In October 1920 C.E., the Bolshevik government of the Russian Soviet Federative Socialist Republic issued its “Decree on Women’s Healthcare” — making the young Soviet state the first government in the modern era to permit abortion in all circumstances, without restriction, and often at no cost. It was a radical break from centuries of prohibition, and it set a precedent no government had dared establish before.
What the decree established
- Soviet abortion legalization: The October 1920 C.E. decree made abortion legal on request within the Russian Soviet Federative Socialist Republic, later extended to Ukraine in July 1921 C.E. and across the rest of the Soviet Union shortly after.
- Medical access: A core goal of the law was to move abortion out of the hands of underground practitioners — known as babki, or rural midwives — and into hospitals and clinics staffed by trained doctors, dramatically reducing the risk of death and injury from illegal procedures.
- Pronatalist tension: Soviet leaders did not frame legalization as a permanent right. They saw it as a temporary public health measure during a period of severe economic hardship, and by 1924 C.E. restrictions were already being introduced, limiting access based on health, financial, and family circumstances.
A century of illegal abortions first
Before 1920 C.E., abortion had been a serious crime across the Russian Empire for generations. Under Tsar Alexis Romanov, the punishment was death. Later penal codes replaced execution with exile and hard labor. Yet despite these penalties, prosecutions were remarkably rare — only 20 convictions were recorded in 1910 C.E., and 60 in 1914 C.E. — suggesting enforcement was inconsistent and the practice was widespread regardless of the law.
Underground abortion providers, particularly the babki, filled the gap. These were not back-alley amateurs. Many were trained health workers — midwives and nurses who served rural communities where doctors were scarce or simply absent. They carried knowledge that formal medicine often dismissed, and they served women who had nowhere else to go.
By the early 20th century, Russian physicians and legal scholars had begun pushing for decriminalization — not primarily on ideological grounds, but on medical ones. The Pirogov Society, one of Russia’s most respected medical organizations, raised the issue as early as 1889 C.E. Other professional congresses followed in 1911 C.E., 1913 C.E., and 1914 C.E. The argument was consistent: criminalizing abortion did not stop it. It only made it more dangerous.
Why the Bolsheviks moved when they did
The Soviet government that came to power after the 1917 C.E. revolution inherited a country shattered by nearly a decade of war, revolution, and civil conflict. Women were already seeking abortions in large numbers. The state, Soviet officials argued, could either ignore that reality and let unsafe illegal procedures continue — or it could bring the practice into hospitals, regulate it, and make it safer.
That pragmatic logic drove the decree. The government explicitly stated it viewed legalization as temporary, tied to the economic crisis of the moment. The longer-term goal was actually to reduce the need for abortion through better material conditions, healthcare, and support for mothers. By 1924 C.E., access was already being tightened. By 1936 C.E., under Stalin, abortion was banned again — this time until 1955 C.E. — as part of a broader push to increase population growth and reinforce traditional family structures.
The 15-year window of legal abortion from 1920 to 1936 C.E. was not a stable policy achievement. It was a contested experiment, marked by overcrowded clinics, escalating restrictions, and ongoing debate among doctors and officials about population, morality, and women’s health.
Lasting impact
The 1920 C.E. Soviet decree established something historically unprecedented: a modern state openly acknowledging that women would seek abortions regardless of legality, and choosing to respond with medicine rather than punishment. That idea — harm reduction over prohibition — was the decree’s most durable contribution, even if the Soviet state itself later abandoned it.
The decree also accelerated the global debate. Over the following decades, other countries began grappling with the same tension between law, public health, and women’s autonomy. The World Health Organization now classifies unsafe abortion as a leading cause of maternal mortality worldwide, and access to safe abortion services remains a significant public health variable across dozens of countries. The Soviet experiment — however imperfect and politically motivated — was the first to test what happened when a state stopped treating the procedure as a crime.
The decree also briefly disrupted the role of the babki. In urban areas, the shift to hospital-based abortion was swift — by 1925 C.E., as many as 75% of abortions in Moscow were performed in medical facilities. But in rural regions, the babki continued to serve communities that doctors simply did not reach. Medical historians note that informal networks of women’s healthcare knowledge have persisted across many cultures precisely because formal systems have so often failed to extend into poorer and more remote communities.
The Soviet experience also shaped how later socialist and communist governments approached reproductive policy — including in Eastern Europe and parts of Asia, where abortion policy swung back and forth depending on population targets, political ideology, and the shifting priorities of the state.
Blindspots and limits
The 1920 C.E. decree is often described as a victory for women’s rights, and in terms of medical safety, it was a real step forward for women in urban areas with hospital access. But the government’s own framing was explicitly pronatalist — legalization was a concession to circumstance, not a principled recognition of women’s autonomy. Scholars of Soviet women’s history have pointed out that Soviet reproductive policy consistently subordinated women’s choices to state demographic goals, and the 1936 C.E. ban made that priority explicit.
Rural women — often the most vulnerable — saw limited benefit from the decree’s hospital-access provisions. The historical record also reflects whose voices were documented: mostly urban, educated, and institutionally connected. The experiences of women in the countryside, including those who continued relying on babki throughout the entire Soviet period, are substantially less visible in the archival evidence. The 1920 C.E. milestone was real — and narrower than it is sometimes remembered.
Read more
For more on this story, see: Abortion in Russia — Wikipedia
For more from Good News for Humankind, see:
- Global suicide rate has fallen by 40% since 1995
- U.K. cancer death rates down to their lowest level on record
- The Good News for Humankind archive on Russia
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