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Saudi Arabia: Difference between revisions

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[[File:Flag of Saudi Arabia.svg.png|300px | thumb|right|]]
'''OVERVIEW'''
'''OVERVIEW'''


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 liberalized and may undergo further change in the years to come.<ref>[http://metro.co.uk/2017/05/07/women-in-saudi-arabia-will-be-able-to-travel-and-study-without-needing-a-mans-permission-6621239/ Women in Saudi Arabia will be able to travel and study without needing a man’s permission]</ref> <ref>[https://www.hrw.org/news/2017/05/09/saudi-arabia-unofficial-guardianship-rules-banned Saudi Arabia: ‘Unofficial’ Guardianship Rules Banned]</ref>  
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.<ref>[http://metro.co.uk/2017/05/07/women-in-saudi-arabia-will-be-able-to-travel-and-study-without-needing-a-mans-permission-6621239/ Women in Saudi Arabia will be able to travel and study without needing a man’s permission]</ref> <ref>[https://www.hrw.org/news/2017/05/09/saudi-arabia-unofficial-guardianship-rules-banned Saudi Arabia: ‘Unofficial’ Guardianship Rules Banned]</ref>  


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) is prescription-only and not generally accessible. 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. 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.
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)==
==Contraception (Birth Control)==
[[File:Gynera saudi frontside.png|250px | thumb|right|frame|'''Gynera pills at a Saudi pharmacy''']]
[[File:Marvelon saudi.png|File:Marvelon saudi.png|250px | thumb|right|frame|'''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 [https://www.plannedparenthood.org/learn/birth-control here].
'''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 [https://www.plannedparenthood.org/learn/birth-control here].
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===Laws & Social Stigmas===
===Laws & Social Stigmas===


In Saudi Arabia, you can access and purchase birth control at pharmacies. While some official sources state that you need a prescription to obtain birth control,<ref>[http://ocsotc.org/wp-content/uploads/worldmap/worldmap.html Global Oral Contraception Availability]</ref> <ref>[http://freethepill.org/where-on-earth/ Free the Pill]</ref> local sources (for example, a local blogger) say that you don't need a prescription.<ref>[http://thearabmode.com/expat-birth-control-contraceptives/ BIRTH CONTROL, CONTRACEPTIVES, VIAGRA, CONDOMS IN SAUDI ARABIA]</ref> This leads us to believe that pharmacists don't require a prescription, but we're still researching the topic. Furthermore, according to a local blog, you don't need to show a marriage certificate in order to purchase birth control. Regardless of your marital status, you can go to a pharmacy and purchase birth control.<ref>[http://thearabmode.com/expat-birth-control-contraceptives/ BIRTH CONTROL, CONTRACEPTIVES, VIAGRA, CONDOMS IN SAUDI ARABIA]</ref>
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,<ref>[http://ocsotc.org/wp-content/uploads/worldmap/worldmap.html Global Oral Contraception Availability]</ref> <ref>[http://freethepill.org/where-on-earth/ Free the Pill]</ref> local sources (for example, a local blogger and a private conversation with a pharmacist) say that you don't need a prescription.<ref>[http://thearabmode.com/expat-birth-control-contraceptives/ BIRTH CONTROL, CONTRACEPTIVES, VIAGRA, CONDOMS IN SAUDI ARABIA]</ref> 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 typically enforced. Based on our conversation with a pharmacist in Saudi Arabia, as well as our online research through personal blogs,<ref>[http://thearabmode.com/expat-birth-control-contraceptives/ BIRTH CONTROL, CONTRACEPTIVES, VIAGRA, CONDOMS IN SAUDI ARABIA]</ref> we have found that you don't typically 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]].<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> 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%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> Nevertheless, it should be noted that Saudi women certainly do use contraceptives, and an estimated six million birth control pills were purchased in 2013.<ref>[http://www.arabnews.com/news/saudi-arabia/609426 SR108m spent on birth control pills]</ref>  
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]].<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> 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%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> Nevertheless, it should be noted that Saudi women certainly do use contraceptives, and an estimated six million birth control pills were purchased in 2013.<ref>[http://www.arabnews.com/news/saudi-arabia/609426 SR108m spent on birth control pills]</ref>  
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===What to Get & Where to Get It===
===What to Get & Where to Get It===
[[File:Nuvaring saudi.png|150px | thumb|right|frame|'''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 can expect to see are Diane, Diane-35, Gynera, Gynovlar, Loestrin 20, Loestrin 30, Logynon, Marvelon, Microgynon-30, Minulet, Nordette, Norinyl-1, Ovulen 50 and Yasmin.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=SA IPPF Saudi Arabia]</ref>
* 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 can expect to see are Diane, Diane-35, Gynera, Gynovlar, Loestrin 20, Loestrin 30, Logynon, Marvelon, Microgynon-30, Minulet, Nordette, Norinyl-1, Ovulen 50 and Yasmin.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=SA IPPF Saudi Arabia]</ref>
* If you want a '''contraceptive shot/injectable''', you can find Depo-Provera SAS 150mg/ml in Saudi Arabia.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=SA IPPF Saudi Arabia]</ref>
* If you want a '''contraceptive shot/injectable''', you can find Depo-Provera SAS 150mg/ml in Saudi Arabia.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=SA IPPF Saudi Arabia]</ref>
* We don't know if contraceptive patches, contraceptive implants or contraceptive rings are available in Saudi Arabia. If you do know, please add the information to this page.
* If you want the '''contraceptive patch,''' you should be able to find the Evra patch in Saudi pharmacies.
* If you want '''contraceptive ring''', you should be able to find Nuvaring 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===
===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).<ref>[Conversation with pharmacist in KSA, 2017]</ref>
* The Evra contraceptive patch should cost around 52 SR per patch (as of November 2017).<ref>[Conversation with pharmacist in KSA, 2017]</ref>
* 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)==
==Emergency Contraception (Morning After Pill)==
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===Laws & Social Stigmas===
===Laws & Social Stigmas===


In Saudi Arabia, emergency contraception (the morning after pill) is by prescription only.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/saudi-arabia/ EC Status and Availability: Saudi Arabia]</ref> We're not sure who is allowed to get a prescription or the laws around prescription accessibility. However, birth control pills are available, which can be used as replacement EC. See the section below for details.
In Saudi Arabia, dedicated emergency contraception (the morning after pill) is not generally available. In the past, it has been by prescription only,<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/saudi-arabia/ EC Status and Availability: Saudi Arabia]</ref> and it may be currently banned from the country, [https://www.reddit.com/r/saudiarabia/comments/1hiosb/the_availability_of_emergency_contraception_or/ as discussed in this Reddit thread]. We're not sure who was previously allowed to get a prescription or the laws around prescription accessibility today.  
 
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===
===What to Get & Where to Get It===
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===What to Get & Where to Get It===
===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. However, if you have some problems communicating what you have or the symptoms, you can ask for Fluconazole, which is an antifungal medication often used to treat yeast infections, or Canesten, another common yeast infection medication (often found in Asia).
* 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.<ref>[Conversation with a pharmacist in KSA, 2017]</ref> 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.
* There are no known providers or PrEP in Saudi Arabia.<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref>
* 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<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref> 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.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226216/ Prevention of HIV-1 Transmission with Post-Exposure Prophylaxis after Inadvertent Infected Blood Transfusion]</ref> <ref>[http://www.croiconference.org/sites/all/abstracts/960.pdf Following Transfusion of HIV-Infected Blood]</ref> 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===
===Costs===
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* You can find sanitary pads/pantyliners in many stores, and they can also be purchased online. For example, [http://sa.pricena.com/en/personal-care/personal-care-for-women/feminine-hygiene Pricena] sells pads/pantyliners from Carefree and Always.
* You can find sanitary pads/pantyliners in many stores, and they can also be purchased online. For example, [http://sa.pricena.com/en/personal-care/personal-care-for-women/feminine-hygiene Pricena] sells pads/pantyliners from Carefree and Always.
* You can find '''tampons''' in some pharmacies<ref>[https://www.quora.com/Are-tampons-not-allowed-in-Saudi-If-so-why Are Tampons Not Allowed in Saudi Arabia]</ref> (such as Nahdi Pharmacy locations) and in large supermarket chains (such as Danube, Carrefour and Tamimi)<ref>[https://desertenlightenment.wordpress.com/moving-to-saudi-arabia-faq/ Moving to Saudi Arabia]</ref> in Saudi Arabia, and they can also be purchased online from Saudi-focused sellers, like [https://www.biovea.com/sa/mobile/Category_Dispatch.aspx?cid=22971&deptid=5 Biovea]. However, it should be noted that you may encounter some pharmacists who warn against using them.<ref>[https://www.quora.com/Are-tampons-not-allowed-in-Saudi-If-so-why Are Tampons Not Allowed in Saudi Arabia]</ref>
* You can find '''tampons''' in some pharmacies<ref>[https://www.quora.com/Are-tampons-not-allowed-in-Saudi-If-so-why Are Tampons Not Allowed in Saudi Arabia]</ref> (such as Nahdi Pharmacy locations) and in large supermarket chains (such as Danube, Carrefour and Tamimi)<ref>[https://desertenlightenment.wordpress.com/moving-to-saudi-arabia-faq/ Moving to Saudi Arabia]</ref> in Saudi Arabia, and they can also be purchased online from Saudi-focused sellers, like [https://www.biovea.com/sa/mobile/Category_Dispatch.aspx?cid=22971&deptid=5 Biovea]. However, it should be noted that you may encounter some pharmacists who warn against using them.<ref>[https://www.quora.com/Are-tampons-not-allowed-in-Saudi-If-so-why Are Tampons Not Allowed in Saudi Arabia]</ref>
* While we don't know any local sellers of '''menstrual cups''', you can but them from Saudi and Saudi-focused retailers, such as:
* While we don't know any local sellers of '''menstrual cups''', you can buy them from Saudi and Saudi-focused retailers, such as:
** [https://saudi.souq.com/sa-en/the-diva-cup-new-menstrual-solution-4677429/i/ Souq] - Sells DivaCup
** [https://saudi.souq.com/sa-en/the-diva-cup-new-menstrual-solution-4677429/i/ Souq] - Sells DivaCup
** [https://www.biovea.com/sa/productlist/results?KW=menstrual%20cup&FiltersObject=%7B%22SortValue%22:%7B%7D,%22PageSize%22:%2212%22,%22CompareProducts%22:%5B%5D,%22Brands%22:%7B%7D,%22FormValues%22:%7B%7D,%22PriceRanges%22:%7B%7D,%22Categories%22:%5B%5D,%22objects%22:%5B%5D%7D Biovea] -- Sells MoonCup
** [https://www.biovea.com/sa/productlist/results?KW=menstrual%20cup&FiltersObject=%7B%22SortValue%22:%7B%7D,%22PageSize%22:%2212%22,%22CompareProducts%22:%5B%5D,%22Brands%22:%7B%7D,%22FormValues%22:%7B%7D,%22PriceRanges%22:%7B%7D,%22Categories%22:%5B%5D,%22objects%22:%5B%5D%7D Biovea] -- Sells MoonCup
** [https://www.ubuy.com.sa/en/brand/Blossom%20Menstrual%20Cup Ubuy] -- Sells LENA, DivaCup, Luna Cup, Blossom, Duchess, Athena, etc.
** [https://www.ubuy.com.sa/en/brand/Blossom%20Menstrual%20Cup Ubuy] -- Sells LENA, DivaCup, Luna Cup, Blossom, Duchess, Athena, etc.
** [http://www.letstango.com/apple-iphone-7-128gb-red-special-edition-44529 Letstango] - Sells Apple Mobile


===Costs===
===Costs===
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===What to Get & Where to Get It===
===What to Get & Where to Get It===
* Check out the city pages, like [Riyadh] and [Jeddah] pages, for local recommendations.


===Costs===
===Costs===
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===Laws & Social Stigmas===
===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 [http://www.gmanetwork.com/news/news/pinoyabroad/315556/pinay-in-saudi-receives-100-lashes-after-getting-pregnant-out-of-wedlock/story/ 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.<ref>[https://www.arabianbusiness.com/saudi-arabia-crackdown-on-unmarried-women-who-have-children-578092.html Saudi Arabia to crackdown on unmarried women who have children]</ref> 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===
===What to Get & Where to Get It===
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===Costs===
===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==
==Advocacy & Counseling==
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===Laws & Social Stigmas===
===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.<ref>[http://www.aljazeera.com/news/middleeast/2013/08/20138290272119559.html Saudi Arabia outlaws domestic violence]</ref> 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 The King Khalid Foundation launched a campaign to raise awareness about domestic abuse that same year.<ref>[http://www.aljazeera.com/news/middleeast/2013/08/20138290272119559.html Saudi Arabia outlaws domestic violence]</ref>
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.<ref>[http://www.aljazeera.com/news/middleeast/2013/08/20138290272119559.html Saudi Arabia outlaws domestic violence]</ref> 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.<ref>[http://www.aljazeera.com/news/middleeast/2013/08/20138290272119559.html Saudi Arabia outlaws domestic violence]</ref>


===What to Get & Where to Get It===
===What to Get & Where to Get It===

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