Daniela Draghici knows firsthand what an abortion ban looks like.
In 1976, when she was a college student in the Romanian capital of Bucharest, she got pregnant after her contraception failed. Abortion was prohibited in Romania.
With the help of a friend, Draghici was taken to a woman with no medical training to end her pregnancy.
"Somebody took me during the night to some kind of house outside the city where there was this old woman," Draghici remembers. "She was boiling these metal instruments in a lot of alcohol on an ancient stove."
After a painful procedure, Draghici went home, but continued having morning sickness several days later. She found another woman who took her to the home of a gynecologist who completed the abortion — again, illegally — on a kitchen table.
"I'm lucky I didn't die," says Draghici, an abortion rights and sex education activist. "I could have been like the thousands of women who got an infection and were left to die."
In 1966, Romania's communist leader, Nicolae Ceausescu, banned abortion and contraception in an attempt to raise the nation's low birthrate. During his rule through 1989, an estimated 10,000 women died from unsafe abortions and hundreds of thousands of children were put in overcrowded orphanages where they often suffered abuse and low nutrition.
In the early 1990s, after the overthrow of Ceausescu, the new government founded Romania's first family planning program. At that point, reproductive rights began to improve: Abortion was legalized up to the 14th week, contraception was free, and sex education was implemented in public schools.
But that didn't last long. Activists say that over the past decade, the government slashed funding for the family planning program, leading dozens of clinics to shut down. Gynecologists are increasingly refusing to perform abortions by invoking a conscientious objector clause, citing moral or personal reasons such as their religious beliefs, according to reports from activists and medical professionals. In 2011, the government took away subsidies for contraceptives. And sex education is no longer taught in schools.
Romania's family planning work was once admired
What's happening in Romania is part of a recent trend across Europe, as Christian organizations and conservative lobbying groups, often bankrolled by U.S. funders, gain political influence. Romania's Orthodox Church is a powerful institution, particularly in rural areas. And so-called pregnancy crisis centers, run by various Christian groups, have popped up around the country to try to dissuade women from having an abortion.
"Up to the European Union accession in 2007, Romania was a leader and a model in Central and Eastern Europe from the point of view of reproductive health care," says Draghici. From 1992 to 2002, she was the family planning program manager at a U.S.-funded Romanian nonprofit group. "Now, what I'm witnessing is the destruction of the network of family planning clinics. So, we've gone up and now we're going down."
The coronavirus made it harder to get an abortion
The COVID-19 pandemic only exacerbated the problem, says activist Andrada Cilibiu, from the abortion rights organization Centrul Filia. In March 2020, the government published a list of "essential emergency services" that public hospitals had to provide while they also treated an influx of coronavirus patients. That list did not include abortion.
"During the emergency period in Romania, there was only one hospital in Bucharest that was performing abortions, and it was a private hospital," Cilibiu says. "It was charging women 3,000 Romanian lei [$720], and that's outrageous."
She says declaring abortion non-essential gave health care providers an excuse to refuse to perform them. After pressure from abortion rights organizations, in April 2020, the government told public hospitals to resume abortions. But Cilibiu says the damage had already been done.
"The hospitals are lying," she says. "They are telling me in [response to a Freedom of Information Act request] that they're providing abortion, but when I call, lots of them tell me they do not."
For the past few years, Cilibiu has been conducting an unofficial survey of public hospitals across Romania by calling and pretending to be a pregnant woman in need of an abortion. She then publishes the results on the organization's website.
According to her records, in June 2020, 55 public hospitals out of the 134 questioned said they provide abortions. This June, only 28 public hospitals said they provide abortions. The National Statistics Institute backs up this trend: The country's birthrate rose at the end of 2020 – nine months after the start of the pandemic – and the number of abortions fell by 35% from 2019 to 2020.
As a result, Cilibiu says, women need to travel for adequate service or find a way to do it themselves.
"Women continue to get abortions with sharp objects at home in 2021," she says, evoking images of Ceausescu's 24-year abortion ban.
Abortion is too taboo to talk about
Others, still, are forced to carry to term.
A 21-year-old Romanian woman says she had no one to turn to for help when she got pregnant in 2019. She wanted to end her pregnancy but it is taboo among her friends and family. She asks not to use her name to avoid the social stigma from trying to get an abortion.
She hit a series of obstacles: First, a family doctor told her to go home and think about her decision. Then, a doctor at a family planning clinic she found on Facebook told her the procedure would be very painful and redirected her to a maternity clinic to find out how far along she was. After a day of tests there, she was sent home. She eventually went to a public hospital, where she says she was treated badly by staff and forced to do an intravaginal ultrasound.
By then, she was too close to the 14th week, the legal threshold for having an abortion in Romania, and had the baby.
"I never thought I'd be in this position," she says. "I thought the doctor would give me some pills and that's it, I would have an abortion and then it'd be over."
Midwife Adina Paun says it's not just abortion that's difficult to access, but contraception as well.
Paun travels all over Romania to provide services and information about reproductive health care, particularly in rural villages where women have little access to clinics. She says many family doctors there refuse to provide contraception. And contraception and abortions that are available can be expensive.
"If you don't give these women access to contraception, you cannot infringe on their right to abortion," says Paun.
Advocates face powerful opponents
Draghici, the activist who had a clandestine abortion in the 1970s, says anti-abortion lobbying groups are becoming increasingly influential in Romanian politics.
"Thirty years later, we are faced with pretty much the discourse that we were faced with during Communism: Women should not have abortions and contraception is not secured by the Ministry of Health," says Draghici. "It's ridiculous that we have to do [the work] all over again."
The Romanian Health Ministry declined to comment. Various anti-abortion organizations could not be reached for comment for this story; one group, Pro Vita Association, refused to comment, citing concerns of "pro-abortion and genderist bias."
In September 2020, after a Romanian woman died as a result of an unsafe abortion, the Health Ministry's spokesperson, Oana Grigore, was criticized by activists for saying that the ministry "encourages pregnancies to be completed and does not encourage abortions."
But Draghici says she's hopeful: In recent months, after many talks between abortion rights organizations and the government, the Health Ministry has promised to revive 100 family planning clinics and the Education Ministry has agreed to resume discussion to reinstate sex ed in schools.
"Our wins are slim at this time, but they're there," says Draghici. "I don't feel tired or discouraged. I keep doing it because many other people have just given up. But as an advocate, I know that the key message is: 'Never give up.' And that's what I'm doing, I'm not giving up."
This reporting was supported by the International Women's Media Foundation.
Copyright 2023 NPR. To see more, visit https://www.npr.org.