Oral contraception is gaining popularity among Slovak women, say sociologists and doctors, as education and better drugs continue to make inroads on communist-era stereotypes of 'the pill' as dangerous and inaccessible.
The newfound faith in contraception has had a dramatic effect on the rate of abortion, which until 1989 was considered the country's only safe method of birth control. Since the end of communism, the number of annual abortions has fallen by 64% from 49,847 in 1988 to 18,141 in 1999.
Nevertheless, middle aged and older women remain concerned over the safety of oral contraceptives, and are less inclined to use them than their western counterparts. "15.2% of Slovak women between 15 and 49 years of age used hormonal contraception in 1999," said Rudolf Štefanovič, head of the health care section at the Slovak Health Ministry. "In more developed European countries, the number is some four times higher."
The reason for the disparity, say experts, lies in beliefs inherited from communism. "It's mainly women over 35 years old who already have a child or two [who are afraid of the pill]," said gynaecologist Michal Kliment, executive director of the Slovak Society for Planned Parenthood (SSPRV).
"During communism, there was almost no other birth control besides abortion," he explained. "Only 2% of the female population were on the pill. Abortions were free and legal, but you had to pay for the pill. And it was not trusted - even medical professionals doubted its safety. As a result, the country's women have bred a sort of pragmatic preference for abortions."
According to a survey carried out in 1997 by the Focus polling agency, reservations towards the pill even today spring from beliefs regarding its inevitable side effects, such as weight gain, loss of appetite, as well as more serious potential health problems. "Women over 30 still have a distorted idea of the pill," agreed Štefanovič.
But not all regard prejudice against the pill as some form of hysteria. Sociologist Magdaléna Piscová, from the Slovak Academy of Sciences, explained that it was the poor quality of the pill available during communism, as much as anything else, that discouraged women from taking it.
"They had very strong doses [of hormones] which caused women more problems than benefits," she said. "Also, there was no open discussion about sex in general, let alone the latest contraceptives. Therefore women just chose the easiest and, by those standards, safest method."
The answer, all agree, lies in education. But while all secondary and primary schools are now required by law to teach students about birth control, Kliment said the teachers were ill-prepared for the task.
"Teachers have problems communicating these things to children, and there are no clear guidelines set as to how to communicate with children of different ages," Kliment said. "Teenagers and school kids are often more easy-going with these issues than those who should teach them the basics."
And while planned parenthood sessions and general education have dispelled some of the myths surrounding contraception, many mature women say the change has come too late.
One Slovak woman, who aborted her pregnancy four years ago, said that she wished she had been better informed about sex as a youth.
"All I knew about sex was from magazines and discussions with my friends," said 24 year-old student Iva Č. of Banská Bystrica. "When it happened, I felt helpless and saw no other way out than to have an abortion. My parents still don't know about it. It was only afterwards that I started to take the pill."
