Under abortion laws in Russia, a woman can end a pregnancy on request through the twelfth week, at no cost in a state clinic covered by compulsory medical insurance. The right sits in Article 56 of Federal Law No. 323-FZ, passed in 2011. What has changed since 2023 is everything around that right: waiting periods enforced more strictly, mandatory counseling scripted to discourage the procedure, private clinics pushed out of the market, medication abortion pulled into tighter drug controls, and new speech laws that penalize even discussing the choice.
The 12-Week On-Request Window
Within the first twelve weeks, a woman decides the question independently. She signs a written informed-consent form and does not have to justify the decision, claim hardship, or obtain any outside approval. The procedure at that stage is a standard medical service.
At state clinics, elective abortions in this window are paid for through the Compulsory Medical Insurance system, or OMS. Repeated proposals from the Russian Orthodox Church and some legislators to strip abortion out of OMS coverage have failed. A patient at a public facility pays nothing. Private clinics charge out of pocket, and the private option has been shrinking.
Two documents get you into the state system: an internal Russian passport and a valid OMS insurance card. A gynecologist issues the initial referral. Without those documents, care has to be arranged privately.
Waiting Periods by Gestational Age
Russian law imposes what are called “days of silence” between the formal request and the procedure. The clock starts when the written request is registered at the clinic, not at the first phone call or consultation.
- Weeks 4 through 7: at least 48 hours.
- Weeks 8 through 10: seven full days.
- Weeks 11 through 12: 48 hours, and the procedure still cannot cross the end of week twelve.
The seven-day pause in weeks 8 through 10 is the one that matters most in practice, because it can push a patient close to the twelve-week cutoff. Facilities that skip the required delay risk administrative penalties or loss of their license.
Mandatory Counseling
Before the procedure is scheduled, the patient has to attend a counseling session. Ministry of Health guidance instructs the counselor to discourage the abortion, to describe the process in terms meant to provoke guilt, and to encourage the patient toward continuing the pregnancy. The counselor then signs a certificate that goes into the patient’s medical file. Nothing can be scheduled until that certificate is on record.
Consent for Minors
The age of majority in Russia is eighteen, but the informed-consent threshold for medical procedures, including abortion, is sixteen. A patient aged sixteen or older consents on her own with no parental notification. Below sixteen, a parent or legal guardian must consent before a facility will proceed.
After the 12-Week Window
Once the on-request window closes, only two paths remain, and each involves outside authorization.
Rape as the Only Social Ground
The only social ground still recognized is pregnancy resulting from rape, and only up to the twenty-second week. Official documentation from law enforcement is required before a clinic will proceed. Earlier Russian law recognized more than a dozen social grounds, including divorce, unemployment, and poverty; that list was cut to four in 2003 and later reduced to rape alone.
Medical Grounds at Any Stage
Medical indications allow termination at any gestational age. A commission of at least three specialists reviews the case and issues a formal decision, which also shields the physician from liability. The Ministry of Health maintains the qualifying list. Maternal conditions include severe hypertensive disorders, serious kidney disease, active tuberculosis, severe diabetes, malignant tumors, and certain mental illnesses. Fetal conditions include severe genetic disorders, malformations incompatible with life, and developmental abnormalities that would cause severe disability.
Medication Abortion
Access to medication abortion has tightened. Ministry of Health Order No. 459n took effect in September 2024, placing mifepristone on the list of drugs subject to quantity-based tracking and control. The order does not separate the lower-dose emergency contraception use from the higher-dose medical abortion use, so both applications carry the same extra prescribing, dispensing, and record-keeping requirements. In practice, this means more paperwork for providers and longer delays for patients, and some are pushed toward surgical procedures or out-of-network options.
The New Layer of Restrictions
The twelve-week framework in the federal law has not been rewritten. What has changed since 2023 is the surrounding pressure.
Private Clinics Pushed Out
Regional authorities have been pressuring private clinics to stop offering the procedure, and some have surrendered their licenses. In Tatarstan, roughly a third of private clinics had stopped providing abortions by late 2024. In the Chelyabinsk region, three clinics agreed to halt services. Kaliningrad has weighed a region-wide ban on private-sector abortions. As the private option narrows, patients are funneled back into state hospitals, where waiting periods and counseling requirements are enforced more rigorously.
Regional “Incitement” Laws
Several regions have passed laws banning the “incitement” or “encouragement” of abortion. Mordovia was among the first. Fines on individuals run from 3,000 to 5,000 rubles, and penalties on officials and organizations vary by region, reaching 200,000 to 500,000 rubles in annexed Crimea. The laws create legal risk for anyone whose information about the procedure could be characterized as promoting it rather than simply describing patient rights.
The Child-Free Propaganda Ban
In November 2024, the State Duma unanimously passed a law banning neutral or positive information about choosing not to have children, across the internet, media, film, and advertising, unless the choice is grounded in medical reasons. Fines reach 400,000 rubles for individuals and 5 million rubles for companies. Non-Russian citizens can face administrative arrest and deportation. The law does not target abortion directly, but it narrows what can be said about reproductive choice generally.
The Federal Pregnancy Registry
In October 2025, Deputy Prime Minister Tatyana Golikova announced a federal register to track all pregnancies in Russia, the health status of pregnant individuals, and the outcomes of those pregnancies. The system was scheduled to be operational by March 2026. The stated purpose is demographic monitoring; the same infrastructure would let authorities see which pregnancies end in termination.
Criminal Penalties
The penalties for stepping outside the legal framework fall on providers, not patients. A licensed physician who performs an illegal termination faces up to two years of corrective labor and a potential ban on practicing medicine. A person without medical credentials who performs an abortion faces up to two years of imprisonment. If the patient dies or suffers serious harm, the maximum rises to eight years. The patient herself is not subject to criminal punishment.
The line between a legal and an illegal procedure runs through Article 56: the gestational limit, the waiting periods, and the authorization rules. An abortion after twelve weeks without a qualifying rape or medical ground, or one carried out before the required waiting period has run, can expose the provider to prosecution.