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Riyadh

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OVERVIEW

Riyadh Skyline New.jpg

As a conservative Islamic country, Saudi Arabia provides some sexual and reproductive health care resources. However, certain health services are difficult to access or completely unavailable. Furthermore, LGBTQ rights are not recognized, and women live under a strict guardianship system, which treats adult women as legal minors. However, the guardianship laws are being gradually liberalized and may undergo further change in the years to come.[1] [2]

In Saudi Arabia, you can purchase birth control at local pharmacies, and some women report that you can buy birth control without being married (since pharmacists often don't ask for a prescription or marriage certificate). However, emergency contraception (the morning after pill) has been banned from the country. If you have had unprotected sex and want to prevent pregnancy, your best bet is to use regular birth control pills as replacement EC, which we explain how to do in the "Emergency Contraception" section, or get an IUD. Regarding STIs, the options available depend upon whether you're a Saudi national or foreigner. For example, if you're a Saudi national who is diagnosed with HIV, you will receive treatment and support. If you're a foreigner who is diagnosed with HIV, you will receive no treatment and be deported. For more details, please visit the "Sexually Transmitted Infections (STIs/STDs)" section. There are currently no providers of PrEP in Saudi Arabia, and we don't know if PEP is available (if you know, please add the information). Regarding menstruation, you can find pads, tampons and menstrual cups in Saudi Arabia. It is illegal to be unmarried and pregnant -- and, if a woman is found to be pregnant out of wedlock, she can face serious penalties. Finally, abortion is illegal except for very rare cases. Generally speaking, women who wish to seek out abortions must do so in other countries, although this choice has often been curbed in the past due to guardianship laws.

Contraception (Birth Control)

 
Gynera pills at a Saudi pharmacy
 
Marvelon pills at a Saudi pharmacy

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 Saudi Arabia, you can access and purchase birth control at pharmacies. While official sources state that you need a prescription to obtain birth control,[3] [4] local sources (for example, a local blogger and a private conversation with a pharmacist) say that you don't need a prescription.[5] This means that, in most cases, you can walk into a pharmacy and purchase contraceptives, such as pills or patches, without a prescription. Furthermore, you typically don't need to show a marriage certificate. While you may technically need to be married to obtain contraceptives, this isn't usually enforced. Based on our conversation with a pharmacist in Saudi Arabia, as well as our online research through personal blogs,[6] we have found that, in most cases, you don't need to show a marriage certificate in order to purchase contraceptives in Saudi pharmacies. However, this is not to say that you have zero chance of being asked for a prescription or a marriage certificate, so one should be aware that such things can happen.

As a markedly conservative country, the rate of contraceptive use is not particularly high. The women of Saudi Arabia tend to use contraceptives at a lower rate than other Gulf countries, such as United Arab Emirates or Qatar. However, the rate of usage is roughly comparable to Oman.[7] According to a 2015 UN report, it was found that 36.8% of Saudi women (who are married/in unions and of reproductive age) use some form of contraception, and 24.1% of Saudi women have unmet family planning needs. The most common methods were found to be IUDs (11.6%), condoms (6.6%), birth control pills (6.5%), and female sterilization (4.2%). There were very low rates of usage for injectables (1.2%) and implants (0.1%).[8] Nevertheless, it should be noted that Saudi women certainly do use contraceptives, and an estimated six million birth control pills were purchased in 2013.[9]

More information:

  • Blog post from 2015 about birth control in Saudi Arabia
  • Study on Awareness and Use of Contraceptives Among Saudi Women Attending Primary Care Centers in Al-Qassim, Saudi Arabia

What to Get & Where to Get It

 
Nuvaring at a Saudi pharmacy
  • If you are interested in purchasing birth control pills, there are at least 15 brands available in Saudi Arabia. Nearly all of the brands come from pharmaceutical companies in Germany, United Kingdom and United States. Some of the brands you may find in pharmacies include Cerazette, Diane, Diane-35, Gynera, Gynovlar, Loestrin 20, Loestrin 30, Logynon, Marvelon, Microgynon-30, Microlut, Minulet, Nordette, Norinyl-1, Ovulen 50 and Yasmin.[10] [11]
  • If you want a contraceptive shot/injectable, you can find Depo-Provera SAS 150mg/ml in Saudi Arabia.[12]
  • If you want contraceptive ring, you should be able to find Nuvaring in Saudi pharmacies.
  • If you want the contraceptive patch, you should be able to find the Evra patch in Saudi pharmacies.
  • We don't know if contraceptive implants are available in Saudi Arabia. If you do know, please add the information to this page.

Costs

  • When you purchase birth control pills at Saudi pharmacies, you can expect to pay between 15-30 SR per pack (as of November 2017).[13]
  • The Evra contraceptive patch should cost around 52 SR per patch (as of November 2017).[14]
  • For the contraceptive ring, like Nuvaring, you can expect to pay around 52 SR per pack (as of November 2017).

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 Saudi Arabia, dedicated emergency contraception (the morning after pill) has been banned.[15] In the past, it may have been available by prescription only,[16] but this is no longer the case. However, if you have had unprotected sex and don't want to get pregnant, you do have options. You can use regular birth control pills, which are available in Saudi Arabia, as replacement emergency contraception. We have provided instructions for how to do this in the section below.

What to Get & Where to Get It

  • In Saudi Arabia, you can use regular oral contraceptives (birth control pills) as replacement ECPs. To do this, you can do any of the following:
    • For any of these pill brands, take 50 pills within 120 hours after unprotected sex: Microlut[17]
    • For any of these pill brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later (note: in 28-day packs, only the first 21 pills can be used): Eugynon, Neogynon, Nordiol, Ovral[18]
    • For any of these pill brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later (note: in 28-day packs, only the first 21 pills can be used): Microgynon-30, Nordette[19]
  • You can also get an IUD as a form of emergency contraception. Contact your ob/gyn for details.

Costs

You will need to purchase regular birth control pills for emergency contraception in Saudi Arabia. For this reason, please refer to the "Contraception (Birth Control)" section of this page for prices.

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

HIV

Since 1984, the Saudi government has been screening blood for HIV, and in 2012, Saudi Arabia launched a “Zero New Infections, Zero Deaths and Zero Stigma and Discrimination" campaign.[20] However, in reality, citizens and non-citizens with HIV are treated completely differently in Saudi Arabia.

If you're a non-Saudi national who wants to work or live in Saudi Arabia, you'll need to show a negative HIV test result before entering the country. Once you enter Saudi Arabia, if you test positive for HIV, you'll probably be placed in solitary confinement and then deported.[21] There are documented cases of foreigners being deported after testing positive for STIs. You will also not receive any STI treatment while awaiting deportation.[22] Since there are such stiff penalties and circumstances for HIV-positive foreigners, the majority of foreigners appear to avoid tests completely.[23]

The situation for Saudi nationals is quite different. If a Saudi citizen tests positive for HIV, they are offered free medical care, employment opportunities and confidentiality. There are several hospitals that specialize in treating HIV/AIDS, though some hospitals reportedly do not treat patients with HIV/AIDS.[24]

While there is little data on HIV on Saudi Arabia, the Ministry of Health estimates that there are over 1000 people living with HIV. The government has opened up 11 specialized health centers for HIV, as of December 2016.[25] The vast majority of infections (96%) are contracted through sexual intercourse.[26]

HPV

Regarding HPV, there is no national data released by the Ministry of Health. However, cervical cancer is the eighth most common cancer for women in Saudi Arabia. There is currently no nationwide HPV vaccination program.[27]

Testing Facilities

  • There are numerous centers for HIV tests (for Saudi nationals and non-nationals) in Saudi Arabia.[28]
  • There are also mobile testing clinics offered in many Saudi cities, including Riyadh, Jeddah, Dammam, Meccah and Jezan. For more information, contact National AIDS Program (Napska).

Support

  • National AIDS Program: "National AIDS Program under the General Administration of Infectious Diseases Control, unit of Deputy of Public Health, Ministry of Health, Kingdom of Saudi Arabia was established in the year 1994."
  • UNAIDS Saudi Arabia: Yamina Chakkar - Director, Regional Support Team for Middle East and North Africa. Telephone: +201093260898. Email: CHAKKARY@UNAIDS.ORG

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • If you have a yeast infection, you can let the pharmacist know and see what medications they have. You may find Miconazole, Clotromazole suppositories or vaginal douche products to treat yeast infections in Saudi Arabia.[29] If you have some problems communicating with the pharmacist, or if they do not have Miconazole or Clotromazole at the pharmacy, you can also ask for Fluconazole, an antifungal medication used to treat yeast infections, or Canesten, another yeast infection medication tha is commonly found in Asia.
  • If you have a urinary tract infection (UTI), you will probably need to visit a physician and get a check-up and prescription before visiting the pharmacy. However, in some cases, pharmacies do give UTI medications without a prescription. It should be noted that it's not advised to seek out UTI medication without a prescription, as the drugs can be powerful antibiotics that should only be taken if the person is sure that he/she has a UTI.
  • There are no known providers of Pre-Exposure Prophylaxis (PrEP) in Saudi Arabia[30] or in the general Persian Gulf region. The closest providers appear to be in India, Kenya or in European countries, such as France and Italy.
  • While we don't know if Post-Exposure Prophylaxis (PEP) is generally available in Saudi Arabia, we have found evidence of at least one recorded case of someone being infected with HIV through blood transfusion at a Saudi hospital, and then being treated with the active ingredients found in PEP.[31] [32] This leads us to believe that PEP, in some form, is available in Saudi Arabia, but we're unaware of which circumstances permit availability.

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

  • You can find sanitary pads/pantyliners in many stores, and they can also be purchased online. For example, Pricena sells pads/pantyliners from Carefree and Always.
  • You can find tampons in some pharmacies[33] (such as Nahdi Pharmacy locations) and in large supermarket chains (such as Danube, Carrefour and Tamimi)[34] in Saudi Arabia, and they can also be purchased online from Saudi-focused sellers, like Biovea. However, it should be noted that you may encounter some pharmacists who warn against using them.[35]
  • While we don't know any local sellers of menstrual cups, you can buy them from Saudi and Saudi-focused retailers, such as:
    • Souq - Sells DivaCup
    • Biovea -- Sells MoonCup
    • Ubuy -- Sells LENA, DivaCup, Luna Cup, Blossom, Duchess, Athena, etc.

Costs

While the cost of menstrual cups completely depends on the brand and store, one source says you can expect to pay between SAR 130[36] and SAR 160 for a menstrual cup in Saudi Arabia (as of May 2017).[37]

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

Costs

Pregnancy

Laws & Social Stigmas

It is illegal to be unmarried and pregnant in Saudi Arabia. If you're found to be unmarried and pregnant, you may face jail time and, if you're a foreigner, potential punishment or deportation. Some women may face lashings, such as the case of a Filipina worker who became pregnant out of wedlock in 2013 and received 100 lashes. There are also cases of Saudi authorities inspecting and cracking down on polyclinics that provide services to unmarried pregnant women.[38] For these reasons, you may need a marriage certificate to access the maternity ward. For these reasons, if you're pregnant and unmarried, it's highly recommended that you leave Saudi Arabia for at least the duration of your pregnancy. You should be aware that you may also face problems if you come to Saudi Arabia after your pregnancy, so you should confirm your legal status with your child if you are later considering return.

What to Get & Where to Get It

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

In Saudi Arabia, abortion is generally illegal. It is only permitted in rare cases when the pregnancy endangers the life of the woman, or when the pregnancy endangers the physical or mental health of the woman.[39] For an abortion to be legally approved, a woman must be a maximum of four months pregnant.[40] Furthermore, a panel of medical experts, composed of three physicians appointed by the hospital director, must sign a recommendation for the abortion. The patient must provide written consent for the abortion. The patient's husband or guardian must also provide written consent for the abortion.[41]

The most common abortion route for women in Saudi Arabia is to seek out abortions in other countries, such as India.

More information:

What to Get & Where to Get It

  • According to Women on Waves, Misoprostol is registered in Saudi Arabia but not easily available.[42]
  • If you are considering leaving the country to obtain a legal abortion, you can get legal abortions in India, Turkey, Greece or Russia. It is especially common for women in Saudi Arabia to seek out abortions in India. Click here for a personal account of an American woman, based in Riyadh, who received an abortion in Mumbai.

Costs

If you are pregnant and considering getting an abortion outside Saudi Arabia, you will need to consider the following costs: transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

Advocacy & Counseling

Laws & Social Stigmas

In 2014, Saudi Arabia officially outlawed domestic violence. These laws allow women to anonymously report abuse, and they can also receive immunity from litigation in cases when the abuse is not proven in court.[43] This change was welcomed by human rights activists and the international community, after years of virtually no laws to protect women from domestic abuse. Furthermore, the King Khalid Foundation launched a campaign to raise awareness about domestic abuse that same year.[44]

What to Get & Where to Get It

  • Domestic Abuse Hotline - Dial 1919 - click here for more information on the hotline.

Costs

List of Additional Resources

  • For information on LGBT issues in Saudi Arabia, click here
  • Jahanamiya: "Jahanamiya is a feminist literary magazine that publishes written work exclusively by Saudi women, as well as accompanying artwork created by regional artists."

References

  1. ↑ Women in Saudi Arabia will be able to travel and study without needing a man’s permission
  2. ↑ Saudi Arabia: ‘Unofficial’ Guardianship Rules Banned
  3. ↑ Global Oral Contraception Availability
  4. ↑ Free the Pill
  5. ↑ BIRTH CONTROL, CONTRACEPTIVES, VIAGRA, CONDOMS IN SAUDI ARABIA
  6. ↑ BIRTH CONTROL, CONTRACEPTIVES, VIAGRA, CONDOMS IN SAUDI ARABIA
  7. ↑ Trends in Contraceptive Use 2015
  8. ↑ Trends in Contraceptive Use 2015
  9. ↑ SR108m spent on birth control pills
  10. ↑ IPPF Saudi Arabia
  11. ↑ [Conversation with pharmacist in KSA, 2017]
  12. ↑ IPPF Saudi Arabia
  13. ↑ [Conversation with pharmacist in KSA, 2017]
  14. ↑ [Conversation with pharmacist in KSA, 2017]
  15. ↑ [Conversation with pharmacist in KSA, November 2017]
  16. ↑ EC Status and Availability: Saudi Arabia
  17. ↑ Princeton EC Website
  18. ↑ Princeton EC Website
  19. ↑ Princeton EC Website
  20. ↑ National AIDS Program - About Us
  21. ↑ SAUDI ARABIA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  22. ↑ Saudi Arabia
  23. ↑ Kingdom defeating HIV
  24. ↑ Saudi Arabia
  25. ↑ Number of AIDS victims in Saudi revealed
  26. ↑ Kingdom defeating HIV
  27. ↑ Saudi Arabia: Human Papillomavirus and Related Cancers, Fact Sheet 2017
  28. ↑ Napsta HIV Prevention
  29. ↑ [Conversation with a pharmacist in KSA, 2017]
  30. ↑ PrEPWatch World Map
  31. ↑ Prevention of HIV-1 Transmission with Post-Exposure Prophylaxis after Inadvertent Infected Blood Transfusion
  32. ↑ Following Transfusion of HIV-Infected Blood
  33. ↑ Are Tampons Not Allowed in Saudi Arabia
  34. ↑ Moving to Saudi Arabia
  35. ↑ Are Tampons Not Allowed in Saudi Arabia
  36. ↑ Menstrual Moon Cup
  37. ↑ Menstrual Cups
  38. ↑ Saudi Arabia to crackdown on unmarried women who have children
  39. ↑ Abortion Law - Saudi Arabia
  40. ↑ UN Report: Abortion in Saudi Arabia
  41. ↑ UN Report: Abortion in Saudi Arabia
  42. ↑ Abortion Law - Saudi Arabia
  43. ↑ Saudi Arabia outlaws domestic violence
  44. ↑ Saudi Arabia outlaws domestic violence


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