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Women

In Romania, Hard-Won Abortion Rights Are Being Systematically Undermined

In 1989, Romania dropped its infamous policy banning all forms of birth control. But, many women are still finding it impossible to get an abortion, faced with a right-wing assault against reproductive rights.

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Is this your first abortion?” asked the woman on the phone.

“Yes,” Kai answered. It was fall 2021, and Kai, a 21-year-old veterinary student in Bucharest was calling a clinic to inquire about obtaining an abortion. She was one month pregnant, after being raped.

“Well, then we can’t see you,” said the woman from the clinic. “We had a girl come in for an abortion and she ended up dying,” she explained. Shocked, Kai hung up. The woman then sent Kai video after video over WhatsApp about how abortion was dangerous and wrong.

This is far from an uncommon experience. Kai (who asked to use a pseudonym) is one of many people in Romania who has needed an abortion but found it extremely difficult to actually get one.

In a country where abortion up to 14 weeks has technically been legal since 1989, reproductive rights are increasingly under attack. Conservative politics, religion, and international funding have combined to forge a movement that seriously threatens access to abortion.

Underground abortion

Abortion on request was first legalized in Romania in 1957, and was used as a major form of birth control. However, researcher Sharon Maxwell Magnus writes, concerned that the population was stagnating, authoritarian leader Nicolae Ceaușescu’s regime soon became fixated on achieving a larger workforce. In October 1966, it passed the pronatalist Decree 770, outlawing abortion and contraception outright. In its own terms, the measure worked: doubling the birth rate in one decade, from 1.9 to 3.7 children born per woman.But Romanian women still wanted access to abortion. Some developed an extensive underground network for “kitchen-table abortions,” according to Daniela Draghici, a former member of the network and a current reproductive and women’s health activist in Romania.

“Every household had a ‘Sonda,’” says Draghici. Romanian for “pipe,” this was a small plastic catheter that a woman inserted into her uterus to administer “some kind of liquid to dislocate [the] fetus and cause abortion.” Other common methods of do-it-yourself abortion were “jumping from a high place or falling on your stomach,” Dracigi explains.

Draghici herself had an abortion as a young woman under the Ceaușescu-era 770 ban. “I was taken to an old woman who didn’t really know what she was doing,” recounts Draghici. “She had boiled metal instruments and placed a rag in my mouth so the neighbors wouldn’t hear.” After her abortion, Draghici joined the underground network of people connecting women with those who could perform abortions.

“There was constant fear of getting found out,” she says, “A constant need to preserve those contacts.” Over the next 23 years at least 10,000 women died from these at-home abortions. Maternal mortality doubled between 1965 and 1989.

“That number only includes the women who actually made it to the hospital,” says Draghici. “The real number is much higher.” State security operatives would hover at hospitals, forcing women to give up the names of underground clinics even as they bled to death. Unable to provide for more infants, many people gave up the children they were forced to give birth to. Hundreds of thousands of children were left to state orphanages, and by 1989 an estimated 170,000 children were found in warehouse-like facilities. There were an estimated 15,000-20,000 unnecessary deaths of children in children’s homes between 1966 and 1989, and images of emaciated and traumatized children shocked the world.

In 1989, a popular uprising brought down Ceaușescu’s regime and he was executed. One of the post-communist transitional government’s first acts was to overturn the 770 Decree. In subsequent years, the government began Romania’s first family planning program, and reproductive rights improved dramatically. Abortion was legalized up to fourteen weeks, contraception was made both free and accessible (in urban areas), and sex education began to be taught in public schools. In 1990, nearly one million abortions were legally performed in Romania and the maternal death rate fell by 50%.

Also read: Illegal Abortion Case Leads Police to 11 Skulls, 56 Foetal Bones in Hospital Premises

Return of anti-abortion policies

Back in 2021, Kai went to several private clinics and public hospitals seeking an abortion. At one hospital where the doctor refused to perform the procedure, he said, “How do I know you won’t come back and say you didn’t want the abortion afterwards?” — meaning that he could be prosecuted for malpractice or negligence. At the Marie Stopes clinic in Bucharest, the technician told Kai that because it was her first pregnancy, an abortion could cause her to bleed out and die. “And then we’d have to call the ambulance anyway,” the technician added.

Three decades after the official legalization of abortion, abortion rights are being steadily eroded across Romania. Even though abortion is technically still legal up to 14 weeks, in practice it is becoming increasingly difficult to access.

In 2011, the Romanian government stopped funding contraceptive subsidies, making birth control much harder to access, and stopped teaching birth control in public schools. Activists claim that the gutting of government funding has forced many clinics to shut. In 2019, investigative publication The Black Sea dove into reports of abortion restriction across Romania. A reporter contacted 189 hospitals with gynecology departments, finding that sixty of them refused to perform abortions.

Indeed, doctors across the country are increasingly invoking a conscientious objector clause included in Romania’s 2016 professional code for medics, where doctors can cite moral reasons such as religious beliefs for refusing to perform procedures. These conscience-based refusal laws are common across the EU. Where a majority of doctors invoke them, it results in a systematic denial of the right to abortion.FILIA Centre, a nonprofit women’s rights and reproductive health organization in Bucharest, conducted a series of investigations along with the Euroregional Centre for Public Initiatives, looking into the real accessibility of abortion in Romania.

One lead researcher was Andrada Cilibiu, who in June 2020 called 134 hospitals asking if they provided abortions. Only 55 hospitals said they did, and only one hospital would prescribe a medical (pill-administered) abortion (as opposed to a surgical procedure). Of 802 specialist obstetricians-gynecologists, only 275 said they would perform an abortion on demand.Data from the National Statistics Institute confirms these numbers. Romania’s birth rate rose at the end of 2020 while the number of abortions fell by 35% from 2019 to 2020.

When asked, roughly a third of doctors questioned cited “religious reasons” as the main reason for refusing to administer an abortion, reports FILIA Centre, and 20 of them invoked “motives of an ethical and moral nature.”

Some of the hospitals issued official responses when asked why they would not perform abortions. A hospital in the city of Turda said that the main reason their doctors do not perform abortions is “to support the increase of the birth rate and to respect the right to life.” A hospital in Pașcani, a city in the Moldavia region, said that “any doctor is free to refuse without explanation the request for voluntary pregnancy interruptions” and “we remind you that the doctors graduated from the Faculty of Medicine to save lives.”

Some hospitals and clinics also claimed that they would not perform abortions because they considered them dangerous medical procedures — which is patently untrue. FILIA Centre documented that a clinic in the city of Iași claimed that abortion can cause “varicose veins” which can then “turn into cancerous tumors” or cause “rupture of the uterus,” citing a case of a girl who died after an abortion cause her uterus to “break.” The clinic also claimed that abortion-inducing pills “burn the uterus,” causing “pieces [to] come out of the uterine lining” and that “many patients have been left with malformed children.”

Dr Radu Vladareanu, president of the Romanian Society of Obstetrics and Gynecology, disagrees that abortion is difficult to access. “I think abortion is quite accessible in Romania,” he says. “But of course some gynecologists refuse to perform abortions. But I don’t think it is extremely widespread and changes the [lives] of many women.”

“They can always find someone else to do it, and pay a little more money.” Dr Vladareanu adds: “We don’t have issues like in Poland.”

Church and state

Poland’s anti-abortion stance has attracted particular media attention, as part of the global backlash against abortion rights. As in much of Europe, the Romanian conservative movement has been emboldened by the growth of right-wing populism. In 2015, the Coalition for the Family attempted to amend the Romanian constitution by changing the definition of the family from the gender-neutral term “spouses” to the “union between a man and a woman.

”In 2018, Daniel Gheorghe, a former MP with the right-wing National Liberal Party, organized a “Babies Go to Parliament” initiative, inviting mothers talked out of having an abortion by a pregnancy crisis center to an event in the Bucharest parliament. This was inspired by American organization Heartbeat International‘s annual event in Washington DC, known as “Babies Go to Congress.” In March 2019, Catalin Ivan, a Romanian representative in the European Parliament, organized a “Babies Go to the European Parliament” event in Brussels.

Also in 2019, the anti-abortion group Pro Vita hosted a “March for Life” in Bucharest, similarly inspired by the annual protest held in Washington, DC. At the event, MP Matei-Adrian Dobrovie stated that Romania is in demographic decline, and there is a need “to support the pro-life movement,” since the country has the second highest rate of abortions per live birth in the EU, behind only Bulgaria.

“In Romania our medical system is very tangled by the conservative parties and political figures,” says Draghici. “There are also lots of anti-choice NGOs that are being funded by American and European funds.” The European Parliamentary Forum for Sexual and Reproductive Rights corroborates this, publishing a June 2020 report detailing how US and Russian organizations have provided nearly a quarter of a billion dollars of funding for anti-abortion and anti-LGBT causes in Europe over the last decade.

And the Romanian anti-abortion movement has been able entrench itself in particular by allying with the powerful Orthodox Church — especially in rural communities. One of the most outspoken anti-abortion figures in the country is Father Nicolae Tanase, a Romanian Orthodox priest and founder of the Pro Vita Association for the Born and Unborn. Tanese and his parishioners built a shrine in their hillside community dedicated to the millions of “unborn children” aborted by their mothers.

“It’s cheap and easy to get an abortion in Romania,” said Tanese. “Abortion should happen only after women are informed. She should stay prone on a bed and see the image [of the fetus] and the heartbeat, and be shown a doll of what she has in her belly.”In 2014, the head of the Orthodox Church granted diplomas to eighteen doctors who refused to grant abortions, and the Independent reports that one Orthodox priest boasted on television that he convinced scores of doctors to stop performing abortions. A hospital in the city of Piatra Neamt forces all women seeking abortion services to first obtain counseling from a priest.

While the 2016 conscientious objector clause allows doctors to avoid providing abortions, the medical code also states that a doctor refusing to perform a medical procedure, they must first give their reasons and then direct the patient to another colleague or medical unit. But when EU Observer contacted hospitals requesting abortion procedures, ten failed to make any referral at all and 16 gave no specific referral — “instead simply suggesting that our reporter go to another city or a private clinic.”

And if a doctor does agree to perform an abortion, they often charge prohibitively expensive rates. “Hospitals can charge whatever they want,” says Cilibiu. At one clinic Cilibiu called, the procedure would cost 3,000 lei (€600) —around the average monthly income.

Also read: Why Amendments to Medical Termination of Pregnancy Bill Don’t Go Far Enough

The impact

Kai ended up having her abortion at a public hospital. A doctor saw her, assessed her, and told her to come back the next day. When she did, she was told that the nurses didn’t feel comfortable treating her because it was a minor Christian holiday. Kai left and came back the next Monday, when she was given a sedative and then waited over a day to see the doctor. By the time the procedure was performed, the sedative had almost completely worn off.

“The procedure was very painful,” Kai recalls. “I was screaming and crying in agony.” The nurse assisting in the procedure told Kai “Well, maybe next time you’ll be more careful.”

“I was raped,” Kai replied.

The impact is clear. Abortions are steadily declining in Romania; the Health Ministry reports that the number performed per year dropped from 103,386 in 2011 to 31,889 in 2020. The number of fake family planning clinics and pregnancy crisis centers that try to dissuade women from having abortions is growing.

In September 2020, a 45-year-old woman named Magdalena Clisaru died of a hemorrhage following a surgical abortion carried out at a doctor’s clinic on the ground floor of an apartment building. The local prosecutor’s office charged the OB-GYN with murder and soliciting an illicit payment from a patient (100 euros).

“We do not encourage these terminations of pregnancy,” said the Romanian Health Ministry’s spokesperson, Oana Grigore, in a statement. “A physician has no obligation in cases of abortion on demand. Doctors’ obligation is to save the life of a fetus or the mother when a pregnancy cannot be taken to term. And the Ministry, as I’ve already told you and I repeat . . . the Ministry encourages giving birth.”

“In 2020, if you don’t want to have any children, there is contraception.”

The situation is most dire for women in rural areas and those who are part of marginalized groups — such as the Roma community, Cilibiu adds. “Women are seen as baby machines,” says Cilibiu. “Some are getting secret IUDs because condoms are out of the question.” In addition, she notes, “Many women don’t have enough education and can’t enter the job market,” — meaning that they are unable to be financially independent. Save the Children Romania found that almost a quarter (23%) of the mothers aged under 18 in the European Union live in Romania. Eighty-three percent of those women were no longer attending school when they filled out their forms.

In 1972, when Daniela Draghici was in high school, the Ceaușescu regime demanded that all high school girls have a gynecological exam to make sure they weren’t secretly pregnant.

“I will never forget that line of school girls,” recalls Draghici, “waiting outside the clinical medical room at the high school.” It was her first experience with any kind of gynecological or reproductive health care, and it drove home what use her body was to the totalitarian regime. Like many who had underground abortions, Draghici’s was painful.

“It was very, very painful physically and mentally,” she says. “I couldn’t make any noise and there was no anesthesia.”

“It was butchery.”

Under Ceaușescu, Romanian women suffered because politicians feared demographic decline. And the same is happening now. Kai’s experience is a parallel of Draghici’s 35 years later: painful, shameful, secret, and difficult to obtain.

“It really changed my perspective on a woman’s right to abortion,” said Kai. “I was always pro-choice, but I never really realized just how important it is to actually be able to get an abortion.”

Rosa Schwartzburg was a Fulbright Scholar to the Netherlands in 2018 and received her MA from the Central European University in Budapest. She is currently at the Columbia University Graduate School of Journalism.

This article was originally published on Jacobin.