Access to Abortion Is Shrinking in Romania

In a country that famously banned terminations, with devastating consequences, new medical rules are once again costing women’s lives

Access to Abortion Is Shrinking in Romania
An anti-abortion rally in Bucharest, the Romanian capital, in 2017. (Daniel Mihailescu/AFP via Getty Images)

Alina Usurelu sensed she was pregnant. An independent artist, she often works with her body, which is how she quickly noticed it change. “Very rationally, I knew I couldn’t deal with having a kid,” the 33-year-old told me in the Romanian capital of Bucharest, citing her financial insecurity. A pregnancy test last September confirmed her suspicion.

But in the city of 1.8 million, Usurelu could not find an affordable, state-run hospital online. “I was struggling. My anxiety grew,” she told New Lines a few months later. We met near her apartment in one of Bucharest’s central neighborhoods, where buildings with high ceilings are sandwiched between crumbling Soviet-era blocks. Her black hair is peppered with gray, cut short for a recent performance.

In Romania, abortions are legal but access is shrinking. The vast majority of state hospitals don’t offer terminations, while private centers are unaffordable to most. Usurelu faced a decision: She could continue her search, hoping she didn’t reach the time limit of 14 weeks for legal abortions; or pay around $920 in a private clinic, double the monthly rent on her small Bucharest home.

Ultimately, she posted on a women-only Facebook group for discussing toxic relationships, where her message was picked up by a member of the Independent Midwives Association (AMI). They helped her obtain a nonsurgical, or medical, abortion for free. The nonprofit organization handles around a dozen such cases every week in Romania, helping women who find it through social media, its website or its youth hotline.

The combination of Romania’s powerful Orthodox Church and the spread of misinformation by U.S.-backed conservative organizations means Romanians are increasingly unable to access abortion services. Last year, a woman who was 13 weeks pregnant died in hospital after she showed up in pain and bleeding, only to be told by doctors to wait until the next day. Four years ago, a woman died from a hemorrhage after a back-alley abortion.

Such cases bring back memories of the ban under the communist leader Nicolae Ceausescu, which lasted for 24 years, killing an estimated 10,000 women through unsafe abortions, increasing crime and creating filthy orphanages often packed with children who suffered from abuse and low nutrition. Women without any medical training devised their own barbaric methods of self-induced abortion at home, using clothes hangers, knitting needles and poisonous plant stems. Some were left mutilated, and doctors who performed the abortions in secret often risked their careers, their freedom and even their lives.

Romania departed from other countries in the Soviet bloc: Russia was the first modern state to legalize abortion in 1920 and this was quickly extended to the rest of the Soviet Union. While Josef Stalin banned the procedure in 1936, abortions became legal and widely available again in 1955, following his death. Most satellite states including Poland, Hungary, Bulgaria and Romania followed suit in the 1950s, but Ceausescu prohibited abortion again in 1966 in an attempt to raise the country’s low birth rate. Within one year, the birth rate rose from 1.9 to 3.7 children per woman. But by 1989, at the end of the ban, maternity death rates had also doubled.

Melanie Elena Tudose, the President of the AMI and still a practicing midwife, worked in a septic ward of a hospital in the 1980s, treating women with infections and often finishing backstreet abortions in a sanitary setting. Still, she saw hundreds of women die. “I still remember their last look in their eyes. And the way their skin turned orange because of the infection.”

In the early 1990s, after Ceausescu’s overthrow, the new government founded the country’s first family planning program. Abortion was legalized (up to 14 weeks), sex education was introduced in schools and contraception was given out free.

But over the past decade, as part of a trend across Europe, funding for the program has been cut, and scores of clinics have shut down. Hoping to profit, some doctors refuse to carry out the procedure in a public hospital citing “conscientious objection” laws, and redirect women to their private practice. These laws, which allow medical professionals to abstain from carrying out procedures that might conflict with their religious or moral beliefs, were included in Romania’s professional code for medics in 2016, partly thanks to a campaign by the powerful Orthodox Church. Parents now have to opt in for their children to receive sexual education, and opt out of religious studies.

Abortion-rights activists urged Europeans to vote against a populist surge in the bloc’s recent parliamentary elections, as the growing far right challenges abortion access across the continent. While the political center managed to hold on to its majority in the European Parliament, far-right parties gained seats, coming a clear first in France and Austria, winning the most seats in the Netherlands and coming second in seats and vote share in Germany. In Romania, the vocally anti-abortion, far-right Alliance for the Union of Romanians received 15% of the votes, second only to the total for the country’s governing grand coalition of the Social Democratic Party and National Liberal Party.

The centrist government in Romania faces three elections this year, including a presidential vote in September. But reproductive rights are largely absent from politics.

This doesn’t mean the American bankrolling of Christian and conservative lobbying groups in Europe is going anywhere. Three years ago, the European Parliamentary Forum for Sexual and Reproductive Rights detailed funds worth tens of millions of dollars that the U.S. Christian Right has pumped into Europe.

Some organizations have open, direct links, as is the case with Brad Hayes, a father of five, missionary and the founder of the anti-abortion nongovernmental organization Outstretched Hands of Romania. Originally from Wisconsin, he moved to Calarasi, not far from Bucharest, in 2002 to set up a church and a community center. He now works with a team of 30 people. Many of the women he speaks to are unemployed and poor. He provides counseling and financial help; he also talks to local doctors about having “compassion for the unborn baby,” he said in a phone interview.

At least part of the funding comes from the U.S.: In April, Hayes hosted a fundraiser for his Romanian organization in New Berlin, Wisconsin, with a $20 entry fee for adults. Donations are sent to a post box in the same city. In 2023, he was the host of the United for Life conference, attended by the president of the U.S.-based global anti-abortion group Pro-Life Global.

Hayes acknowledges that a lack of money is among the main motivations for women seeking abortions in rural Romania, where rates of teenage pregnancies and forced marriages are high, driving girls out of school. Financial help, he says, motivates the new mothers, or “takes away the excuse.”

Between November 2023 and February 2024, operators at the AMI conducted a phone survey of 959 medical units around the country. According to their findings, over 80% of Romania’s public medical facilities do not offer abortion services. The majority of both private and public clinics that offer abortions have a cutoff below the legal limit, at nine weeks for medical, and 14 weeks for surgical abortions.

The report said 90% of hospitals and clinics refuse to refer women to another clinic on request, despite their obligations as laid down in the country’s medical ethics code. Out of Romania’s 41 counties, there are no hospitals performing abortions in 13, leaving millions without direct access. According to official numbers, most counties performed zero abortions in 2021 and 2022.

In the past two years, the AMI helped around 400 women, among them Ukrainian refugees and other minorities including Roma and illiterate women, by providing them with information, connecting them to institutions providing safe abortions and obtaining funding for their journey or the procedure.

“This should not be a job for an NGO, it should be the state,” said Irina Mateescu, the AMI’s vice president. “It’s fucking outrageous.”

She has personal experience: In 2000, pregnant at 18, she walked into a Bucharest-based Pregnancy Crisis Center, a covertly anti-abortion institution inspired by the U.S., where she had to watch the movie “Silent Scream,” showing the ultrasound recording of a surgical abortion performed during the 11th week of a pregnancy. She was almost dissuaded.

Misinformation also abounds. “People tell you you might become infertile from having an abortion,” said 34-year-old Anca, a Bucharest-based project manager who spoke to New Lines without giving her last name. “And that’s why some women don’t do it.”

Browsing online forums and “dark and obscure” websites, Anca decided to opt for a medical abortion. Her doctor didn’t tell her the procedure would involve contractions, so a few weeks later she returned to the hospital, riding the metro covered in blood, and terrified. The forums didn’t prepare her for this. “I made the best decision,” she told me, a few years after her abortion. “I just wish medical institutions were better.”

When feminist activist Daniela Draghici procured an abortion in 1974, she almost died afterward. She became pregnant even though she was using some sort of contraception she picked up below the counter. “I had to insert it into my vagina before sex, and it burned like hell.”

Through an underground network, Draghici went to an old lady in the suburbs of Bucharest. With no anesthetics to hand, the woman gave her a piece of rug to bite down on while she performed the operation on a kitchen table. Draghici decided the operation wasn’t successful when her morning sickness returned. The second time, she was taken to a male doctor, in another district of Bucharest, who likely saved her life with another operation, also performed on a kitchen table.

Draghici later worked with U.S. organizations spreading information and contraceptive equipment around the country. At 71, she wears her red hair short, matching her orange flip-flop-shaped earrings, and speaks fast with an American accent. “I’ll give up when I’m dead. Up until that time I have to do this because not enough people are talking about it,” she said. “The restrictions could come back.”

There are no statues to the women who perished during the abortion ban. Bucharest’s Museum of Communism, a narrow two-story building sandwiched between a Hungarian beer garden and a rock club, dedicates a short paragraph to the daring doctors who performed life-saving operations. Women are mostly absent from the room, the history books and classrooms.

This creates an information vacuum, said Ela Craciun, a researcher, the president of feminist organization FRONT, and organizer of abortion-rights protests. In this vacuum, the far right flourishes. “They were able to build a lot of support against abortion through the discourse on the traditional family and through the hysteria around children. If they would have started straight on with abortion, it would have been rejected. But now it makes sense within the narrative,” she said.

But there are some trying to challenge this. Simina Tulbure is the vice president of the centrist Renewing Romania’s European Project (REPER), the country’s most progressive party, in her words. A linguist by education, she is a member of the lower house of Parliament representing Romanians living abroad, around 8 million people. At 31, she would be too young to enter the Parliament’s Senate, where the minimum age is 33.

She is the co-author of a motion, currently in front of the Parliament, that would oblige at least one hospital per county to perform abortions. When her colleague presented it in the parliament, however, the majority-male committee cited religion as a reason to dismiss the motion, she says.

“Unless the far-right party comes to the government, I don’t think they will ban abortions. But still, there is a big danger, because [the government] closes their eyes when it comes to safe procedures,” Tulbure told New Lines.

The Romanian health ministry didn’t respond to a request for comment from New Lines. Four years ago, its spokesperson Oana Grigore said: “We deal with people who are sick. We encourage birth.”

According to Raoul Chereches, an obstetrician-gynecologist at a private fertility clinic in Bucharest, doctors face pressure from religious and anti-abortion groups. Until recently, he worked in the only public hospital that performed abortions in Timisoara, a city of 300,000.

“Our book was always full,” he recounts. Due to poor management, the ward often ran out of equipment: stitching needles or pregnancy tests. Chereches and his colleagues, as well as patients, were also greeted each day by an anti-abortion activist at the front door. These two factors led him to leave the public system when he was 32.

Such inattention has even impacted those who campaigned for harsher abortion laws. In August 2023, Alexandra Ivanov waited for a doctor to see her in the hospital of Botosani, in northeastern Romania. The 25-year-old mother of three was 13 weeks pregnant, and in a lot of pain. She was told her fetus had died, and she would need a medical miscarriage, a procedure similar to abortion, to avoid infection. She was told a specialist would see her the next morning to carry it out, but by then Ivanov had died of sepsis.

“She was good, helpful, faithful, a family girl,” her brother, Vlad Miron, told me. After her death, marches and commemorations sprung up across her small city. The family sued the hospital, and are currently waiting for the result of the investigation, Miron added.

Ivanov met her husband at the local Orthodox youth group, and was a key member of the local branch of anti-abortion group Pro-Vita. According to an interview published by the news agency of the Romanian Orthodox Church, she handed out leaflets and talked to pregnant women in crisis.

In April 2024, local media reported that another woman, 38 years old and four months pregnant, died within 24 hours of being admitted to the same hospital.

Their deaths speak to larger issues. “We know of doctors who want to do (abortions), but the management of the hospital doesn’t allow them,” said Mateescu in a back room of the AMI’s office in Bucharest. As if to illustrate her point, she explained how her organization is converting the space into a room for medical examinations.

Behind her, in a locking glass cabinet, were rows of abortion pills in packs.

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