How the state checked gynecological clinics
In 2024, Roszdravnadzor conducted almost 300 checks in clinics, which provide medical assistance on the profile of “obstetrics and gynecology”, including abortion. Violations were identified in 73% of state medical institutions (checks took place in 7% of such clinics) and 100% of private ones (0.3% checked). Only 9.5% of commercial clinics have cabinets of psychological and medical and social assistance, they say in Roszdravnadzor. They conclude that in most private institutions the requirements of the law regarding abortion, in particular “days of silence”, that is, the term that the law requires the woman before the operation, is not observed.
Roszdravnadzor Published The results of the audit of the state of the obstetric and gynecological service in Russia. In 2024, the territorial bodies of Roszdravnadzor conducted 254 unscheduled inspections, 23 planned and 16 inspection visits. According to their results, 243 instructions were issued on eliminating violations of mandatory requirements and 126 protocols on an administrative offense were drawn up (96 per legal entity, for an official).
The department explained that on the profile of “obstetrics and gynecology”, risk indicators have been developed, which may be the basis for checking: an increase in the number of deceased pregnant women and women in labor by more than 1% per year, as well as taking and removing drugs with the active substance of mythipristone (used for drug termination of pregnancy) without a license to carry out abortion.
The Roszdravnadzor specified that they checked 7.1% of the total number of state clinics providing medical care in this profile, and 0.3% of private. At the same time, violations were identified in 100% of proven private institutions and 73% of state.
Most of the violations (40%) are associated with the quality of the medical assistance provided. Incorrect routing of patients (29%), insufficient level of internal control (18%), problems with the availability of specialized medical care, especially for patients living in rural areas (8%), and insufficient equipment with medical equipment (5%), were also revealed.
Violations of the legislation regulating abortion were found in private clinics. In particular, seven cases of private medical organizations without a license for “obstetrics and gynecology (artificial termination of pregnancy)” were identified. In Roszdravnadzor, it also states that private clinics make up 48% of all medical organizations that carry out artificial termination of pregnancy, the cabinets of psychological and medical and social care are organized only in 9.5% of them. This may indicate a non -compliance with the majority of commercial clinics prescribed by the law of “Days of Silence” – a period of two days to a week before abortion, in which a pregnant woman can consider his decision. The share of state clinics with psychological and medical and social assistance rooms in 2023 was 31%, but by the end of 2024 it increased to 78%.
In December 2023, the State Duma was introduced bill On the complete ban on abortion in private clinics. The authors complained, in particular, to problems in compliance with the established regulations, including in terms of consultations of psychologists and lawyers for pregnant women. But in July 2024, the government called for the document, and at the end of November, deputies recalled it.
More than 500 private clinics independently abandoned licenses to terminate pregnancy.
The reproductologist, obstetrician-gynecologist Victoria Shustova admits that private clinics cannot always provide a proper level of consulting and psychological assistance to pregnant women. She emphasizes that the “days of silence” play a key role in preventing rash solutions. Often the money becomes “more important than the quality of medical care or honor”, so most commercial clinics do not withstand the accepted norms, the head doctor of the clinic “To Medicine” obstetrician-gynecologist Alexei Chernikov agrees. The clinic, according to him, does not practice abortion and seeks to « promote the preservation of the reproductive health of the population. » “Each gynecologist should try to prevent abortion, because it leads to complications and carries risks for the mother,” he says. “If the patient has a request from the patient, you should concentrate on the selection of planned contraception.”
The director of the Association of Private Clinics of St. Petersburg, Alexander Solonin, considers it incorrect comparison of state and private organizations: it is much more logical, in his opinion, to evaluate the fulfillment of licensing requirements the same for everyone: “We are aimed at creating a unified national health system, and patients have the right to choose the equipment, competencies of doctors, quality and efficiency of assistance. Such should be the criteria for inspections to protect the interests of patients. ”
