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In Romania, women living in precarious conditions face restricted access to abortion

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Bucharest, Romania – Although abortion has been legal in Romania since 1990, more and more doctors are refusing to perform it. With the pandemic, access has become even more restricted, especially for vulnerable women and teenagers in a country with one of the highest rates of underage mothers in the EU.

“I could not keep this child, my financial situation did not allow it.” At the very beginning of the pandemic, Cristina (her name has been changed), 19 years old, could not find a doctor who would agree to perform an abortion in Bucharest: “I was told that it was not a serious emergency.” From March to May 2020, abortion was not considered an emergency operation, despite it being guaranteed by law, until the 14th week of pregnancy.

Only one in ten public hospitals – among those that usually perform abortions – was available to terminate an unwanted pregnancy. In Bucharest, Romania’s capital city of two million inhabitants, not a single hospital performed abortions during these two months, with only one exception: a private clinic that charges €700 for the operation. As for medical abortions, they’re rarely administered. “At first I thought of having an abortion on my own,” writes Cristina. But then I found a gynecologist who performed the operation in her flat. Everything looked clean and sterilised, but I was still not reassured. “

Cristina’s testimony was shared with us, with her consent, by Adriana Radu, from the sexual education association Sexul vs Barza (Sex vs Stork). To make up for the state’s shortcomings, Romanian NGOs have stepped up to help women in distress. While Cristina managed to find a solution, this was not the case for another 21-year-old woman from Bucharest, who was living in extreme poverty. “She already had two children, and no hospital would take her,” recalls Adriana Radu. “I helped her get a free gynecological consultation, but all this took time and she had already passed the legal deadline for abortion. She had to keep the child.”

Another women’s rights association, Centrul Filia, is developing a map of hospitals and clinics that perform abortions. In April 2020, Andrada Cilibiu, together with her colleagues from the association, spent several hours calling public hospitals one by one. Pretending to be patients, they realised what a headache it was to access this information. “Not to mention the assistants who hung up on us, advised us not to terminate the pregnancy or called us sadistic because we were calling around Easter,” explains Andrada. “So we also have a problem with the way medical staff address patients. There should be a regulated protocol for that. “

The map clearly shows empty areas, such as the Moldovan region, which are already among the poorest territories in the country. “This means that women, especially the most socio-economically vulnerable ones, had no access to abortion during this period,” continues Andrada. “It’s very likely that some of them sought to perform abortions at home, with non-sterile medical equipment.”

This situation is reminiscent of the dark years of communism under Ceausescu’s 1966 decree, one of the strictest ever. During that period, 10,000 women died as a result of clandestine abortions and more than 100,000 self-mutilated. This troubled past seemed to resurface in September when a 45-year-old woman died following a surgical abortion at a private clinic. An investigation by the media outlet PressOne revealed that no public hospital was performing abortions in the rural area where she lived because of Covid-19. However, the journalist showed that only one of these facilities was actually dedicated to treating Covid-19 patients, and that the private practice to which she was referred by a public hospital did not comply with health regulations.

The vicious circle of poverty

Despite this tragic event, abortion is still difficult to access one year after the start of the pandemic. In Bucharest, two public hospitals now perform the operation, but not without additional restrictions: the pregnancy must be at 10 and 12 weeks maximum. This limited access for almost a year is reflected in the official statistics: in 2020, the number of abortions fell by 35% compared to 2019. By contrast, in December 2020, nine months after the start of the restrictions, 15,857 children were born in Romania, 2,103 more than in November and 433 (2.8%) more than during the same month a year earlier, according to data from the National Statistics Institute (INS). This is despite the fact that the trend in Romania is towards a plummeting birth rate.

For midwife Adina Paun, who works with Centrul Filia and other associations in rural areas, the correlation is clear: “The fact that there were fewer abortions does not mean that these women did not want to have them. They just couldn’t. “

She fears that access will be even more restricted for women in precarious situations: “They already have almost no access to this right in Romania. Many gynaecologists in the surrounding towns do not perform abortions, and the only ones who do are two or three hundred kilometres away. Imagine a poor woman from a village: if she has to go to another district, she needs to be able to save up to pay for the bus and the operation, which is not reimbursed unless there is a malformation of the foetus [a cost of about 100 euros in public hospitals]. All this in a very short time, whereas it’s something that cannot wait. It’s a system that simply doesn’t work and leaves no options.”

While Romania has the highest rate of teenage mothers in the EU after Bulgaria (in 2018, a quarter of teenage mothers in Europe were Romanian), Adina Paun sees no real improvement in sight: family planning clinics are remote and almost non-existent, contraception isn’t free, and sexual education still isn’t taught in schools. The first child born in 2021 in Romania was to a 15-year-old girl. “If hospitals cannot perform abortions during the pandemic, we need to find a national solution: distribute contraceptives and make medical abortion accessible, offer IUDs, go into communities to give information on reproductive rights. We must not leave them alone and tell them to ‘behave’ for a few more years,” the midwife argued.

She reminds us that an unwanted pregnancy condemns young girls who are already in a precarious situation to a vicious circle: “With a child, they will no longer have access to education, so they will not be able to get a decently paid job, and this also condemns their child to poverty, and so on.” She also points out the contradictions of the Romanian Orthodox Church and politicians close to the Church “who strongly condemn abortion but do not encourage sexual education or contraception.”

Romania: Tug of war between the Church and civil society

In recent years, an increasing number of gynaecologists have decided no longer to perform abortions, asserting their “conscience clause”. According to a survey by Centrul Filia in 2019, almost a third of gynecological services in public hospitals have decided to stop performing the operation, a majority of them citing moral and religious reasons. So-called “pregnancy crisis” clinics, which are sometimes found in the first results of search engines when one types “abort” (in Romanian), urge women not to have an abortion. As for sexual education, its implementation is constantly decried by some politicians. At the onset of the pandemic, the government wanted to introduce a few hours in optional courses called “health education”, but the proposal faced an avalanche of criticism. The law is still being debated in Parliament, in particular to add the obligation to have the parents’ consent.

However, unlike in other countries such as Hungary, the discourse on reproductive rights remains present in the media and on the internet. The TikTok account of Sexul vs. Barza had over 200,000 new followers during the pandemic. In the town of Piatra Neamt, known for the simple fact that the management of the public hospital has banned abortion, a play about a teenager who becomes pregnant became an unexpected success. Written by Andreea Tanase for the city’s Youth Theatre, 98%: Correct Decision initially caused a scandal in local newspapers.

But it also helped the theatre play reach a wider audience: during the two weeks of its broadcast on Vimeo in November 2020, it accumulated nearly 8,000 online views. One evening, the ensuing discussion on Zoom lasted over three hours. “It was incredible, young people came from all over the country,” comments Andreea Tanase. “All the interventions were very relevant. They discussed access to contraception, and they shared channels where to find information. It’s a pity that all this is only available outside the school setting. It shows that there is an interest and that they should have access to this information at school. “

Experts on the topic, like Adriana Radu, hope to work with the new Ministry of Health to set the budget for the next National Reproductive Health Strategy (2021-2024). This new line of action will perhaps make these rights to abortion, contraception and sexual education more accessible, for everyone.

Article written by Marine Leduc and published in partnership with Le Courrier d’Europe Centrale. The research for this article was partly funded by n-ost, with support from the German Federal Foreign Office.

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