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Istanbul

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Turkey / Marmara / Istanbul
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OVERVIEW

As the largest city in Turkey, Istanbul has a wealth of health care resources available. But it can also be complex, often confusing, environment for women's health care. While birth control pills are available in many pharmacies ("eczane" is pharmacy in Turkish) in the city center, and abortion is legal, it can be difficult to find reliable and responsive treatment. This is due to the conflicting messages surrounding women's sexual and reproductive freedom in the country.

On the one hand, Turkey is constitutionally secular and certain districts of the city, such as Beyoglu and Kadikoy, are famously progressive for Turkey. Furthermore, Istanbul is full of internationally accredited hospitals, making it a hotspot for medical tourism. On the other hand, it is typically considered taboo to discuss many aspects of sexuality, and unmarried women are often expected to remain virgins. This creates a discrepancy between the legal options and the social realities of the city. For this reason, it is especially important to do one's research in advance when looking for a gynecologist or STD test.

Contraception (Birth Control)[edit]

Laws & Social Stigmas[edit]

In Turkey, you do not need a prescription to purchase birth control pills or condoms at pharmacies. While President Erdogan made headlines by advising Muslim families to avoid birth control in May 2016, birth control is still available in Turkey. Furthermore, the rate of contraceptive use has increased in the past few decades. According to a 2015 United Nations report, it is estimated that 74.2% of Turkish women (who are of reproductive age and married or in unions) use some form of contraception. Meanwhile, 6.1% of Turkish women have unmet family planning needs. However, it should be emphasized that a great portion of Turkish women use traditional contraceptive methods. In fact, the most common form of contraception used by women is the withdrawal or "pull-out" method (25.8%). Following this method, the most common methods are IUDs (16.9%), condoms (15.9%), female sterilization (9.5%) and birth control pills (4.6%). Meanwhile, there is extremely low usage of contraceptive injectables (0.6%) and essentially none for contraceptive implants (0.0%). In total, this means that the vast majority of women in Turkey today depend on withdrawal, IUDs or condoms for their contraceptive methods.[1]

Despite increasingly religious government policies, Turkey has also seen an increase in contraceptive use over the past two decades. In a 1998 study, 63.9% of women practiced some form of birth control, with 4.4% on the pill, 19.8% with IUD and 24.4% practicing the pull-out method.[2] This is compared to the 74.2% of Turkish women who used birth control in 2015.

What to Get & Where to Get It[edit]

In Istanbul, birth control pills are available in many pharmacies ("eczanes" in Turkish). While pharmacies don't have tons of options, they do carry a few brands, including Yasmin,Yazz and some generic brands. NuvaRing is also available in Istanbul. Most pharmacies do not carry the Nuvaring but the bigger ones (i.e. In shopping malls) have it, without prescription for max 36tl per 1-month pack. There are no limitations as for how many packages you can buy.

Costs[edit]

Birth control pills should cost between 15-36 lira, depending on the brand. As of 2016, Yasmin is 25 TL, Yazz is 36 TL (2017 June). If you want the pills that are better than breastfeeding moms, they're 42 TL. Mirena and the Copper IUD can be purchased for about 700 TL.

Emergency Contraception (Morning After Pill)[edit]

Important Note: The earlier you take emergency contraception, the more effectively it will work. After you have unprotected sex, take it as soon as possible.

Laws & Social Stigmas[edit]

In Turkey, you do not need a prescription to purchase emergency contraception, and there is no age restriction. It is generally easy to purchase in pharmacies. However, according to a 2008 study, only 29.1% of Turkish women of reproductive age were aware of emergency contraception and only 2.3% had practiced it.[3]

What to Get & Where to Get It[edit]

Most pharmacies should have emergency contraception. For progestin only, they typically sell NorLevo .75 mg (take 2 pills within 120 hours). As another option, some people take Lo/Ovral, Lo-Femenal pr Microgynon 21 according to the following instructions: 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later. Another option is Miranova according to the instructions: Take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later.[4]

Costs[edit]

Emergency contraception should cost 20 TL (this is based on one stat from Bursa, so we'll need to collect more info).

Ella, a single 30mg tablet, costs 51.50 TL and is available over the counter in Istanbul.

Medications & Vaccines[edit]

Pharmacy in Istanbul

Laws & Social Stigmas[edit]

You can access most medications in Istanbul for reproductive health and STDs. But this is not the case for everything. The European Centre for Disease Prevention and Control (ECDC) has recommended that all European teenagers receive the HPV vaccine, but Turkey has no program in place. Regarding HIV, PreP is not available in Turkey, and not all antiretroviral drugs are available either. But the HIV drugs that are available can be found in pharmacies.

What to Get & Where to Get It[edit]

Pharmacy Recommendation - Karacabey Pharmacy near Dunya Goz Hastanesi Etiler

You can get medications for yeast infection at Turkish pharmacies. The word of "yeast infection" in Turkish is "mantar enfeksiyonu." You typically need a prescription for a urinary tract infection ("idrar yolu enfeksiyonu" in Turkish) since it's an antibiotic. However, you can often get drugs like Monural without a prescription. The word for "chlamydia" is the same and it seems that the word for "gonorrhea" is "belsoğukluğu." HIV and HPV are the same, and "Hepatitis" is " Hepatit."

Costs[edit]

Menstruation[edit]

Laws & Social Stigmas[edit]

While tampons are technically available in Turkey, there seems to be less comfort or familiarity with them. Tampons are less commonly sold in stores and most Turkish women do not use them. This has lead to some travelers mistakingly thinking that there are absolutely no tampons in Istanbul. To clarify: There are tampons, but you need to look in special places.

What to Get & Where to Get It[edit]

Pads and panty-liners are easy to find in Istanbul. However, tampons are much more difficult to find. They are sold in select pharmacies. It's been reported that in expat areas, like Cihangir or Moda, you may be more likely to find them in grocery stores or stores like Gratis as well. If you do find tampons, they're almost always OB (so no applicator).

There are no known sellers of DivaCup in Turkey so it should be purchased online. The only known seller of Mooncup in Turkey is in Canakkale (Dedetepe Eco Farm ) so it's probably easiest to purchase it online as well.

2018 update: Look in cosmetics stores and smaller shops that sell beauty supplies near universities. One box of Tampax (with applicators) will cost you ~16TL.

Costs[edit]

One box of 32 tampons should cost you around 11 TL.

Gynecological Exams[edit]

Laws & Social Stigmas[edit]

While cervical screenings are common in Turkey, a July 2016 Hurriyet article claimed that "cervical screening remains taboo in Turkey."[5]

What to Get & Where to Get It[edit]

There are a many hospitals and clinics in Istanbul, not only because it's a massive city, but also because it's a medical tourism destination. For this reason, it's recommended that you carefully consider the full range of options before making your choice. As a starting point, you should first know the three main types of hospitals to choose from. There are three main types:

  • First, there are the state hospitals, or "Devlet Hastanesi" in Turkish. These public hospitals can be found all over Istanbul (for example, Uskudar Devlet Hastanesi, Beşiktaş Sait Çiftçi Devlet Hastanesi, etc). This map can give some sense of the distribution of the state hospitals in the city (though, be aware, that it probably doesn't show all state hospitals). If you're a Turkish citizen or have Turkish health care coverage, this is your cheapest option, and services will often be free. If you don't have Turkish health care coverage, the prices will be cheaper than a private hospital but they will not necessarily be "cheap." You can expect to pay quite a bit more than someone with Turkish health coverage. Meanwhile, for all patients at these hospitals, it's typical to deal with long wait times and bureaucracy. Health care practitioners will have varying levels of skill and sensitivity. The majority of the staff will not speak English, so it's recommended that you either know Turkish yourself or bring along someone who does.
  • Second, there are the Medical Centers, also known as "Tip Merkezi" in Turkish. You'll see many of these medical centers in Turkey, which always have "Tıp Merkezi" or "Medical Center" in the name. They function like private hospitals in many ways, in the sense that they're more independently run and can have higher-quality care. Unlike private hospitals, they work harder to keep down the costs and they only accept Turkish Social Security (SGK).
  • Finally, there are the private hospitals. Generally speaking, you'll find the most efficient, responsive and highest-quality care at these facilities. However, the costs will be much higher. You can check out this list of private hospitals in Istanbul. For private hospitals with English-speaking staff, you can check out this list from the American Consulate General.

Here are some useful terminology for hospital visits: Vagina = vajina. Labia = labia. Biopsy of the endometrium (= endometrium in Turkish) is called probe curetaj. Curettage = curetaj. Myoma= myom. Fibroid = fibrom . Cervix = serviks. Uterus = uterus. Cyst= kist. Polyp= polip. Breast = meme. Nipple = Mamelon.

Recommended Gynecologists at Public and Tip Merkezi Hospitals[edit]

  • Dr Zeynep Asil at Ümran Tıp Merkezi Namazgah, which is located in Üsküdar. The gynecologist speaks English but not fluently. This hospital (and all other Tip Merkezi hospitals) are neither private hospitals nor public hospitals (also known as "devlet hastanesi"). Instead, they are a special type of hospital in Turkey: Tip Merkezi (translated as "Medical Center"). At these facilities, the costs are low and they only accept SGK. Even if you don't have SGK, the costs should be affordable. For example, the cost of a gynecological exam is 65 TL and the cost of a pap smear is 35 TL, as of October 2017. Hospital Address: Bulgurlu Mh. İzzettin Bey Sk No: 3 Üsküdar). Email: info@umrantip.co. Hospital Phone: 0216 461 94 92

Recommended Gynecologists at Private Hospitals[edit]

  • Dr. Munip Berberoglugil, Vital Fulya Plaza, Sisli - "I warmly recommend gynaecologist Dr. Munip Berberoglugil at Vital Fulya Plaza in Sisli who cares a lot about his patients, studied in Brussels and speaks perfect French and English. He fixed me up after the surgery at Acibadem which had left me with abnormal bleeding and lots of questions (they did not even bother to make a second appointment after surgery for control, which is often free - like at Amerikan hastanesi for example)." - Istanbul local
  • Prof. Dr. Yucel Karaman - "He is an authority, both in Istanbul as in Brussels, in the field of fertility problems and excellent gynaeclogist. He also speaks French and English." - Istanbul local
  • Cevahir Tekcan, Liv Hospital Ulus - Recommended by someone in the family: "Her name is Cevahir Tekcan and she is amazing. Takes good care of you, makes you comfortable and speaks to you straight. And she doesn't try to push you to an expensive surgery if she can avoid it."
  • Dr. Hakan, Maltepe Delta Hospital - Recommended by a user. She says, "He is my gyno he also delivered my son. He is very friendly, speaks english -- not perfect but I had no problem understanding him. Very helpful."
  • Prof. Dr. Kılıç Aydınlı in Nişantaşı: This female gynecologist comes highly recommended by an Istanbul local. "Very good, speaks English well." In 2016, a consultation was 350 TL, but you should inquire to find current rates.
  • Dr Ebru Alpher at American Hospital, Nisantasi: This gynecologist was recommended by an Istanbul local.
  • Dr. Levent Konuk at Central Hospital: He speaks Turkish (no English) only. He comes highly recommended by an Istanbul local. The hospital where he works (Central Hospital) is close to the Bostance metro station.

Personal Testimonials[edit]

Acibadem Maslak - Testimonial 1: I was very unhappy with a gynecological check up at Acibadem Maslak hospital lately. It is all about the money rather than about the patient. I am not complaining about the medical care but about the total lack of information I got by the doctor. (Asked the same question 3 times: why my endometrium was abnormally thick but all she could say was she had to do a hysteroscopy and perform a biopsy of my endometrium first and send it to the lab). This scared me to the point that I agreed to immediate surgery the next morning without asking around, since i thought it might be cancer. I guess I was unlucky to end up with a gynecologist that was bad in communication. She didn't even tell me I was going to have general anesthesia (so I planned to drive to the hospital myself). When I woke up, I was not given any information, except that they had found polyps and sent it to the lab. Afterwards, another doctor translated the report: they had removed a benign myoma and did a curettage. I was not given any hygenic pads (nobody told me beforehand i would be bleeding either). I was complaining about pain and they said it was normal, gave me a prescription to buy painkillers at the pharmacy before going home (in my country, they give you the necessary medication before going home, as well as complete detailed information by the doctor). I just felt awful and scared because i didn't know what was wrong with me.

Acibadem Maslak - Testimonial 2: I had an experience and Acibadem Maslak, with this lady ob/gyn. I forgot her name, but I wasn't pleased at all. I needed to ask the same question multiple times and still couldn't get clear information. And she was just trying to get me to do a surgery without further tests beforehand, just with basic controls. So my boyfriend and I decided to try another doctor.

Costs[edit]

Sexually Transmitted Infection (STI) Testing & Support[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

To say "STD Test" in Turkish, simply say "STD Test" (it's the same as English). It seems that many hospitals can give tests for HIV, Hep B, Hep C and syphilis. However, it is much more difficult to also get tested for gonorrhea, chlamydia, etc. One way to get a free HIV, Hep B, Hep C and syphilis test is to donate blood to Kizilay (https://www.kizilay.org.tr/) because they test the blood and then get back to you. In July 2016, Şişli municipality launched a free and anonymous health service for the LGBT community, focusing on the prevention of STDs. Every 3 months, patients can receive a free STD test and examination. Patients can register with a nickname if they wish.

Testimonial: "For all STD, after morning pills and infections, I believe the Austrian Hospital http://www.sjh.com.tr rocks! I am not sure about the abortion since it is not legal here. The prices are affordable (max 90-100 tl for a check up and you have a second one within 10 days, free of charge, called 'control visit'). Moreover, it is half shared cost with SGK (national insurance) if you have it."

Here's a list of some clinics that do STD testing in Turkey: http://www.whatclinic.com/doctors/turkey/sexually-transmitted-diseases-testing

Costs[edit]

Tests for Turkish citizens are supposed to be free (can we confirm this?) at public hospitals. As for foreigners, this may greatly vary, depending on whether you go to a public or private hospital, as well as how many tests you order.

Pregnancy[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

Testimonial: Dr. Hakan is my gyno. He also delivered my son. He works in Maltepe Delta hospital. He is very friendly, speaks English -- not perfect but I had no problem understanding him. Very helpful.

Costs[edit]

Abortion[edit]

Laws & Social Stigmas[edit]

Since 1983, abortion has been fully legal in Turkey. In 2012, a law was proposed that would allow doctors to refuse performing abortions. In response, protesters took the streets. The law did not pass, but many doctors (especially in public hospitals) have reportedly acted like the law passed, and they have decided to stop performing abortions. This means that, currently, you can get an abortion in Turkey -- but only at select hospitals/clinics.

In Turkey, you can get an abortion for up to 10 weeks of pregnancy. After 10 weeks, the abortion can only be performed if the woman's life is endangered or in cases of fetal impairment. Overall, legal reasons for abortion include: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons, and availability on request. According to Law No. 2827 of 24 May 1983, Population Planning Law, married women need spousal consent, and minors or mentally disabled patients need approval from their parents, guardians or the magistrate's court. If there is endangerment to life or vital organs, no approval is required from spouses or parents/guardians. If there is a risk to the woman's life or risk of fetal malformation, two specialists (one ob/gyn and one specialist in a related field) must write their objective findings in a confirmation letter.

There are cases of some gynecologists who may also secretly/illegally perform abortions after 10 weeks. One anonymous testimonial: "My private doctor would have done it much, much later than 10 weeks. Not sure about the legality, but she said it would happen if necessary. I had amnio during both pregnancies to check for genetic abnormalities at around 20 weeks, and she told me that if there was a problem, then she would do an abortion, if we wanted to."

According to a UN report, "Despite the liberal nature of abortion laws in Turkey, the number of legal abortions performed in the country has been sharply restricted by the requirement that the procedure be carried out only by or under the supervision of gynaecologists. This factor is especially critical in rural Turkey, where medical specialists of any type are scarce or non-existent" (Abortion Policy - Turkey).

Misoprostol (the abortion pill) is no longer available.

Note that pre- and post-abortion counseling is not common in Turkey.

What to Get & Where to Get It[edit]

It is advised to try to book an appointment at a private hospital. In March 2016, the Turkish Society of Obstetrics and Gynecology declared that public hospitals have effectively banned abortion. There is also reported discrimination against single woman, and it has been found that some hospitals ask for marriage certificates from patients. In 2013, Ayse Arman wrote about the condescending, judgmental and unprofessional treatment she received upon receiving an abortion at an Istanbul public hospital.

Places that supposedly don't perform abortions anymore:

  • Develet Hastanesi is not performing abortions anymore due to government/political pressure (though they are legally allowed to do so). This isn't confirmed but has been rumored.
    • Details: "I asked from a doctor working a devlet hastanesi (marmara university hospital) and they don't perform abortions unless there is a medical necessity. I dont know if other hospitals are different, but i have a feeling this is how it is now."

Testimonials[edit]

Testimonial 1: Mitera Clinic - My gf went to the location in Şişli. She was quoted 800TL but she ended up paying 700 after negotiating. The experience was awesome. Very clean, professional and kind. They gave her a small dose of something to make her sleep for the procedure. She woke up, it was all over and no pain, no issues at all. She was so thrilled compared to one she had in the States years prior. I waited for her in the lobby, 30 minutes. She was exactly 6 weeks. Oh and doctor spoke English.

Testimonial 2: Estegyn Istanbul, Dr. Burcu - I had my abortion in Bakirkoy at this private clinic. It was clean and neat. Dr. Burcu spoke English, German, Russian and Turkish. I was in my 8th week when I had mine and it cost almost around 700TL. For Devlet Hastane, it will cost you much much cheaper. Just make sure you don't go alone.(http://www.estegyn.com/en/category/abortion/)

Testimonial 3: A friend got an abortion, private gynecologist clinic (performed at a hospital). It cost a few thousand liras. But i bet the price varies a lot depending on the doctor. But, in short, you can go to a private clinic to get one.

Costs[edit]

Turkey has a nationalized health care system so prices are lower for Turkish citizens. For foreigners, expect to pay between 700 TL-1000 TL, depending on the clinic.

Advocacy & Counseling[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

  • Morçatı Kadın Sığınağı Vakfı (Purple Roof Women’s Shelter and Foundation) - Provides legal and practical aid to women who are victims of domestic violence Phone: Email: 0090 212 292 52 31-32. Katip Mustafa Celebi Mah. Anadolu Sok. No:23 D:7-8, Beyoglu-Istanbul, Turkey morcati@ttnet.net.tr. (http://www.morcati.org.tr/tr/)
  • We Will Stop Femicide: "The platform strives for stopping femicide and ensuring their protection from violence. It fights against all types women’s rights violations, starting wih the violation right to life." Phone: +90 506 880 20 61. Email: kadincinayetlerinidurduracagiz@gmail.com

Costs[edit]

List of Additional Resources[edit]

  • Turkish Ministry of Health
  • Türkiye Aile Sağlığı ve Planlaması Vakfı (Turkey Family Health and Planning Foundation)
  • Istanbul Hollaback - "Hollaback! is an international movement to end harassment. We believe that everyone has the right to feel safe and confident in public spaces." (http://istanbul-en.ihollaback.org/)
  • Kirmiza Semsiye/Red Umbrella Sexual Health and Human Rights Association - "Red Umbrella Sexual Health and Human Rights Association aims to raise awareness and visibility regarding human rights violations experienced by male, female and transgender sex workers in Turkey." Based in Ankara. Phone: +90312.419.2991. Email: kirmizisemsiye@kirmizisemsiye.org. Website: http://kirmizisemsiye.org/
  • Amargi: Feminist collective based in Istanbul.
  • Kamer: "We are women who have recognized, questioned, and started to transform the violence in their lives and their traditional statuses. We are sharing our awareness with other women so we can all challenge the norms and redefine our roles."
  • Morçatı Kadın Sığınağı Vakfı (Purple Roof Women’s Shelter and Foundation): - Anti-domestic violence organization. "We work to end domestic violence against women and children by building women’s self-esteem and confidence. When women are ready we encourage them to make their own decisions. We support a woman’s process in decision-making without judging her or putting pressure on her."
  • Lamda Istanbul - LGBT organization; reports human rights violations (http://www.lambdaistanbul.org/s/)
  • Kadın Eserleri Kütüphanesi ve Bilgi Merkezi Vakfı (Women’s Library and Information Centre Foundation - First and only women's library and education center in Turkey. Fener Mahallesi, 34220 Istanbul, Turkey, Phone: 0090 212 534 9550, Fax: 0090 212 523 7408, E-Mail: kadineserli@gmail.com, Website: http://www.kadineserleri.org
  • Pazartesi - Feminist magazine of Turkey. Abdullah Sok. No: 9, Beyoglu-Istanbul, Turkey. Phone: 0090 212 292 0739. E-Mail: pazartesidergi@superonline.com. Website: http://www.pazartesidergisi.com
  • Sosyalist Feminist Kolektif/Socialist Feminist Collective - Address: Katip Çelebi Mah. Tel sok. No: 20/3, Beyoğlu-İstanbul, Turkey, Phone 0090 212 243 4993, E-Mail: sosyalistfeministkolektif@gmail.com, Website: http://sosyalistfeministkolektif.org
  • Kadının İnsan Hakları Projesi (Women for Women’s Human Rights) - "an independent women’s non-governmental organization (NGO) that aims to promote women’s human rights, equality and non-discrimination in Turkey and on the international level." Address: Inonu Cad. Saadet Apt. No: 37/6, Gumussuyu 80090, Istanbul, Turkey, Phone: 0090 212 251 00 29, Fax: 0090 212 251 00 65, E-mail: wwhrist@superonline.com, Website: http://www.wwhr.org

References[edit]

  1. Trends in World Contraceptive Use 2015
  2. Infoplease data on contraceptive use
  3. link to study by International Consortium of Emergency Contraception
  4. Princeton Emergency Contraceptive Website
  5. Hurriyet Article on Cervical Cancer Remaining Taboo in Turkey