In Uzbekistan, women have always had access to safe abortion. Current legislation allows the termination of a pregnancy within the first 12 weeks and at any stage if the pregnancy threatens the mother’s health or life. The law lists 86 types of various life and health threatening medical indications, including severe types of diabetes, hereditary and degenerative mental disorders, mood disorders, epilepsy, and more. Age is also viewed as a risk factor and girls under 14 are allowed to access abortion.
At the same time, abortion and the delivering of babies have long been among nine types of medical practices that cannot be performed by private medical entities, along with organ transplants, blood donation, providing medical-forensic examinations and other similar medical services. Such services are restricted to the government in part as an effort to prevent the sale of children and the illegal documentation of births and deaths. Local private clinics can lose their licenses by illegally performing abortions or delivery services. In recent years, for example, a local private medical clinic in Samarkand that practiced abortion and baby sales had their license taken away four times in a row. Although the government approved allowing private medical institutions to engage in childbirths in 2019, the presidential decree does not allow private clinics to perform abortions.
The criminal code of Uzbekistan envisions administrative or criminal liability only for those who force women to abort a child or who carry out abortion illegally, but a woman herself is not liable for terminating a pregnancy under any circumstances.
The main reason for the government’s support for bodily autonomy of women is perhaps worry about overpopulation. Uzbekistan is the most populous country in Central Asia. From a mere 24 million in 2000, the country’s population has boomed to over 35 million in 2021. Tashkent has long promoted family planning and prevention of unwanted babies via local healthcare entities even in the most remote villages. Contraceptives are available without any restrictions.
Yet the number of abortions has been decreasing – it fell from 42,682 abortions in 2007 to 35,449 in 2021. The number of abortions per 100 births fell from 7.4 in 2007 to a 4.1 in 2021. One reason for this is an improving quality of life in the country. Many women in the early 2000s chose abortion because of the financial difficulties of raising multiple children, especially amid the global financial crisis. Traditionally, Uzbek families have 5-7 children, but living through the economic hardships of a newly independent country made it nearly impossible for many couples to support more than a couple of children. Some women reported having six or more abortions, which caused detrimental health problems for them later. This can be seen in the practice of abortion among different age groups – in 2007, women aged 35 or older were responsible for over 25 percent of abortions, but it decreased to a mere 7 percent by 2020s.
Apart from economic motivations, reportedly women also chose abortion in the 2000s because contraceptives were expensive. For example, a good quality contraceptive product that would not harm a women’s health cost 7,000-8,000 Uzbek som per month in the mid-2000s; the monthly minimum wage in the country was set at 10,800 som in 2006. Because abortions were (and still are) provided in public hospitals (and either very cheap or free), for many local women it was an obvious choice. This may be a factor even though the use of contraceptives officially has been decreasing, too. In 2007, 51.1 percent women aged 15 to 45 were using IUDs while another 5.3 percent were on hormonal pills, but as of 2021, only 46.9 percent of women use contraceptives (44.1 percent IUDs and 2.8 percent hormonal pills). But because hormonal birth control pills are available everywhere and women do not have to register with local health institutions to acquire them (unlike IUDs), it is safe to assume more women are on hormonal pills than is officially reported.
Decreases in abortion additionally might be due to the increasing influence of Islam in the community. Although Hanafi Islam, practiced by the majority of Uzbekistanis, allows abortion in certain circumstances (if a pregnancy threatens the mother’s life or the fetus has dangerous defects that cannot be treated), in general, Islamic leaders exhort Muslims against it, especially after the first 120 days of pregnancy. The online space, successfully used by local Muslim scholars and preachers, has made it possible for millions to re-learn Islam after seven decades of Soviet atheism and this has included cautioning against abortion.
Uzbekistan remains one of the safest countries for women to terminate unwanted pregnancies. Not only are women not punished for choosing an abortion, but the wider society also does not condemn or confront them for their choices. Still, women often share their experiences in their inner circles only, and abortion is not widely discussed in public.