Every Monday, Wednesday and Friday night, Dr. Mira Marchenko sits by her phone in Krakow and spends four hours answering questions from Ukrainians on a topic: birth control. Women are all refugees from the war in Ukraine and are almost always anxious when on the phone, sometimes speaking in silent tones or giving one-word answers. They are not sure who they can trust or where they can go if they need urgent contraception or abortion, both of which are readily available in Ukraine but almost entirely illegal in Poland. “They are very afraid to ask these questions because they do not know who answers and what will follow,” said Dr Marchenko, an obstetrician-gynecologist who is also a refugee from Kyiv, where she had a thriving pre-war practice. “They are afraid of everything.” While Poland has generously opened its doors to more than one million Ukrainians since the Russian invasion on February 24, the country’s strict birth control laws have become a topic for many refugees, the vast majority of whom are women. One of the biggest concerns is the care of Ukrainians who have been sexually assaulted during the fighting. Human Rights Watch and medical examiners working for Ukrainian prosecutors have documented dozens of cases of sexual violence committed by Russian soldiers. Some aid groups fear the number could be in the hundreds and that it will continue to rise as the conflict continues. It is not clear how many of these women have arrived in Poland, but this country can be a difficult place for any pregnant woman at risk. Poland has some of the strictest anti-abortion laws in Europe. New restrictions came into force last year, banning terminations, except in cases of sexual assault, incest or if a woman’s life is in danger. But even under these exceptions, access to abortion can be difficult. Doctors often force women to attend repeated visits, which take them beyond the 12-week deadline for an abortion. Victims of a sexual assault must also have a certificate from a prosecutor to prove that the assault took place, something that Ukrainian refugees cannot obtain. Abortion pills – two drugs that terminate early pregnancies – are only available with a prescription in Poland, and anyone taking the pills without a doctor’s consent can face imprisonment for assisting in abortion. Strict rules mean that for years thousands of Poles have gone abroad to seek help, including in Ukraine, where terminations are legal if they take place during the first 12 weeks of pregnancy. Abortions between 12 and 28 weeks require the approval of a medical committee and only for important medical, social and personal reasons. And abortion pills are available in Ukraine without a prescription. “From [the] “In the second week of the war, we began to organize our aid and assistance to adapt our activities to the needs of Ukrainian refugees, women and girls,” said Krystyna Kacpura, president of the Polish Federation for Women and Family Planning or Federa . Ms Kacpura said the organization had helped more than 100 refugees obtain emergency contraception through a network of like-minded doctors, hospitals and organizations across Europe that legally supplied the pills and then mailed them to refugees in Poland. Federa also set up the hotline run by Dr. Marchenko and has volunteers all over Poland who distribute Ukrainian information to refugees. Kateryna Shukh, right, leads a group of Ukrainian refugees from Mariupol to an art therapy session. Mothers and children made posters that reflected what they wanted for their lives in five years. Anna Liminowicz / The Globe and Mail Dr Marchenko said she receives about 10 calls per shift and at least three have abortion questions. She recalled one of her patients in Kyiv who discovered abnormalities in her fetus just two days before the war began. “She wanted to terminate this pregnancy for medical reasons, but she did not have time,” said Dr. Marchenko. “And when he arrived in Poland he was in a terrible situation because he could not solve this question. He had to go to [the] The Czech Republic.” She added that while she had some idea of the Polish abortion law before leaving Ukraine with her 10-year-old son and mother, nothing prepared her for the reality of life in the country. He even had trouble accessing standard birth control pills, which also require a prescription in Poland. She had to get a doctor in Ukraine to write her a prescription and then find a pharmacy in Krakow that would accept her. “These were just birth control pills, not emergency contraception, just pills I usually take in Ukraine,” he said. Anti-abortion groups and Catholic Church officials in Poland have expressed concern about any attempt to weaken the law or provide special treatment to Ukrainian women seeking abortion. The Foundation for Life and Family encourages its supporters to print a leaflet outlining abortion restrictions in Poland and give it to refugees as they cross the border. The pamphlet notes that any doctor who performs an abortion is “subject to imprisonment for up to eight years.” It also warns refugees that anyone who helps with an abortion could face up to prison. He added: “If the procedure is complicated and you seek medical help, law enforcement agencies should start an investigation into how an abortion was attempted.” A leaflet from the group also states: “The greatest threat to peace is abortion. “If a woman is allowed to kill her child, what prevents me or you from killing each other?” Kateryna Shukh, a psychologist who advises refugees from Mariupol, said most women do not want to discuss the sexual violence they have experienced. “All these women need time. “We’re just doing it a lot step by step, we’re not in a hurry,” he said of a Warsaw refuge run by a charity called HumanDoc. At a recent meeting, Ms. Shukh encouraged a group of nine women to make photo posters showing how they hoped their life would be in five years. “It’s a way of making them think about moving forward,” he explained. Ms. Shukh is in a better position than most therapists to connect with refugees. She also had to leave Mariupol, where she spent years working with the Mariupol Women’s Association. This organization was founded by her mother, Marina Pugaczowa, and started in 2015 supporting women involved in the war in eastern Ukraine. Now Ms Shukh and Ms Pugaczowa are both refugees in Warsaw. With the help of a group of volunteers, they continued some of their work in Mariupol by organizing evacuations from the city and advising refugees as soon as they arrived in Poland. “I never thought I would be a refugee,” Ms Shukh said. “I’m a woman and a man, and I have a lot of feelings about it and sometimes I cry.” Ms Pugaczowa said she was aware of four cases involving women being gang-raped by Russian soldiers. “Our women are still in a very bad psychological state,” she said. She is well aware that the Mariupol refugees have little chance of returning to her homeland and her goal now is to help them start from scratch in Poland. “With our Polish friends, we want to show that refugees are not only victims of war, but refugees can be people who can be independent and dynamic for the country where they live,” he said. “They can gain independence and start a new life in the country.” Our Morning and Afternoon newsletters are compiled by Globe editors, giving you a brief overview of the day’s most important headlines. Register today.
