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The covert effort to get abortion pills into Ukraine

MICHEL MARTIN, HOST:

In the early months of the Russian invasion of Ukraine, Ukraine's supply lines were abruptly cut off. One of the supplies people could no longer get? Abortion pills. NPR's Rough Translation podcast followed the story of a secret effort to resupply Ukrainian doctors. Because of the potential legal consequences for some involved in this mission, many people in the story we're about to hear are only referred to by one name or no name at all. Also, we'd like you to know that this piece refers to sexual violence. Rough Translation host Gregory Warner and reporter Katz Laszlo tell the story.

GREGORY WARNER, BYLINE: When Katz and I arrived in Ukraine this past October, everyone told us, if you're doing a story about abortion, you have to talk to Galina Maistruk.

GALINA MAISTRUK: Yeah. I know. You sent me so many messages, just like lovers in previous times. Yeah.

KATZ LASZLO, BYLINE: Exactly.

We met Maistruk at her office in Kyiv. Her organization is the Ukrainian partner for International Planned Parenthood.

MAISTRUK: I'm an OB-GYN.

LASZLO: Maistruk has been practicing medicine for four decades. And abortion has been legal for her whole career. And 10 years ago, abortion pills came on the market. But when Russia invaded in February 2022, first of all, supply chains to the country were cut off.

MAISTRUK: We have no air connection. We have no ship connection.

MARTIN: So by mid-April, about seven weeks after the Russian invasion...

MAISTRUK: No. No. No pills at all at this time.

LASZLO: And because of this, doctors were worried.

WARNER: Just a heads up. Most of the Ukrainian doctors you'll hear from in this story asked us not to use their last names to protect their privacy at work.

LASZLO: This doctor in Kyiv - her first name is Olga - said that in the early months of the invasion, three to five times more women were showing up in her office and asking for abortion pills.

OLGA: (Through interpreter) We realized that women would come and come and come, and there are going to be more and more of them. But the pills, there's not going to be more of them. And we didn't know if there was going to be any.

WARNER: But what those doctors did not know was that tens of thousands of abortion pills were making their way to Ukraine, donated by a major supplier of those pills.

LASZLO: Are you comfortable with us calling you supplier?

UNIDENTIFIED SUPPLIER: Yeah, why not?

WARNER: We agreed not to use the supplier's name because of the way he got the pills into Ukraine. See, abortion is legal in Ukraine, but there were no planes flying into Ukraine after the invasion. So the fastest way that the supplier saw to get those pills into the country was to take them by land across Poland. But Poland has some of the strictest abortion laws in the region. In Poland, it's illegal to give someone abortion pills.

UNIDENTIFIED SUPPLIER: I didn't want Polish customs to find any mifepristone.

WARNER: Mifepristone is one of the drugs in the medical abortion kit. The other drug is misoprostol.

UNIDENTIFIED SUPPLIER: If these pills are labeled misoprostol and mifepristone, it's a big problem.

WARNER: So the supplier's solution was to take the medicine out of its packaging, out of its labels and pour it in bulk into plastic bags. Imagine a bunch of plastic bags with 75,000 loose pills inside. And actually, you need multiple pills for an abortion. So that's enough of about 15,000 abortions. The supplier then flew those bags to Poland, where they were handed off to a chain of volunteers. And one of those volunteers on the chain was Ukrainian woman named Yevgenia. She has an NGO that delivers medical supplies.

YEVGENIA: It looks like a drugs packing. I don't want to touch it.

WARNER: She's taking a huge risk. If she's arrested or in any way compromised because of this delivery, her charity work could be jeopardized.

YEVGENIA: I'm definitely not against abortion, but it was like, why we should bring it in this amount? It's a large amount to Ukraine, into Ukraine to take it. And the reason, the first reason was rape cases.

WARNER: The request that first sparked this donation of pills was a plea on behalf of women raped by Russian soldiers.

YEVGENIA: And here I became a bit sad. I mean, I need to do this.

LASZLO: Evgenia and her friends get to the border crossing, and to their relief, the Polish border guard waives them through, doesn't check the bags. Soon after, Yevgenia is back at home getting in touch with doctors, including Galina Maistruk.

MAISTRUK: Connection with Yevgenia was like magic situation.

WARNER: Galina calls all the doctors she can think of across the country.

MAISTRUK: I call to Vinnytsia...

NATALYA: Hello.

MAISTRUK: ...To Poltava...

OKSANA: (Speaking Ukrainian).

MAISTRUK: ...To Dnipro and to Odesa.

YEVGENIA: We started to contact doctors, and they started to tell about us to other doctors.

MAISTRUK: From Kherson, from Mykolaiv, from Donetsk, from Zaporizhzhia.

YEVGENIA: We started to receive the mails and telephones like, can you bring it to us?

LASZLO: The first second that I heard about this story, I was immediately like, what was this like for the women who needed the pills?

WARNER: But when we tried to reach out, none of those women were willing to come forward.

LASZLO: But we did talk to the people that they talked to. We talked to their friends and their doctors.

OLGA: (Through interpreter) They all came with a really strict decision, strong decision to offer abortion.

WARNER: Doctor Olga, who we heard from earlier, is one of the doctors who received the pills.

OLGA: (Through interpreter) I didn't have any case when woman told me that she experienced that sexual violence or raping. So - and we didn't ask them in purpose, like, we didn't ask them this question.

LASZLO: Another doctor we met, Valentyna, told us about this woman who came to her from the east, from the city of Slovyansk.

VALENTYNA: She told me, I had, in Slovyansk, everything. I had two flats. I had house near seaside. I had two restaurants. Now I am bomsh.

WARNER: Now I'm a bum.

VALENTYNA: Now I am bomsh. I don't know what I should do with my child.

LASZLO: She said, I already have a child to take care of. And I just lost my house. I lost my money.

VALENTYNA: I should be healthy, strong and to have time and energy for my one child.

WARNER: We heard stories of patients where the war came into their lives, changed their environment, their living situation, their relationships, their income. And they knew they needed these pills. But we also heard stories that went beyond abortion.

LASZLO: And that revelation, it started with Dr. Oksana.

OKSANA: (Speaking Ukrainian).

LASZLO: Her hospital is in Lviv, near the train station. And she sees local patients and also patients who fled fighting in the east.

OKSANA: (Through interpreter) And these are a lot more complicated cases, more complications with pregnancies and more issues with pregnancy. Everyone is in a lot of stress.

LASZLO: Do you mean that just because of the stress, like, there's more complications like miscarriage and stuff like that?

OKSANA: (Through interpreter) Yeah, that's right.

DIANA: When the war starts, we have a lot of complications of pregnancy.

LASZLO: This is Diana. She's a gynecologist in Kharkiv, really close to the frontlines. And she described having a day where...

DIANA: All women get to our hospital by ambulance with bleedings.

LASZLO: Every single woman that came in was hemorrhaging. When doctors see these complications happening, they can reach for these pills because it's really dangerous if a miscarriage doesn't complete. Like, if anything is left in your womb, then you can get pretty serious infections. So you take the pills, and then those pills make sure that your uterus is completely cleared out. In the case of bleeding, you don't actually need both pills. Doctors would just go for misoprostol. That's the pill that causes the contractions. And so when you have that contraction, it clamps down on the blood vessels, and essentially, it stops the bleeding.

WARNER: We'd come to Ukraine to do a story about abortion pills and war. But it was only when we were in the country, where doctors had been running out of pills because of the war, that we could see the story of this medicine was so much bigger. For all the risk people took to smuggle these pills into Ukraine, all the concerns they had over being arrested because of Polish abortion laws, most of these pills were used either to help women safely give birth or to deal with the complications of pregnancy.

Since that April shipment we were following, there's been more deliveries of abortion pills. Since the mail systems were back on, those pills were mailed instead of smuggled over the border. And we went to the place where those pills are being kept.

LASZLO: Like, the stack is taller than us.

WARNER: So 24, 25, 26, 27, 28, 29.

LASZLO: It was so dramatically casual. We're just standing in this guy's apartment. And each of these pills is a story. It's someone's story, a moment in their life, whether that's pregnancy or a complication or a family decision or pressure, a traumatic event or just something they'll forget.

YEVGENIA: Have a nice day.

WARNER: Thank you. Thank you so much.

Yevgenia says they now have more than enough pills. Some of them may even expire.

LASZLO: But the hope is that they'll never have to go back to a situation like in April, that they'll never run out.

All right. And then we step back into a beautiful day. You would never guess.

MARTIN: That was reporter Katz Laszlo and Rough Translation host Gregory Warner. To hear the full story of the smuggled pills and how war is complicating the abortion conversation in Ukraine, check out NPR's Rough Translation podcast. Transcript provided by NPR, Copyright NPR.

Gregory Warner is the host of NPR's Rough Translation, a podcast about how things we're talking about in the United States are being talked about in some other part of the world. Whether interviewing a Ukrainian debunker of Russian fake news, a Japanese apology broker navigating different cultural meanings of the word "sorry," or a German dating coach helping a Syrian refugee find love, Warner's storytelling approach takes us out of our echo chambers and leads us to question the way we talk about the world. Rough Translation has received the Lowell Thomas Award from the Overseas Press Club and a Scripps Howard Award.