It’s strange so many years later, in the United States of America, to feel as if I’m living in a country threatening to become like the Russia of Vladimir Putin that I spent years experiencing earlier in this century. To start, let me tell you a little something about that.

For decades as a young adult, I lived and traveled in Russia. I was an anthropology doctoral student and human rights worker, studying the effects of President Vladimir Putin’s centralizing policies and that country’s Christian nationalist media on the everyday lives of Russians. In one of my last projects, I investigated the government’s practice of separating kids with disabilities (and poorer kids generally) from their parents and detaining them in closed institutions. My report detailed how much changes in society when the government excludes swaths of the population from basic services like healthcare, education, and even just access to city streets. The answer? Everything.

That marginalization was part of a governing process aimed at further enriching the wealthiest few and those in power. It reflected the leadership of figures lacking a basic understanding of what all people need and deserve. I consider that a hallmark of a fascist regime.

One of my last evenings in Russia was a chilly November night in 2014 in the northern city of St. Petersburg. Mothers and children, grandparents and teenagers alike stepped with care to avoid slipping on black ice and bumping into (and possibly falling thanks to) large plastic advertisements for fast food, clothing, cosmetic dentistry, plastic surgery, and even IVF treatments sticking up like weeds on the cobblestoned sidewalks of the city’s center.

I look around at what’s happening in our country and worry that we may already be on a superhighway to the sort of class- and race-stratified autocracy that it took Russia so many years to become after the Soviet Union collapsed.

Those glowing placards seemed to replace what had once been a slew of different kinds of people when I first traveled to Russia as a college student in the late 1990s. In the same central train stations of that city, old women then sold carrots and beets from cardboard boxes they had lugged from their country homes. Young women could sometimes be seen in bikinis and stiletto heels (even in that weather!) with beer advertisements scrawled across their chests. Uzbek and Tajik men scrambled to finish construction on new stores, restaurants, and apartment buildings before winter set in. Roma mothers, their babies strapped to their backs in jewel-toned scarves, begged for money for food and housing.

Sometimes, when traffic grew too congested for their liking, Russia’s newly rich—aptly dubbed “New Russians” in the country’s popular press—drove their luxury Mercedes and BMWs onto the sidewalks, forcing pedestrians like me, along with mothers pushing strollers and a few wind-worn men and women hurrying to work, to scatter in panic. Despite the chaos and a significant amount of deprivation (more on that later), for many I met then, much seemed possible, including working for ever larger companies, migration, and new luxuries. Electronic remixes of Western songs like “If I Were a Rich Girl” and Cher’s “Believe” blasted from vendors’ tinny sounding boom boxes on repeat.

By the time of my last trip to Russia in 2014, however, shiny buildings had been built, older ones renovated, and developers with close ties to Russia’s political elite were even richer, thanks to the country’s growing oil wealth. Roma (or gypsy) families were no longer anywhere to be seen, as St. Petersburg’s government had conducted “purges” of the city’s informal Roma settlements. Nor were old women selling their wares on the streets, while Central Asian migrants from poorer countries to Russia’s south seemed ever fewer and less visible during the busiest times. Indeed, local authorities were rounding them up and detaining them without warrants, based on appearance and language alone. (Sound familiar?)

Having spent years interviewing families who could no longer access this new cityscape with their kids who used wheelchairs or were blind or deaf, all I could think was: I’m lucky to be able to go home to the United States.

That last night in 2014, I was also nearing the end of the first trimester of my first pregnancy. I rubbed my still barely visible baby bump as I spotted an old friend from St. Petersburg who was waiting to meet me for dinner at a nearby cafe. As I sat down with her, a waitress approached our table. She noted my American accent and told me with gentle, motherly scorn that I shouldn’t be traveling while pregnant. As if on cue, stomach cramps made me double up. After a trip to the restroom revealed that I was bleeding, I started to wonder if the waitress had been right. Was it possible that my relentless travel had caused me to miscarry—and in a country where I knew women sometimes faced withering criticism and blame for poor pregnancy outcomes? Just stay with me until I go home, I implored the baby I carried.

At least, my friend understood. Before she gave birth to her healthy son in the 1990s, when Russia’s newly privatized healthcare system included few viable options for working-class women, it took exhausted, overworked doctors weeks after she started feeling sick during her first pregnancy to determine that the baby inside her had actually died. She had an abortion without anesthesia and returned to her teaching job right away to make ends meet. And stories like hers were anything but unique then.

By 2014, urgent-care clinics and hospitals were plentiful enough in large cities like St. Petersburg and Moscow, but many were exorbitantly expensive even for young Americans like me. Worse yet, the attitudes of medical workers toward women who couldn’t or wouldn’t have babies had not exactly softened under a president—Vladimir Putin, of course—known for describing women as “guardians of the hearth and linchpins of large families with many children.”

Fearing the worst, my friend snapped into action, calling around to several acquaintances until one located an obstetrician she trusted who traveled from her home on the outskirts of the city to a clinic downtown.

In the 1990s, following the collapse of the Soviet empire, the International Monetary Fund and other international lenders pushed Russia to slash public spending and rapidly privatize state functions as part of the deal for their crucial loans to a society then in trouble. In the end, such changes dismantled the Soviet Union’s social safety net, including universal healthcare.

Well-connected elites carved up many of the remaining state assets and used them for their own private gain. Included in Russia’s newly privatized healthcare system were private clinics for the ultra-wealthy offering hotel-like amenities, including private rooms, hot tea, and soft background music. Ordinary Russians who couldn’t afford such ritzy private services used the remaining state clinics, though they were often overcrowded, undersupplied, and understaffed in the austere new world so many Russians had no choice but to navigate, especially outside the big cities. What’s more, as anthropologist Michele Rivkin-Fish has pointed out, private healthcare facilities didn’t mean better quality care, as medical workers and all kinds of........

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