Map of access to safe abortion in Romania: Over 80% of public medical facilities do not provide abortion services or cannot be contacted

March 6, 2024 (PRESS RELEASE) – The Independent Midwives Association has retraced, within a research, the route that any patient who needs abortion services has to go through and shows that over 80% of public medical units in Romania do not provide abortion services or cannot be contacted.

The results of the research were presented at a round table, organized on March 4 in partnership with the Center for Equal Opportunities Policies (CPES) – Faculty of Political Science within the University of Bucharest, and the Gender Equality Plan, attended by representatives of the academic environment, central public institutions, civil society organizations from Romania as well as the  international ones,  patients, students, embassy representatives, human rights activists and journalists.

According to the research, in Romania, out of 176 public medical units listed with obstetrics and gynecology departments, only 7 units provide either medical or surgical abortion in accordance with the recommendations of medical guidelines, prospectus and national legislation and, out of 783 private medical units (clinics and hospitals), only 3 units offer both types of abortion services according to the medical guidelines, prospectus and national legislation. No public facility offers both types of abortion.

In Romania, the maximum legal limit for surgical abortion is 14 weeks, and for medical abortion the recommendations in the medical guidelines, corroborated with those in the prospectus, show a limit of 9 weeks.

Situation in public health facilities

  • 111 out of 176 public facilities (63.06%) responded that they do not provide this medical abortion service;
  • 7 facilities (4%) said they provide either medical abortion up to 9 weeks or surgical abortion up to 14 weeks, according to the medical guidelines, prospectus and national legislation;
  • 26 units (14.77%) provide abortion services up to limits lower than those provided for in recommendations in medical guidelines, prospectus and national legislation;
  • 32 units (18.18%) did not answer the phone.

The situation at a national level (public and private system)

  • 552 out of 959 public and private medical units (57.55%) answered that they do not terminate pregnancies;
  • 66 units (6.88%) provide either medical abortion up to 9 weeks, surgical abortion up to 14 weeks, or both;
  • 142 medical units (14.8%) provide medical abortion services on demand, but up to low pregnancy stages (5-7 weeks for medical abortion or 7-10 weeks for surgical abortion), with disregard of the provisions of the prospectuses, guidelines, do not provide information over the phone about the time limit up to which they provide medical abortion or surgical abortion, or have answered the phone aggressively;
  • 52 medical facilities (5.42%) provide access to medical abortion up to 8 weeks of pregnancy or surgical abortion up to 13 weeks of pregnancy;
  • 147 medical units (15.32%) did not answer the phone or the phone was not functional.

AMI research also shows that, in most cases, patients are not redirected: 90% of hospitals and clinics reported that they do not refer women who request a termination of pregnancy on request elsewhere, although this obligation is expressly laid down in the Code of Ethics for Doctors (Article 34). Of those who stated they refer patients to other medical units, more than half provided information about referral routes to clinics and hospitals where this service is not actually available.

Research also includes a number of barriers faced by patients, including cost. The price of a medical abortion is up to 1,800 lei, and that of a surgical abortion up to 4,800 lei, abortion on request and therapeutic abortion being medical services provided for a fee, both in the public and private system. The only procedures covered by the national health insurance system are ongoing abortions and and care for impending abortion. The report states that even if a victim of sexual assault needs medical services to terminate a pregnancy, they will be provided for a fee if there is access in the county.

The extensive results, conclusions, recommendations and situation at the level of each county can be consulted in full HERE.

The communist period was marked by induced abortions that resulted in most cases in the death of women. Between 1986 and 1989, I worked as an obstetrics and gynecology nurse in the resuscitation department of a maternity ward and witnessed the deaths of hundreds of women, victims of induced abortions. There were women who still had children at home, women brought to the hospital by desperate husbands who did not understand what was happening and what chances of salvation there were for the mothers of their children, women who resorted to empirical practices, out of desperation because they did not want to give life to children condemned from the start to a life with shortcomings or uncertain or marked by violence and abuse. I remember their resigned gaze in the face of death, their assumed choice, and their sad silence during the interrogation of the policeman assigned to find out the person who caused their abortion. Today’s society must be informed about the brutal reality of those times, about the dramatic consequences of violating a woman’s right to choose for her own body, in order to prevent a return to those practices. We must not go back to those times, I do not wish anyone to experience the oppression and suffering caused by such abuse„, said Melania Tudose, licensed midwife, president of the Association of Independent Midwives, at the event presenting the research results.

„Reproductive and sexual rights are defined as human rights in several international political and legal conventions and texts. The right and access to abortion is a women’s right: it concerns both women’s autonomy and the right to decide about their health, body and sex life, and a central element of sexual and reproductive health. The main problem we face in Romania is the increasingly limited access to this medical service «guaranteed» by law. More and more public hospitals are not offering this service, thus violating women’s right to health. Due to the lack of sex education in schools, the lack of effective information about and access to contraceptives, especially for women living in poverty, for whom the cost of contraceptives makes them unaffordable, Romania leads the EU in terms of the number of underage mothers. The reduction in the number of abortions in recent years reflects diminishing access to this medical service. This reduction often means that girls or women resort to unsafe means of abortion, putting their lives at risk. It also means forcing girls and women to have a child in difficult, sometimes critical, conditions for both mother and child: extreme poverty, domestic violence. On March 4, France voted to incorporate the right to abortion into its constitution. In Romania, abortion is legal, but inaccessible for a large part of girls and women. Guaranteed and safe access to abortion is a women’s right that should be defended and strengthened by any political party with a democratic agenda. We expect to see this in this year’s election programmes. Women should vote only for political parties that represent both their interests and their needs,” said Ionela Baluta, university professor at the Faculty of Political Science, University of Bucharest, director of the Center for Equal Opportunities Policies.

Girls and women in Romania need safe health services, provided on time and with respect for them. Abortion must be a settled service, along with contraceptive and protective means, especially for vulnerable categories in our country. Access to sexual and reproductive health services is currently severely restricted and, in fact, only applies to people who know a doctor, who can afford very high costs in many cases and who know how to avoid ending up in so-called „crisis pregnancy centres”, whose sole purpose is to force every woman to give birth,  Whether she’s underage, whether that pregnancy comes from rape, or whether she simply doesn’t want to have a child. We want every woman to be respected within the medical system, and for her rights regarding her own body and her own choices not to be restricted, leaving out tens of thousands of people who end up becoming mothers by force, starting from 11-12 years of age. The solutions identified by us are available, some of them can be implemented simply and quickly and we hope that the Romanian state will assume the protection of girls and women and access to health for all categories of population in Romania„, said Irina Mateescu, licensed midwife, vice-president of the Association of Independent Midwives.

The telephone research was carried out between November 2023 and February 2024, after the identification at a national level of 1,000 public and private medical units (clinics and hospitals) listed with obstetrics and gynecology departments. Of these, 41 units were eliminated due to the identification of clinics/hospitals as duplicates, the purpose of the clinic being exclusively as a test sampling point, the reprofiling of the clinic to other specialties or the retirement of the doctor. Each medical unit was called at least 4 times, on different days and at different times of the day.

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