In some ways my personal and political ties with
Russia
seem to have an uncanny quality -almost like destiny.
The ties began with CHOICES, the women's medical center I
founded in 1971. and around which I've built my life
and work. In the 1980s, as the immigration policies of the Soviet
Union eased, masses of Russian emigrees
found their way to New York and
many of the women found their way to CHOICES. Counselors at the clinic would
tell me that a surprising number of these women had 10, 15 and 20 previous
abortions: and so we learned that abortion was the major form of birth control
in the Soviet Union. For these women, the
"issue" of abortion posed no questions of morality, ethics or women's
rights versus fetal life. There was only the harsh reality that sex rarely came
without anxiety and that the price one often paid for it was high and
dangerous. Then one day there was a 35year old woman who came to me for her
36th abortion. She expressed relief and some pleasure at the supportive and
positive aspects of the clinic as opposed to the brutal conditions she was familiar
with, but seemed quite resigned to having continued abortions. Like so many
other Russian women, she was violently opposed to using birth control because
she was taught by her doctor that the Pill was far more dangerous than repeat
abortions and other forms of contraception were practically unavailable.
Thinking about her and the conditions of her life, I began
to have dreams and fantasies of going to Russia
to rescue women from this brutal system of sexual oppression. Several months
ago my dreams came closer to reality when two Russian feminist publishers
visited New York and familiarized
themselves with new work. My philosophy of informed medical consumerism,
Patient Power, arid the need for personal and sexual styles to be part of an
individual's birth control decision astonished them. In Russia
you got whatever was being pushed at the moment. If they had a stock of old
fashioned spiral IUDs, that's what was dispensed. If they had high dose
estrogen pills, that's what was prescribed regardless of any individual contraindications or preferences!
The two feminist publishers had dreams also: Dreams of
giving Russian women dignity, autonomy, and choice -and they viewed me as the vehicle
to help make those dreams a reality.
Two weeks after they left New York
for home they faxed me an official invitation to lead a team of physicians and
counselors from CHOICES to Moscow
for an educational exchange. We would be meeting with gynecologists from a
state subsidized teaching hospital to demonstrate state of the art women's
healthcare.
Taking little time to say yes, three months later I was on
my way to Russia
with nine of my staff, carrying visions of being a pioneer and of changing
their world.
As the plane began its nine and a half hour flight, I
recalled a different time 10 years earlier when I first traveled to Russia.
I was with a friend who was familiar with the culture; she begged me to take a
suitcase full of contraceptives: pills, diaphragms, condoms anything. My
concerns about arbitrarily distributing hormonal medication and diaphragms
which would not be fitted by physicians were laughed off. "They need
anything and everything they can get." After learning that the two most
popular forms of birth control were douching with lemon juice and jumping
office boxes if periods were late, I Stuffed my bags full.
Now, here I was again -in Moscow.
My hosts had arranged for us to stay in a pre-revolutionary
mansion called Perendelkina that now functions as a
government artist colony where pensioned writers and old artists retire. Perendelkina is in a so called "green zone" 20
minutes outside of central Moscow,
and boasts the grave of Boris Pasternack. As I walked
the carpeted halls, with fading old Persian rugs
buckling under my feet, I could hear the muted sounds of typewriters. These writers seemed content and secure in their work, but, in
general, very little works properly in Russia
at this time. At Perendelkina, the phone system is
primitive and erratic. For a complex of 100 rooms there is only one outside
line which often crosses wires with a private home. Getting anything done is
always a matter of extreme negotiation. My hosts told me that despite the fall
of communism many people are not ready for a "market economy. Most
Russians did not work hard under the old system because the paternalistic state
took care of everything - housing, healthcare and vacations were subsidized. Now
they can't imagine why the have to work harder to get paid more. It seems that
everyone wants to feel and use the only power the really have -the power to
no. Everything is a struggle: at
least one to two hours a day are spent negotiating .and navigating just to he able to get from one place to another -or trying to find
a phone that works.
Our first lunch at Perendelkina
combined politics and poignancy. Apologizing fur the co for the country's
economic crisis, an attentive staff served us a meal of boiled eggs, bread,
cheese, squash and oatmeal. In the evening we were taken to an extraordinary
banquet at the Artist Guild. The hall is a famous meeting place for
intellectuals, artists and writers of the Russian intelligentsia. Oak-beamed
walls and ornate glass chandeliers were the background to a pianist playing Chopin
and Rachmaninoff with an occasional American favorite like "Feelings"
thrown in.
I was aware as I looked at the table spread out with caviar,
lox, sturgeon and vodka that my hosts had gone to unusual expense and time to
produce this. The dinner continued for hours with each one of us in turn rising
to propose a toast, then drinking our vodka "to
the end." One of my hosts rose and expressed her gratitude for my coming
and for the chance to exchange ideas. She asserted that the country needs women
to take it in hand and lead it out of crisis.
There was an easy affection, an ability to touch and to
connect with each other's eyes and energies without the need for continual
translation -and there was also a strange tension and excitement in the air. As
I looked about me I saw that people had broken up into small groups and were
discussing potential business deals -everybody was hustling!
There was a keen awareness that with the fall of communism
people were able, indeed, desired, to show creativity and entrepreneurial
spirit. One person rose to toast capitalism -and I found myself saying
"Yes, capitalism, but capitalism with a conscience!" The next day
brought meetings and interviews. I spoke with Dr. George Kavkassidze,
who specializes in infertility, which has reached epidemic proportions in Russia.
He was eager to assist with the creation of a women's health center where there
could be pregnancy testing, counseling and state of the art abortion care. I
learned that there are practically no pregnancy tests available in Russia;
that by the time many women find that they are pregnant they are well within
their second trimester. If they are to receive a state sponsored abortion at no
cost, they must have the approval of three physicians, including a psychiatrist.
Because most women cannot, and will not, navigate this difficult bureaucracy,
most opt for "clandestine abortions," done in their homes by state
gynecologists eager to earn extra money. The unsanitary and dangerous
conditions result in many teenagers and young women becoming sterile.
Most of the women that I spoke with seemed to be insulated
from feminist thought and the feminist movement as we know it in the United
States. They continually referred to me as
Miss or Mrs. Hoffman and one of my staff corrected them and wrote out
"Ms." "But is she married or
single?" I explained that yes, I am married but that it is not necessary
that my marital status be public and they loved it! It was as if I were
catapulted back 20 years to the dawn of the women's movement, remembering the
"clicks of consciousness," the constant explosion of insights.
An interesting thought then occurred to me. There is no word
for "counseling" in the Russian system, because they don't perceive a
need for it. Abortion is not only the status quo, but the only choice the
majority of women have to control their fertility. There is no organized
opposition on religious or moral grounds (although there is a growing right to
life presence in Moscow), and women
regard their multiple abortions pragmatically, as just a way of "getting
cleaned out." Abortion is not a major moral crisis for Russian women -it's
just life.
If I bring in the concepts of "choice" and
"responsibility," the need for women to think deeply about birth
control and abortion, the need even for counseling prior to abortion, will I be
adding to an antiabortion groundswell? Will I inadvertently be introducing
anxiety or guilt to an already overburdened and oppressed female population?
After all, the slogan of many pro-choice activists in the U.S.,
"Abortion on demand and without apology," is a reality in Russia.
Russian women have abortions on demand -on request really -no apologies needed
because there are no other choices. But because there are no other choices,
abortion has little to do with freedom and privacy and much to do with
oppression and coercion. As in most societies, women's health and women's lives
are not a high priority for the Russian government.
The day of the Educational Symposium, I awoke with an
intense feeling of excitement. This was the day I would make my presentation
and challenge the assembled feminist physicians and journalists to create a
truly revolutionary society - a society where women's lives really count for
something.
At the symposium, I spoke of how reproductive freedom must
be the bottom line of women's autonomy. If a woman cannot decide when, or
whether, to bear children, the other choices in her life are diminished. The
availability of legal and safe abortion is critical to her health and quality
of life. But, it is not enough. Without full information about all reproductive
and sexual issues, access to abortion is an illusory freedom.
I stressed what I know to be true in the most personal and
political sense, that "there is no choice without knowledge. If we accept
that the exercise of free will defines what it is to be moral and frilly human,
then women who lack the information to make choices will be destined to remain
second-class citizens."
The speech was received extremely well. The audience was
intense, like sponges soaking up every word. Most interesting, I found a piece
of anti-abortion literature on a chair as I left the hail. It was exactly the
same propaganda that the anti-choicers thrust into
the hands of patients every day at CHOICES except that it has been translated
into Russian and printed in Alaska.
I had to laugh; in a strange way, it made me feel right at home. It also
reinforced a truth I have always known: The war against women's freedom is
global and has no boundaries.
Along with translated literature, T-shirts and magazines, I
had brought 7,000 condoms with me to distribute after the presentations.
Suddenly, the well dressed professional journalists, feminists and physicians
turned into a swarming mob. We were surrounded and pushed and shoved as a
frenzy of hands reached out to grab the condoms. I was left breathless and
amazed.
While condoms are the only birth control method produced and
sold in Russia,
they are not highly utilized. Most are substandard and break easily -and the
strength of the "macho" myth prevents many men from even using them.
I think of the enormous statue of Yuri Gagarin, the first man in space. It
stands like a colossus overlooking the main thoroughfare in Moscow.
How a society with the technology to conquer space cannot find its way to
produce an adequate rubber speaks volumes about its priorities,
and the primacy of politics over reason.
I was still recovering from the onslaught of grasping hands,
when I found my way to the ladies' room. I was with my translator, who was part
of my staff, and with whom, before leaving for Russia,
I had practiced a few phrases like "Women of the World Unite." We
were saying it together and laughing as an old lady came in to clean. Listening
to us she asked, "Unite? What do they want to unite for? And if they
unite, what will they do?" Looking at her and picturing my mother saying,
"Are you playing Joan of Arc again?" I said, "Well, maybe we
will make the world a little bit better place." "Okay," she said
resignedly as she went off with her bucket and pail.
The next day my staff was scheduled to perform abortions and
Norplant inserts at the state teaching hospital, Gynecological
Hospital #53. It would be historic:
the first time Norplant would be inserted into Russian women, and the first
time abortions would be performed with state-of-the-art technology. We had
brought equipment, machinery and drugs with us that had never been imported to Russia.
The entire hospital was on full alert. There were approximately 25 people in
the operating room where CHOICES physicians would be giving a demonstration.
Students of anesthesia, gynecology residents and the administrative staff of
the hospital hovered around the operating room tables. The patients were
brought in in their own nightgowns because of the
shortages of paper and supplies. Fashions ranged from plain flannel to see
through red lingerie. The women's stoicism and seeming lack of modesty amazed
me -even more so when I remembered that these are women who were taught to be
so ashamed of their bodies that they were not permitted to mention the word
menstruation in mixed company. It's a dangerous form of modesty that I've seen
lead to medical and sexual problems. Of the small amount of birth control
available, out of date spiral IUDs are the most commonly used (by 5 percent of
the population). But because of the social stricture against openly
acknowledging menstruation, women are too embarrassed to go to their
gynecologists during their periods, the optimum time when IUDs should be
inserted. As a result they are often left infected and infertile. Yet, there in
the operating room there was no observable modesty, and absolutely no concept
of privacy or patient dignity. The collectivism of this society even extends to
the medical sphere where it is not uncommon to see four or five abortions
performed in the same room at the same time. The women did not notice the large
audience as they obediently lifted their gowns above their waists. It is just
the way life is here, and they deal with it: They place themselves on the table
and follow orders.
I looked at their faces and into their eyes. What I saw
there were the thousands of women before them whose hands I'd held. We are all
sisters.
The staff at the hospital was extraordinary -eager to learn
-eager to please -eager to participate with me in a joint capitalist venture.
The abortions cost 900 rubles, which equals $3.00 -less than the cost of a
McDonald's hamburger and about one week's average salary.
The next day brought a meeting at the Russian Family
Planning Association; it was to produce an historic feminist act. Formed nine
months earlier and existing on donations and government subsidies, the
Association is the major voice in Russia
calling for a reasoned and intelligent family planning program. The director, Inga Grebesheva, famous for being
the "only woman deputy" of the Central Committee of the Communist
Party, told me she became a feminist when, at party meetings, her colleagues
began to refer to her as the "woman minister." She recognized that
they had never thought of her in relation to her work or her tide, but only to
her gender.
Grebesheva, having produced one
film on the horrifying state of abortion care, was raising funds which she
hoped would educate people further on the Russian abortion system. She
envisioned producing 12 hours of tape of individual women telling about their
abortion experiences. It seems that having 15, 20 or even 30 abortions does not
equal coming to terms with it. Most women are ashamed to talk about their
abortions, and doctors, with their fanciful prescription for birth control, do
not help them break the silence: They tell them if they worked harder, they
would not have time to think about sex and, therefore, would not get pregnant.
My mind immediately flashed to all the soap box actions I
had arranged in the American abortion wars -all the "My name is Joan or
Ruth or Karen, and I've had an abortion" feedback that led me to the
knowledge of how important it is for women to own that experience.
When I suggested to Grebesheva
that we replicate this in Red Square, she loved the idea
but said, "Our Russian women do not yet have the courage for this."
But the energy in that room was so strong and driving, I urged them to do
something now. The result was a decision to draft an open letter to Boris
Yeltsin outlining the grave conditions of women's healthcare and demanding
economic funding for birth control and education. When I asked Grebesheva if she could have it done by the next day so
that leading feminists at the Feminist Round Table where I would be speaking
could sign it, she smiled "I've been writing it in my head for four
years," she said. This was one of those transcendent connections, the
times when you meet someone -a group of women -and you know that the different
languages and different realities cannot obscure the one reality -that we are
all struggling with the same issues and the same problems.
The next afternoon brought over 30 feminists together to
share information at a "Feminist Round Table." Writers, scientists,
journalists and representatives from governmental agencies engaged in lively
dialogue. A self described radical feminist made the distinction between women
who were part of the "women's movement," and women who called themselves
feminists. Women who were part of the women's movement believed in a philosophy
of "women are people, too," whereas feminists wanted to change the
patriarchy. I asked whether it was the difference between being a liberal and a
radical, and she said it was much greater than that. Another raised her voice
to say that it didn't matter what women called themselves,
"all women are feminists and fighting for the same thing."
And still others said that they never thought of using the
word sisterhood, that the concept was always one of "brotherhood."
Women never considered themselves unequal or oppressed
because they believed the propaganda fed to them by the communists that men and women were truly equal. At that
point, Grebesheva came into the room and, not taking
time to remove her coat, proceeded to read the letter she had drafted to
Yeltsin. I watched the faces -pleasure, pride, anger, anxiety. Some got up to
sign, some left the room and some watched transfixed. A feminist movement
begins?
The mixture of the spiritual and profane surrounded me.
Lunch in a Moscow hotel had me
sitting next to a young couple who held hands across the table, had their eyes
closed tightly and mumbled under their breaths. This went on for about five
minutes, and I realized that they had been praying. As the young man left the
table, the woman turned to me and started a conversation. It seemed that they
were missionaries; Evangelical Christians who had been in Moscow
one year and had started their own church on October Street. "This is
extremely fertile ground for gathering new souls," she told me as she
searched her handbag for prayer cards. "Now that communism is dead, their
spiritual hunger can be fed." In Moscow
I saw advertisements for Billy Graham's Crusade and remembered the delegation
of Bible students who shared my plane ride over. Souls are a new growing
market, ripe for the picking.
Conversations in the hotel leapt into my memory. They
continued to affirm that the personal is the political. The one with Maya, for
instance, a Russian chemist who was my liaison, who stated, "You can build
a clinic for the elite. We can treat women who are part of the government or
married to high government officials." I explained that I would have no
part of that -my clinic would offer the highest quality care to all women
regardless of who they were. Fees would be based on an ability to pay, so that
if there were any profit to be made it would not be made off the backs of the
poor .Maya listened to me with amazement and said, "But that is not what
we do here -you must be a Christian." I replied, "No, I'm a Jew and
the Jews taught before Jesus (who was also a Jew) about equality and social
justice." Maya in formed me that she knew nothing of Judaism because it
was so suppressed. She also told me she had been taught that "Capitalism
is cruel."
Then, there was Svetlana, a dark eyed Russian journalist,
who was writing a newspaper piece on my visit. We had gotten into a discussion
about Stalin's criminalization of abortion, when she put down her pen and said
quietly, "You know, there was some good in what Stalin did. If he had not
criminalized abortion, I would not be here." I responded that Stalin's
motivation was to populate Russia
with soldiers to counteract Hitler's rising militarism. Certainly, encouraging
the birth of girl children was not part of the equation. Nevertheless she still
thought it was a good thing because she would not have been here.
I was being moved and challenged on all counts. So much of myself elicited through these extraordinary meetings so much
to give back.
Now, once again in New York,
I think frequently of Moscow and
recent reports of street demonstrations calling for the return of communism. I
worry that the driving need for security may indeed stamp out the sense of
risk, the desire for growth, and the seductive pull of freedom that this new
era has ushered in. I think of the women I met, the energy, the drive and the
vision for a better life -of the new society that is being created: One where
women can have a hand and a voice, one where they have the opportunity to create, to make a true revolution, to
make their world a place where a woman's life really matters.
Note: Merle Hoffman is planning to open a clinic in Moscow
through a joint venture with the Russians. The center will be called,
"CHOICES East" and will be modeled after CHOICES Women's Medical
Center, Inc. in New York. It will
be the first of its kind and will offer counseling, abortion and family
planning services.
Merle Hoffman is publisher/editor-in-chief of On The Issues magazine and founder/president of both Choices Women's Medical Center, Inc., and Choices Mental Health Center.
© 1996 - 2010 On The Issues.
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