Estonia

OVERVIEW

Generally speaking, Estonia is a technologically advanced society that follows European Union standards. You can access many forms of contraception, including condoms, pills, and IUDs. However, a prescription is required for most forms of contraception. You can access emergency contraception over-the-counter, and there are 24-hour pharmacies where you can access them. You can also find pads, tampons, and menstrual cups sold in pharmacies and stores. Regarding STIs, you can find low-cost or free testing services at youth counseling centers and HCT sites. Concerning pregnancy, women are entitled to 140 days of pregnancy and maternity leave. Finally, abortion is legally available during the first 12 weeks of pregnancy.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Estonia, you can purchase condoms without a prescription at pharmacies. However, you need a prescription to obtain most forms of contraception, such as birth control pills, implants, and IUDs.

In 2015, it was estimated that about 65% of Estonian women (who were ages 15-49 and married or in unions) used any form of contraception. This was markedly lower than the Northern European average, where about 77% of women use contraception. Furthermore, it was found that about 13% of women had unmet family planning needs, which was a higher rate than the Northern European average of about 7% of women with unmet family planning needs. The most common forms of contraception used by Estonian women were IUDs (22% of women), birth control pills (19% of women), and condoms (14% of women). For all other modern forms of contraception, there were low rates of usage. For example, vaginal barrier methods were used by less than 1% of women. There were practically no recorded users of contraceptive injectables (0% of women) or contraceptive implants (0% of women). However, some women did practice traditional contraceptive methods, such as the rhythm method (3% of women), withdrawal (2% of women), and other traditional methods (3% of women).

What to Get & Where to Get It

• You can find condoms sold in pharmacies, sex shops, and online stores, like Apotheka, Kondoomipood, and Care to Beauty. Some brands you can expect to find in pharmacies are Durex, Actual, and One Touch. It's important to note that, while you can buy condoms online, they will probably be cheaper if you buy them in person at stores.
• You can find oral contraceptive (birth control pills) in pharmacies, but you will need a prescription to obtain them.
• You can get an IUD inserted at hospitals or clinics, but you may need to first purchase the device at a pharmacy.
• You can get a contraceptive implant inserted at hospitals or clinics, but you may need to first purchase the device at a pharmacy.

Costs

• The fee for the IUD procedure will vary, depending on the clinic you visit. For example, the procedure is 45€ at Medicum and 590€ at Klinik Elite, as of January 2019.
• The fee for the contraceptive implant procedure will vary, depending on the clinic you visit. For example, the procedure is 60€ at Medicum and 400€ at Klinik Elite, as of January 2019.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex to prevent pregnancy. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Estonia, emergency contraceptive pills (morning after pills) are available over-the-counter at pharmacies. No prescription is required and there are no age restrictions regarding who can purchase them. The use of emergency contraceptive pills is also rather common. It has been estimated that about 41% of Estonian women have ever used emergency contraception.

The Estonian government and social services have made efforts to provide educational resources on emergency contraception. The country has seen local guides published (such as "Ravimeetod – postkoitaalne kontratseptsioon" in 2005 and " Õpilase seksuaaltervis: Tegevusjuhend kooli tervishoiutöötajale" in 2007), which focus on emergency contraceptive use. Young people can also find information on emergency contraceptives when they visit youth counseling services. In addition, health care professionals (such as gynecologists, family doctors, and health personnel at schools) often let people know about emergency contraceptive options when they receive general consultations or checkups.

What to Get & Where to Get It

• Note: You can find 24-hour pharmacies in Tallinn and potentially other Estonian cities.
• You can find emergency contraceptive pills (morning after pills) at pharmacies, and they are sold over-the-counter. Some brands you may find are Escapelle, Postinor Duo, and ellaOne.
• Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex. Check to see if your country carries ellaOne. If your country doesn't carry ellaOne, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

Costs

• Emergency contraceptive pills (morning after pills) are not reimbursed or covered by Estonian social security. For this reason, you'll probably need to pay the full price of the pills at pharmacies. However, you may be able to find reduced costs for pills at women's clinics or special programs.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Estonia, there are no known travel or residency restrictions for people with HIV/AIDS. This means that you can enter the country, regardless of your HIV status, and you should not be deported if you test positive for HIV while you are in the country.

The testing for HIV in Estonia is voluntary, and tests can only be administered with the informed consent of the patient. It is common for doctors to recommend an HIV test for patients, especially in areas with a higher HIV infection rate, such as Tallinn or northeastern Estonia. The only times that HIV testing is mandatory is when people donate blood or organs. You can only receive an HIV test in a healthcare institution from a medical professional (i.e. doctors, nurses, midwives, lab technicians, etc).

Testing Facilities

• There are different types of testing facilities in Estonia, including HCT (HIV Counseling and Testing) sites, youth counseling centers (for ages 19–24 years old_, hospitals, and clinics. Generally speaking, if you're qualified to visit a youth center, they are great options, since they tend to provide free and responsive services. If you're uninsured, you can visit the HCT centers, which provide free testing to the uninsured. If you're insured, you will find that many places provide free or low cost tests.
• AIDS-i Tugikeskus (AIDS Infornation and Support Centre): They provide: "HIV – testing, HIV pre- and post test counselling, consulting about sexually transmitted diseases (STD-s) for public in general and youth; possibility of anonymous HIV/STD testing, treatment of STD-s, etc." Address: Kopli 32, 10412 Tallinn, ESTONIA. phone/fax +372 6413165. e-mail: aids@tugikeskus.ee
• Testikodus.ee: "TESTIKODUS.EE is an environment for fast, discrete and safe testing for the most common venereal diseases in Estonia. Testing can be performed for the following diseases: Urogenital chlamydiosis (Chlamydia), Gonorrhoea, Trichomoniasis, Herpes viruses (HSV1, HSV2), Mycoplasmosis (Mycoplasma genitalium). From Testikodus.ee home page requested test(s) can be selected. After making a choice, the orderer will receive the sampling kit in a suitable way, and then the sample should be taken... The sample should be sent to the laboratory, where the test results will become clear during 5 days max (usually 2 workdays)."
• Klinik Elite: You can get an STI tests (Chlamydia 20 eur, HIV 20 eur, others 20 eur), price quotes from January 2019.

Support

Treatment

• Lääne Tallinna Keskhaigla, Merimetsa nakkuskeskus (Hospital for infectious diseases): Paldiski mnt. 62, 10617 Tallinn, Doctors in charge: Dr. K. Zilmer, Dr. M. Raukas, Phone: +372 659 8586; 659 8524, Registry phone: 1314.
• Tartu Ülikooli Kliinikum (Tartu University Clinic): L. Puusepa 1a, 50406 Tartu. E-mail: kliinikum@kliinikum.ee
• Narva Haigla, Nakkushaigusteosakond (Narva Hospital, infectious diseases section): Karja 6, Narva, Doctors in charge: Leonid Sizemski. Phone +372 3548802
• Ida-Viru Keskhaigla, Puru Haigla (North East Central Hospital, infectious diseases section): Ravi 10, 30322 Kohtla-Järve, Doctor in charge: Jelena Shmidt. Phone: +372 3322188.

NGOs & General Resources

• Confidential hotline: 645 5555 (24 h; Estonian & Russian)
• Eesti HIV-positiivsete võrgustik (Estonian Network of PLWH): They provide peer support, consultations on adherence to ARV treatment, care, support, education, trainings. Address: Mardi 3, 10145 Tallinn, Phone: +372 56506316, Contact person: Mr. Igor Sobolev, E-Mail: eesti.hpv@gmail.com
• LIGO (Life is Going On, NGO for women): Mardi 3, 10145 Tallinn. Phone: +372 6607302. Contact person: Ms. Irina Moroz. E-Mail: info@ligo.org.ee
• NGO Convictus Eesti: They provide needle exchange and drug user consultation. Postal address: Merivälja tee 1-K102, 11911 Tallinn, Estonia, Phone (office): (+372) 6 410 133, E-mail: convictus@convictus.ee . Address: Narva mnt. 46 Tallinn. Open every day 13.00-21.00 . Phone: (+372) 6414107.
• AIDS Healthcare Foundation (AHF) Estonia: "AHF has operated in Estonia with help from the Estonian Network of People Living with HIV (EHPV) since early 2009. Through the partnership, people living in areas most affected by the epidemic are able to receive rapid HIV testing, free condoms, and referrals to healthcare providers if they test positive. In 2013, AHF and EHPV opened an HIV treatment clinic at the epicenter of the epidemic, Narva; a city severely impacted by the confluences of socioeconomic depression and widespread drug use. The clinic was the first AHF clinic in the EU and is also a meeting site for support groups for people living with HIV/AIDS."
• ESPO Society (PLWH in Estonia): Mardi str.3, 10145, Tallinn, Estonia. Phone +372 660 7707. Mob. +372 525 6449. Contact person: Slava Vasiljev. E-mail: slava@aids.ee
• AIDS Support Centre: Kopli 32, 10412 Tallinn, Estland. Phone +372 641 3165. Fax +372 641 3165. Contact person: Ms. Svetlana Denks
• Estonian Association "Anti-AIDS": Hiiu 42, 11619 Tallinn, Estland. Phone +372 251 4360. Fax +372 670 6814. Contact person: Ms. Ludmilla Priimgi

Costs

• If you have health insurance, you can often get HIV tests (and other STI tests) for no fee.
• If you're a youth (i.e. 24 years old or younger), you can find free testing services at youth counseling centers.
• If you don't have health insurance, you can often find services (testing and counseling) for HIV, Hepatitis B, and Hepatitis C, especially at anonymous HCT sites, which can be found in multiple cities in Estonia.
• There are also free and anonymous testing sites in Tallinn for injection drug users, sexual partners of injection drug users, and sex workers.

Medications & Vaccines

What to Get & Where to Get It

• While you can most likely get the HPV vaccine at hospitals or clinics in Estonia, there is no nationwide HPV vaccination program, as of December 2018.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

• You can find menstrual cups sold in venues, such as Mahkmed (sells Lunette) and Rimi CHM Norde (sells Organicup).

Gynecological Exams

What to Get & Where to Get It

• East Tallinn Central Hospital: "East-Tallinn Central Hospital Department of Gynecology is specialized on diagnostics and treatment of women´s health conditions. Our doctors are widely competent - we help you with cervical cancer (malignant and benign tumors), infections or prolapse of pelvic organs, infertility, endometrial polyps and endometriosis. Gynecology department includes 2 well-equipped operating rooms and 18 hospital beds, including 4 intensive care units."
• Klinik Elite: You can get an exam here (35 eur consultation fee; 20 euro for a pap smear; 30 euro for gynecological ultrasound; 35 euro go ultrasound during first trimester of pregnancy), price quotes from January 2019.
• Lasnamäe Medicum and Port Medicum: Services include: counseling, prescription for a hormonal contraceptive device, registering your pregnancy

advice and assistance during pregnancy, advice and assistance after giving birth, screening of cervical cancer, and help with simple gynaecological disorders (e.g., bacterial vaginosis, candidiasis). E-mail: medicum@medicum.ee

Costs

• At Medicum, here are some prices from 2019: Gynaecologist's complex service (examination, preparation of a treatment plan, vaginal ultrasound scan; tests and analyses as needed) - 59€; Visit to a midwife: examination and counselling (fees may be added for tests and analyses)- 15€; Midwife's appointment with a Pap test - 27€

Pregnancy

Laws & Social Stigmas

In Estonia, women are entitled to 140 days of pregnancy and maternity leave. The beginning of maternity leave period can begin up to 70 days before the birth term. If women are employed, their benefits are paid out by the Health Insurance Fund. Meanwhile, men are granted ten days of paternity leave within two months of the anticipated birth date. The paternity leave funds are covered based on the average wage. In addition, the mother or father has the right to take general "parental leave," which allows the parent to care for the child until it is three years old. However, only one parent can take parental leave. The benefits for parental leave are determined by the Family Benefits Act.

What to Get & Where to Get It

• East Tallinn Central Hospital: "The women’s clinic at East Tallinn Central Hospital offers reliable professional help for taking care of your health and becoming a mother... The maternity hospital at the Central Hospital is the oldest in Estonia. One fourth of Estonian children are born here. Many of our patients are connected with long-term traditional ties – often multiple generations of mothers and grandmothers have given birth here."

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Estonia, abortion is legally available upon request in the first 12 weeks of pregnancy, according to the Termination of Pregnancy and Sterilization Law. Furthermore, abortion is legally available in the first 22 weeks of pregnancy when the pregnancy causes physical issues for the pregnant person, if the baby has a high risk of severe mental or physical disabilities, if the pregnant person has a disease or heath issue that would prevent them from bringing up the child, or if the pregnant person is under 15 years old or over 45 years old.

What to Get & Where to Get It

• Eesti Seksuaaltervise Liit / Estonian Sexual Health Association: You can contact them to learn more about abortion laws or abortion providers in Estonia. "As Estonia’s leading advocate of family planning and sexual and reproductive health (SRH), the Estonian Sexual Health Association has chosen to focus particularly on sex education for young people."
• Medicum: "Performed at the request of the patient up to the 9th week of pregnancy. To induce an abortion, medications are administered according a regimen. Before that, a gynaecological visit is required, where an ultrasound scan is used to determine the extent of the pregnancy and necessary analyses are taken." "Medicum is the largest outpatient care facility providing general and special medical care in Estonia, and it has been operating since 1986 when it developed from Lasnamäe polyclinic." Registration office +372 605 0601.

Costs

• At Medicum, here are medical abortion costs (as of January 2019): Medical abortion - 120€; Copayment for medical abortion - 17.67€

Advocacy & Counseling

What to Get & Where to Get It

Emergency Numbers

• Emergency number: Call 112
• First Aid (Ambulances): Call 112 (24-hour)
• East-Tallinn Central Hospital, Emergency Room at Women’s Clinic – midwife of duty: Call +372 53 080 874
• Trauma centers:
  • East Tallinn Central Hospital, Ravi 18, Tel: 1900 or 372-6227070
  • Tallinn North Estonia Medical Center Hospital, Sütiste 19, Tel: (372) 617-1049 or (372) 617-1300 or (372) 6171369 (for Emergency Room 24 hours).
• Tallinn Helpline: Call 1345 (for information on transport, environment, pets, etc)

Organizations

• AIDS-i Tugikeskus (AIDS Infornation and Support Centre): They provide: services for sex workers, youth, LGBTQ people, harm reduction, HIV testing and counseling, and more. Address: Kopli 32, 10412 Tallinn, ESTONIA. phone/fax +372 6413165. e-mail: aids@tugikeskus.ee

List of Additional Resources

• Ministry of Social Affairs: The areas of focus include: Health care, Public health, E-Health, Labour, Social security benefits, Social services, Children and families, Gender equality and equal treatment. Their website is in Estonian, Russian, and English. Address: Ministry of Social Affairs, Suur-Ameerika 1, 10122 Tallinn. Phone: 626 9301. Fax: 699 2209. E-mail: info@sm.ee
• Eesti Seksuaaltervise Liit / Estonian Sexual Health Association: "As Estonia’s leading advocate of family planning and sexual and reproductive health (SRH), the Estonian Sexual Health Association has chosen to focus particularly on sex education for young people."
• Estonian Gynecologists Society (Eesti Naistearstide Selts): This organization was established in 1953, and it focuses on supporting and advocating for gynecologists of Estonia. Phone: 7319902. Email: ens@ens.ee
• The Estonian Women’s Associations Roundtable (EWAR): "The Estonian Women’s Associations Roundtable (EWAR) is an open and democratic women’s organizations network based on co-operation. Its aim is to form common positions among women on questions important to society, to advance participatory democracy and equality between women and men." Email: enu@enu.ee
• Equaldex - Estonia: This website provides information on LGBTQ rights and laws in Estonia.
• Estonian LGBT Association: "The mission of the Estonian LGBT Association, as a representative of the Estonian LGBT people, is to raise awareness of LGBT topics in the society through education and advocacy. The association also aims to increase the self-awareness and social activity of LGBT people by providing support and personal growth possibilities." Phone: +372 5551 5817. Email: info(at)lgbt.ee
• The Integration Foundation: They provide services to help non-Estonians integrate into Estonian society. This is a potentially useful for foreigners. Address: Lõõtsa 2a, 8th floor, 11415 Tallinn. Phone: 800 9999. Email: info@integratsiooniinfo.ee