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Serbia

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OVERVIEW

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While there is certainly room for improvement, you can find many health care options in Serbia. You can purchase oral contraceptives (birth control pills) over-the-counter. No prescription is required. You can also purchase emergency contraception (the morning after pill) without a prescription. There are certainly some taboos around discussing sexuality and contraception, and this is in large part due to the nonexistent sex education in many Serbian schools. However, the country also does boast an array of contraceptive options, including pills, rings (e.g. Nuvaring), injectables and IUDs. You can receive STI tests at various clinics, and PEP is available for free. While you can find pads and tampons in Belgrade, you may have some difficulty finding menstrual cups or certain eco-friendly menstrual products, so those should be purchased online. Regarding abortion, for the first ten weeks of pregnancy, abortion is completely legal in Serbia. If you're under 16 years old, you need permission from your parents to receive an abortion. On this page, we have included some recommended gynecologists and obstetricians (from locals), which you may find in the sections below.

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 Serbia, you can purchase oral contraceptives (birth control pills) without a prescription.[1] While there are minimal religious or moral stigmas attached to birth control pills, according to locals, some women may avoid the pill because they consider it detrimental to hormonal health.

When discussing contraception in Serbia, it's important to consider the state of sex education. As of September 2016, Serbia has no nationwide sex education in public schools,[2] although at least one province has introduced an optional sex education program.[3] In total, sex education remains uncommon and even taboo in parts of Serbia, which therefore makes discussion of contraceptive options all the more uncomfortable for some women.

When examining Serbian family planning policies, one must consider the country's recent history. From the end of WWII to 1991, Serbia was a part of the Socialist Federal Republic of Yugoslavia.

What to Get & Where to Get It

  • You can find condoms in Belgrade pharmacies. Typically, Durex brand condoms are sold.
  • You can buy birth control pills in Serbia without a prescription at pharmacies. Some brands you can expect to see are Neogynon, Stediril, Stediril-d and Microgynon-30.[4] Note that progestin-only pills, like Cerazette and Azalia, are not sold in Serbia (as of May 2017), so local women tend to purchase them in Croatia or Hungary (and then bring them back to Serbia), if they prefer progestin-only pills.
  • If you have a prescription for birth control from another country, you can probably get the prescription filled in a Belgrade pharmacy. Bring the prescription with you and show it to the pharmacist.
  • You can get an IUD in Serbia, where you'll find the Mirena and Novaplus brand at pharmacies.[5] It is typically used by women who have already had children, but it's not commonly used in general in Serbia. One local said: "I don't know the price or if they will give them to a younger woman." If you know of gynecologists giving IUDs to younger, unmarried or women without children in Serbia, please add information to this section.
  • You can find the contraceptive ring (Nuvaring) in Belgrade pharmacies.[6]
  • According to a Belgrade local, contraceptive shots/injectables are not available in Serbia.
  • It seems like contraceptive patches aren't available in Serbia (as of May 2017). One Belgrade pharmacist says, "We don't have contraceptive patches in my pharmacy, nor i'm know more of their current availability."[7] Also, no contraceptive patches are listed on the official Serbia page from the International Planned Parenthood contraceptive database.

Costs

  • Serbian health insurance covers about 20% (or more) of birth control costs, according to a Belgrade local (May 2017).
  • For condoms, you can expect to pay the following: Durex brand, 252 din- 300 din box, or Romed, 15 din single piece (May 2017).[8]
  • Here are the prices for various birth control pill brands at a Belgrade pharmacy (May 2017): cerazette 1021.69, cyclo proginova 238.02 din, diane-35 524,46 din, jeanine 752.38, legravan 199.83, lindynette 483.44, logest 586.56, microgynon 408.41, novynette 518.55, primolut-nor 264.39, qlaira 1345.96, yasmin 1157.09, yaz 1153.28, orgametril was 399.29 (but currently unavailable at the pharmacy).[9]
  • For Pharmatex vaginal caps (local spermicidal contraception), you can expect to pay 528.53 din (6 caps) (May 2017)[10]
  • For IUDs, here are prices that you may see at a Belgrade pharmacy (May 2017): hormonal - mirena - 13740.74. copper-Ag - novaplus t380 -normal size - around 5000 dins.)[11]
  • For a Nuvaring, here's the price that you may see at a Belgrade pharmacy (May 2017): 1282.27)[12]

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. 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 Serbia, you can purchase emergency contraception (the morning after pill) without a prescription.[13] [14] It's important to note that while you can get LNG emergency contraception (like Escapelle and Postinor-2) without a prescription in Serbia, you may need a prescription for UPA emergency contraception (like ellaOne).[15]

What to Get & Where to Get It

  • In Serbia, you can get emergency contraception (the morning after pill) without a prescription at pharmacies. Typically, EC is not on the shelves of pharmacies and you must specifically ask for it from the pharmacist. You will primarily find the LNG type of emergency contraception, like Escapelle (take 1 pill within 120 hours after unprotected sex) or Postinor-2 (take 2 pills within 120 hours after unprotected sex).[16] You may also find the UPA type of emergency contraception (like ellaOne) sold in Serbia. For ellaOne, you take 1 pill within 120 hours after unprotected sex. Note that ellaOne is considered the most effective EC on the market.[17] So, if you feel that you may need ellaOne, you should contact a physician to see if you can get a prescription.
  • If you can't access dedicated emergency contraception (like Escapelle, Postinor-2 or ellaOne), you can use regular birth control pills as replacement EC. If you do this, remember that, in 28-day packs, only the first 21 pills can be used. You can do the following:
    • For any of these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later: Neogynon, Stediril, Stediril-d[18]
    • For any of these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later: Microgynon-30[19]
  • You can also get an IUD as emergency contraception. Contact your physician to learn more details.

Costs

You may pay the equivalent of € 8,80 for LNG emergency contraception and € 24 for UPA contraception. Note that EC is not reimbursed or covered by social security.[20] At one Serbian pharmacy, the price for Escapelle was 1781.27 dinars (May 2017).[21]

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

There are no travel or residency restrictions related to HIV status in Serbia. You're also allowed to carry around antiretroviral medication for personal use.[22]

Some locals report that there's significant stigma around HIV tests. It's common for locals to feel like they don't want to get tested or to feel like they don't need to be tested.

Testing Facilities

  • In December, there are free HIV tests in Serbia for HIV awareness month.
  • You can a range of STI/STD tests at Konsilium Laboratories. They have a location on Makenzijeva.

Treatment & Support

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • You can supposedly access PEP (post-exposure prophylaxis) for free in Serbia.[23] Contact a local emergency room or hospital to get more information.
  • There is currently no PrEP (pre-exposure prophylaxis) program in Serbia, as of May 2017.[24]
  • If you have menstrual pain ("menstrualne tegobe" in Serbian), you can tell the pharmacist "Boli me stomak; dobila sam," which means "I have a stomach ache; I got my period."
  • If you have a urinary tract infection (UTI) (or "urinarna infekcija, infekcija urinarnog trakta" in Serbian), here's what a Belgrade pharmacist says: "For sistemic antibiotics for uti, yes, we need a prescription and it's valid 3 days from prescript.date. for antibiotics-uroantiseptics like pipemidic acid (pipem, pipegal, palin), norfloxacin (uricin, nolicin), phosphomycin (monural) we don't need a prescription. some doctors like to advice patients to find nitrofurantoin for persistent e.coli."[25]
  • If you have a yeast infection (or "gljivicna infekcija" in Serbian), you can try to get Fluconazole (the generic name for the active ingredient) at pharmacies. In Serbia, the active ingredient Fluconazole may be found in the following medications: Diflucan, Fluco Sandoz, Fluconal, Flukonazol Zdravlje or Flumycozal.[26] Also, here's more information from a Serbian pharmacist (May 2017): "The most popular antimicotics are clotrimazole ("canesten"-vag.tbl 3x200mg 554.4, 1x500mg 529,76, vag.cream 554.4; or domestic "kansen" with lower prices: 3x200mg 431.2, cream 431.2), miconazole (gino-daktanol 7x200mg tbl. 374.28 ), enticonazole (lomexin 1cps 351.24), nystatin (macmiror -12 tb 1095.99 re cream 819.77, polygynax-6cps 388, 12 cps 776.04), butoconazole (cream name - gynofort, 526.80 ). And then some wide broad spectrum antimicrobials for mixed infections like povidone iodine (povidon jod tbs - i lost the price, betadine), dequalinium chloride (fluomizin tb. 890.37) or oral cps like diflucan, 1x150mg or 7x50 mg (forgot to check the exact prices). And there are vaginal probiotics, alone or with hormones (gynoflor), or fitoeostrogens (vagilact 746.46) probiotics only: gynophilus 14 tbs, or gynophilus SR 2 tbs (1377.34), lactogyn vaginal and oral cps (around 1200-1300). Then different gels or tbs for balancing vaginal flora: multigyn gels lubricants or infection treating,vaginal gels for moisture lactogyn (lactic acid); intimo help tbs (558.6), and many others on the market."[27]
  • Serbia has no nationwide HPV vaccination program (as of April 2017), despite the fact that cervical cancer ranks as the second most prevalent cancer for women (ages 15-44) in Serbia.[28]

Costs

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.

Laws & Social Stigmas

What to Get & Where to Get It

  • The most common menstrual products in Serbia are pads and sanitary napkins. They can be found in nearly all grocery stores, drug stores and pharmacies. They tend to be rather affordable and there's a wide range of options. The two most popular brands are Always and Carefree.
  • You can find tampons in some stores, but they typically don't have applicators. Overall, tampons are less commonly used by Serbian women.
  • There are no known local menstrual cup sellers in Serbia, but you can buy menstrual cups online.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

Note: To say "gynecological clinic" in Serbian, you say "Ginekoloska klinika."

Public Health Centers

  • The public health centers tend to be free (if you're Serbian or have Serbian health coverage), but they can be crowded. You may have to wait a long time to see a gynecologist.
  • "As for women's clinic, I've heard lots of praises about the public clinic Narodni front but lately I've heard some bad impressions as well." - Belgrade local

Private Health Centers

  • It's common for Serbian women to visit private health centers (if they can afford it) for gynecological exams, since they tend to be efficient and less crowded.
  • Poliklinika dr Rončević (Roncevic Clinic): One Belgrade local says, "As for private clinics, I would personally recommended Roncevic clinic, they offer a full package of exams for about 35 euros and their doctors are nice and great experts." Address: Baba Višnjina, Beograd, Serbia. Phone: +381 11 3447517.
  • Clinica Nova: "Dr Maglic is amazing and he explains everything in perfect english!!!" - Belgrade local. From the clinic (May 2017): "Regular price for gynecologial examination is 3500,00 rsd [edit: we believe they mean 35,000 - waiting for confirmation]. But now we have special offer for ladies for only 1900 rsd. This price include gynecological scanning, ultrasound, colposcopy, papanicolau and VS test with final opinion. For appointment you can call our Call center +381 71 51 777." Address: Višegradska 26, Belgrade, Serbia. Phone: +381 11 7151777. Email: visegradska@clinicanova.rs
  • Ginekološka Ordinacija Taurunum Medical: Their price for a gynecological exam (with a pap) was 4000 dinars in May 2017.[29] Address: Ugrinovačka 117, Zemun. Phone: +381 66 6334225. Email: taurunum.medical@gmail.com.
  • Ginekoloska Ordinacija Raovic: Address: Golsvordijeva 6, Belgrade, Serbia. Phone: +381 11 244.77.63; 063 687889. Email: office@ordinacijaraovic.com
  • Ginekološka Ordinacija Biljana Živaljević: Address: Kumanovska 23, Belgrade, Serbia. Phone: +381 11 3863716. Email: biljanazivaljevic@gmail.com

Costs

Pregnancy

Laws & Social Stigmas

What to Get & Where to Get It

  • Tip from Belgrade local, May 2017: "I used Dr Miloš Petronijević for both my pregnancies, his clinic is at Kičevska 13a. I found him to be extremely good at his job and very professional. He is also the head of the high risk pregnancies department @ GAK of Višegradska (Klinički Centar). His wife is also a gyno and took a long time to do a specialist ultrasound for me once, so nothing but praise for both of them. Miloš is also my standard gyno so he isn't just a pregnancy specialist btw."

Costs

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

For the first ten weeks of pregnancy, abortion is completely legal in Serbia. In other words, you can get an abortion upon request if you're over 16 years old. If you're under 16 years old, you'll need parental permission.[30] Between 10 and 20 weeks of pregnancy, you can get an abortion for the following reasons: if the pregnancy is the result of rape or incest, or if the pregnant woman is suffering from psychological trauma or socio-economic challenges that prevents her from carrying the pregnancy to term. To receive an abortion after 10 weeks, the pregnant woman must receive approval from a panel of experts.[31]

Historically, Serbian abortion policy has been rather lenient. Abortion was legalized in 1969, when Serbia was a part of the former Yugoslavia.[32] For decades, abortion was rather common, and it was even a primary birth control method for many Serbian women. This was partially due to the limited availability and usage of others contraceptives, and the fact that many women perceived birth control pills to be unhealthy. However, women have progressively begun using more preventative contraceptive methods over the years.[33]

In 2012, it was reported that Serbia had the highest abortion rate in Europe, with about 8000 abortion rater per year. However, the numbers are hard to gauge as many abortions go unreported. In fact, one of the greatest challenges for Serbian abortion providers are the strict laws around licensing. It's so difficult for physicians to become licensed practitioners of abortion that many simply work as unlicensed practitioners at private clinics, and the abortions go unreported. Generally speaking, it seems like many Serbian women go through the private clinics.[34]

What to Get & Where to Get It

  • As of 2012, the following surgical abortion methods were available in Serbia: aspiration (this is performed until 6 week of gestational pregnancy, and it's commonly used in private clinics), curettage – surgical intervention (this is performed between 12 to 15 weeks of gestation, and it's most commonly used in public/state clinics), and dilatation & evacuation.[35]
  • As of 2012, the following medical abortion methods were available in Serbia: prostaglandin suppositories (but they're not common), RU-486 (available for up to 10 weeks of pregnancy in clinics, though supervision is required) and induced labor (this is available for "older than 16 gestational weeks").[36]
  • Asocijacija za seksualno i reproduktivno zdravlje Srbije - SRH Srbija (Serbian Association for Sexual and Reproductive Rights): They should be able to direct you to the best information/resources. Address: Strahinjića Bana 55/1, 11000 Beograd, Srbija.T/F: +381 11 3036 248. email: office@srh.rs

Costs

If someone is covered by Serbian health care and receives an abortion in a public health institution, the procedure should be covered by their health insurance. If they go through a private clinic, they may pay between180 – 300 EUR.[37]

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

  • Autonomous Women's Center: If you're a victim or if you're under the risk of becoming the victim of gender-based violence, you can get help from Autonomous Women's Center. They can also provide free legal aid. "You can schedule an appointment by calling our Telephone helpline 011/266-222 (working days from 12pm to 8pm). Counseling sessions are run every working day between 2.30pm and 6.30pm. This service is free of charge."

Costs

List of Additional Resources

  • Autonomous Women's Center - Belgrade: This is a feminist NGO, founded in 1993, that focuses on women's empowerment, education, issues related to gender-based violence, etc. They also work on issues related to multiple forms of discrimination faced by women, such as Roma women, women with disabilities, etc. Address: Tiršova 5a, 11000 Belgrade. Email: azc@azc.org.rs. For consultations, call +381 11 266 2222. Email: tt@azc.org.rs
  • Women in Black: This is an antimilitarist group, formed in the former Yugoslavia (during the war). It's been a pivotal group in the history of Serbian women's mobilization.
  • Reconstruction Women's Fund: "Reconstruction Women's Fund is the first local women's foundation in Serbia, established in 2004." They fight issues related to nationalism, militarism, racism, sexism, etc. Address: 6 Braće Baruh (Apt No 41), 11000 Belgrade. Phone: +381 11 2184674. e-mail: office@rwfund.org
  • Association of Business Women in Serbia: Focuses on female entrepreneurship.
  • Kontracepcija - sve što jeste i niste znali: This Facebook provides educational information for women in Serbia about contraception.

References

  1. Globral Oral Contraception Availability
  2. Sex education introduced in Serbian schools!
  3. Serbian Province Launches Sex Education Classes
  4. Princeton EC Website
  5. [Conversation with Belgrade pharmacist, May 2017]
  6. [Conversation with Belgrade pharmacist]
  7. [Conversation with Belgrade pharmacist, May 2017]
  8. [Conversation with Belgrade pharmacist, May 2017]
  9. [Conversation with Belgrade pharmacist, May 2017]
  10. [Conversation with Belgrade pharmacist, May 2017]
  11. [Conversation with Belgrade pharmacist, May 2017]
  12. [Conversation with Belgrade pharmacist, May 2017]
  13. EC Status and Availability: Serbia
  14. Princeton EC Website
  15. ECEC: Serbia
  16. Princeton EC Website
  17. ellaOne
  18. Princeton EC Website
  19. Princeton EC Website
  20. ECEC: Serbia
  21. [Conversation with Belgrade pharmacist]
  22. SERBIA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  23. PEP in Nelp
  24. PrEPWatch World Map
  25. [Conversation with Belgrade pharmacist]
  26. Flucanozale
  27. [Conversation with a Serbian pharmacist]
  28. Serbia: Human Papillomavirus and Related Cancers, Fact Sheet 2017
  29. [Conversation with clinic over Facebook, May 2017]
  30. Abortion Legislation in Europe
  31. Women on Waves, Serbia
  32. Reframing the abortion debate in Serbia and the world
  33. The Question of Abortion in Serbia
  34. Serbia Has Highest Abortion Rate In Europe
  35. IPPF - ABORTION: Legislation in Europe
  36. IPPF - ABORTION: Legislation in Europe
  37. Women on Waves, Serbia