Final Report Summary - REPROAB (Controlling Reproduction in Post-communist Romania: The Abortion Issue)
REPROAB (Controlling Reproduction in Post-Communist Romania: The Abortion Issue) was a FP7-funded Marie Curie Career Integration Grant coordinated by Dr. Lorena ANTON (as researcher and scientist in charge) at University of Bucharest, Romania. Developed between October 2013 and September 2017, the project consisted in an anthropological research focused on evolution of the politics and policies of sexual and reproductive health (with main regards to abortion) in post-communist Romania, after more than two decades of pronatalist policies implemented by former communist regime.
The main goal of REPROAB was to try understanding how the post-communist Romanian State has dealt with the abortion issue after the previous totalitarian pronatalism, in terms of public policies and their implementation. Interdisciplinary in nature, and primarily qualitative, the project combined a social anthropology and Memory Studies approach in order to (1) inventory the public policies concerning abortion after 1989, as well as associated debates, and (2) analyze the individual practices of the medical profession, and their evaluation by the patients, both in a synchronic (participatory observation in abortion-providing facilities) and diachronic perspective (in- depth interviews, following a social memory approach, with medical practitioners and their patients). The associated long-term fieldwork took place in south-central contemporary Romania (Bucharest and Prahova jurisdiction), and involved several case studies in urban and rural settings. The results of this research could contribute to the advancement of the state of art of medical anthropology in Romania, and could also be relevant in the development of better public policies concerning abortion care and the understanding of Romanian fertility-control between past and present.
The analysis of reproductive health legislation, interviews with medical-professionals and associated public debates available in Romanian mass-media underlined the existence of different periods in post-communist abortion-governance: (1) a difficult recovery in the early 1990s, when Romania had the biggest abortion-rate ever registered (177.6 per 1000 women in 1990, according to the National Institute of Statistics); (2) a phase of intense reconfigurations of reproductive health policies (1994-2001), when numerous initiatives – like the creation in 1994 of the National Network of Family Planning - have been implemented with the help of international organizations as WHO, UNFPA or USAID; (3) a focus on abortion-prevention (2001-2007) by the developing of national policies of free-contraception for numerous categories of women-at-risk, and the struggle for the implementation of better abortion-care; (4) a general deterioration in abortion-care and reproductive-health services (2007-2012), mainly due to the consequences of the global financial crisis, and (5) a phase of contentious challenges to reproductive rights (2012-at present), with the rise of anti-abortion campaigns or the spread of cases of conscientious objection.
In terms of abortion-prevention, the research findings showed that even a large system of family-planning centers have been implemented during the 1990s, and a big number of specialized medical practitioners have been trained especially in the first years of the second decade of post-communism with the help of international organizations, the prevention-policies have been gradually abandoned after 2007. They were not totally re-implemented after the worse effects of the global financial crises passed away, being instead added to the services provided by general practitioners (or ‘family-doctors’, as referred to in Romanian society) and restricted to ‘general counselling’, i.e. no delivery of free-contraception, one of the best policy previously developed. This had negative effects for many women who could not afford the high price of contraception and relied on the supplies delivered by the family-planning centers. Emergency-contraception is generally available in city-pharmacies, but many of the women interviewed reported not to use it as they don’t know how exactly works or do not trust its efficiency. A better education related to emergency-contraception is thus needed, by public campaigns and/or by family-doctors.
In term of abortion-care, the research findings showed that those services are substantially better in the private sector, even if more expensive. This creates a burden for women with lower resources, who are thus the main victims of this discrepancy. A possible solution will be the standardization of abortion-service fees, in order to ensure equal medical services.
Even if in 2003 the Patient Rights Law established, in its Reproductive Rights Chapter, that ‘the right of the woman to decide whether or not to have a child is guaranteed’ (Article 28), abortion is still highly stigmatized in contemporary Romanian society. This goes hand in hand with a general lack of sexual education, which is crucial for abortion-prevention. A public protest initialized in autumn 2015 that demanded the necessity of introducing hours of sexual education in public schools was drastically silenced down by pro-life lobby, which since then managed to organize bigger and bigger Marches for Life all over Romanian major cities. The rise of pro-life lobby in contemporary Romania, in parallel to intensification in neo-nationalist and populist discourses, can seriously challenge women’s reproductive rights in the near future.
Another problem identified by the REPROAB project is the increase of reported cases of conscientious objection among the medical professionals working in public hospitals. Even if this practice is not regulated by Romanian law, it became a fashion during Easter and Christmas periods. This problem can seriously challenge access to better abortion-care in the near future, and adequate legislation should be debated and put into practice.
The creation of an effective, fully-functional system of abortion-care after twenty-three years of communist pronatalism and totalitarian control over women’s reproductive bodies, all in the name of the ‘nation’s vigor’, was a complex and complicated endeavor. Post-communist Romania have made significant efforts to develop better sexual and reproductive health policies, especially with regards to the abortion issue - initially with the precious help of international health organizations and afterwards by the development of national and local campaigns. Continuous efforts should be continued, and the past should not be forgotten but instead became a lesson for future generations.
The main goal of REPROAB was to try understanding how the post-communist Romanian State has dealt with the abortion issue after the previous totalitarian pronatalism, in terms of public policies and their implementation. Interdisciplinary in nature, and primarily qualitative, the project combined a social anthropology and Memory Studies approach in order to (1) inventory the public policies concerning abortion after 1989, as well as associated debates, and (2) analyze the individual practices of the medical profession, and their evaluation by the patients, both in a synchronic (participatory observation in abortion-providing facilities) and diachronic perspective (in- depth interviews, following a social memory approach, with medical practitioners and their patients). The associated long-term fieldwork took place in south-central contemporary Romania (Bucharest and Prahova jurisdiction), and involved several case studies in urban and rural settings. The results of this research could contribute to the advancement of the state of art of medical anthropology in Romania, and could also be relevant in the development of better public policies concerning abortion care and the understanding of Romanian fertility-control between past and present.
The analysis of reproductive health legislation, interviews with medical-professionals and associated public debates available in Romanian mass-media underlined the existence of different periods in post-communist abortion-governance: (1) a difficult recovery in the early 1990s, when Romania had the biggest abortion-rate ever registered (177.6 per 1000 women in 1990, according to the National Institute of Statistics); (2) a phase of intense reconfigurations of reproductive health policies (1994-2001), when numerous initiatives – like the creation in 1994 of the National Network of Family Planning - have been implemented with the help of international organizations as WHO, UNFPA or USAID; (3) a focus on abortion-prevention (2001-2007) by the developing of national policies of free-contraception for numerous categories of women-at-risk, and the struggle for the implementation of better abortion-care; (4) a general deterioration in abortion-care and reproductive-health services (2007-2012), mainly due to the consequences of the global financial crisis, and (5) a phase of contentious challenges to reproductive rights (2012-at present), with the rise of anti-abortion campaigns or the spread of cases of conscientious objection.
In terms of abortion-prevention, the research findings showed that even a large system of family-planning centers have been implemented during the 1990s, and a big number of specialized medical practitioners have been trained especially in the first years of the second decade of post-communism with the help of international organizations, the prevention-policies have been gradually abandoned after 2007. They were not totally re-implemented after the worse effects of the global financial crises passed away, being instead added to the services provided by general practitioners (or ‘family-doctors’, as referred to in Romanian society) and restricted to ‘general counselling’, i.e. no delivery of free-contraception, one of the best policy previously developed. This had negative effects for many women who could not afford the high price of contraception and relied on the supplies delivered by the family-planning centers. Emergency-contraception is generally available in city-pharmacies, but many of the women interviewed reported not to use it as they don’t know how exactly works or do not trust its efficiency. A better education related to emergency-contraception is thus needed, by public campaigns and/or by family-doctors.
In term of abortion-care, the research findings showed that those services are substantially better in the private sector, even if more expensive. This creates a burden for women with lower resources, who are thus the main victims of this discrepancy. A possible solution will be the standardization of abortion-service fees, in order to ensure equal medical services.
Even if in 2003 the Patient Rights Law established, in its Reproductive Rights Chapter, that ‘the right of the woman to decide whether or not to have a child is guaranteed’ (Article 28), abortion is still highly stigmatized in contemporary Romanian society. This goes hand in hand with a general lack of sexual education, which is crucial for abortion-prevention. A public protest initialized in autumn 2015 that demanded the necessity of introducing hours of sexual education in public schools was drastically silenced down by pro-life lobby, which since then managed to organize bigger and bigger Marches for Life all over Romanian major cities. The rise of pro-life lobby in contemporary Romania, in parallel to intensification in neo-nationalist and populist discourses, can seriously challenge women’s reproductive rights in the near future.
Another problem identified by the REPROAB project is the increase of reported cases of conscientious objection among the medical professionals working in public hospitals. Even if this practice is not regulated by Romanian law, it became a fashion during Easter and Christmas periods. This problem can seriously challenge access to better abortion-care in the near future, and adequate legislation should be debated and put into practice.
The creation of an effective, fully-functional system of abortion-care after twenty-three years of communist pronatalism and totalitarian control over women’s reproductive bodies, all in the name of the ‘nation’s vigor’, was a complex and complicated endeavor. Post-communist Romania have made significant efforts to develop better sexual and reproductive health policies, especially with regards to the abortion issue - initially with the precious help of international health organizations and afterwards by the development of national and local campaigns. Continuous efforts should be continued, and the past should not be forgotten but instead became a lesson for future generations.