved by different studies that it is more painful, especially for those women, who need to take public transport to go to the hospital. Apart from the increased cost, it is bad for their emotional wellbeing as well,” Iluridze says.

“Nobody has the right to insult a patient over her decision, regardless of what it concerns," says Marina Darakhvelidze, the director of the healthcare department under the Ministry of Labour Health and Social Affairs of Georgia. But she adds that "a doctor must understand how dangerous it is for a woman's body and her physical and mental health to end a pregnancy."
Marina Darakhvelidze, the director of the healthcare department under the Ministry of Labour Health and Social Affairs of Georgia,notes that while it may be difficult to find abortion providers, the ministry cannot force clinics to offer the service. 

She adds that the ministry is ready to work with specialists about this topic, including geographical access to the abortion services. However, she says their main purpose is to increase awareness of contraception and the harmful sides of abortion.

"Females are generally inclined to become a mother. This is her natural condition and abortion impacts that," she says, adding however that while the ministry views the infant's life as "the main priority," women still have the right to make the "final decision" about a pregnancy.  

But the lack of access to safe abortion services push women to take risks that endanger their own lives, notes gender researcher Kvinikadze. 

If a woman doesn’t want to have a baby and decides to have an abortion, she will somehow find a way to do it, she notes.

“Studies find that women can take some very risky steps to terminate the unwanted pregnancy. Access to abortion is directly related to a woman's health and life."

Six years later it is still very hard for Mariam to talk about the experience. Her fiancée left after he found out about the pregnancy, even though they were planning to get married. Mariam knew she couldn’t take care of a baby alone and she wasn’t ready to be a single mother as she wanted to study and build her career. And she couldn’t handle the possible reactions of her family members.

For Mariam, the search for a doctor to perform an abortion was a difficult and painful one.

The first doctor tried to persuade Mariam not to have an abortion. And the second one advised her to use a condom.

“My first gynecologist was a man. When I told him I wanted to have an abortion, he looked at me sardonically, took a box out of the table and said: ‘Take it, dear! This is a box full of condoms. Maybe you can somehow learn to protect yourself from getting pregnant and not to come afterward begging me for an abortion. Well, I don’t do abortions. Try someone else'. I ran out of his cabinet crying. Even if he’d said yes, I would’ve never allowed him to touch me!” Mariam says.

In addition, the health ministry's policy priorities the child, noted Marina Darakhvelidze, the director of the healthcare department under the Ministry of Labour Health and Social Affairs of Georgia.

Gender researcher Gvantsa Kvinikadze, who works on issues like access to abortion, notes that the obstacles and restrictions on abortion coincide with the increased influence of the Georgian Orthodox Church.

Two generations ago, during the Soviet Union, abortions were widely viewed as a form of birth control. In fact as late as 2005, government statistics showed Georgian women were having, on average, 3.1 abortions in a lifetime, a figure that is high by global standards. By 2010, the number was down to an average of 1.6, according to UNICEF.

Once the influence and authority of the Church strengthens, this proportionally increases the stigma on abortion. The Church considers a fetus a human being, therefore the decision of getting abortion is equal to murder for them. Our government is always sensitive to the position taken by the Georgian Orthodox Church and never makes a statement that is against its position,” Kvinikadze says.

As a result, it is getting more and more difficult for women to find doctors to perform an abortion. 

Tamuna, 25, who was told she should terminate her pregnancy for medical reasons, also struggled to find a doctor willing to perform the procedure. Her own doctor refused on religious grounds, saying she was the mother of three little children and “didn't want to commit such a sin.”

“She said she would never do it and wouldn’t even send me to another doctor because she thought it would also be a sin. I asked her to recommend a qualified specialist who could give me the medication. She told me to go to Dighomi [a neighborhood in Tbilisi where there are a lot of hospitals] and saw me off. I went to one of the most prestigious clinics but my doctor turned out to be very rude, asking why I got pregnant in the first place if I didn’t want to keep the baby. I felt terrible! You know, I was there because I had no other choice!” Tamuna says.

The names of the doctors who do abortions are confidential for their own safety, and it is extremely difficult to find a clinic that provides the service, even in capital Tbilisi.

Material is produced in partnership with the initiative “Real People, Real Vision" funded by Safe Abortion Action Fund.
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