In Romania’s Communist period after 1966, women owed it to the state to have children. Only after a woman gave birth to four or five children, would the state allow her to have an abortion, but did not allow any other method of contraception. This is the framework that defined the maternity system in communist Romania. A system in which peoples’ needs did not matter, only their obligations. Its effects are still felt in hospitals today and in the way society perceives the idea of ​​motherhood.

The year is 1980.

You are a 25-year-old woman and live in an industrial neighborhood in a provincial town. You share a two-room apartment with your husband and two-year-old child. You are pregnant. Nicolae Ceausescu has been the General Secretary of the Communist Party for 15 years, and for seven years he has also held the position of President of the Republic. Ceausescu’s rules are compulsory for everyone, even for the unborn. In Romania, abortion has been banned since 1966, and pregnancy is a duty to society.

But you don’t want to keep the baby.

You have two options. The first is to perform an abortion by yourself. You have heard of all kinds of mixtures that you can swallow, but also of plants that you can introduce into your uterus. Some have told you that it also works with liquid soap. You’ve heard fermented yeast works too. You could also try the rubber tube, but you need someone to teach you how to use it.

The second option is to find someone to perform curettage, where an instrument scrapes the lining of the uterus, removing its contents. But that costs a lot of money and is risky. You remember there was a midwife in your native village who attended your own birth. The midwife helped women. Sometimes she also performed abortions. But that was a few years ago. The year is 1980, and the Romanian state has brought midwives into the hospital system in order to monitor their activities.

In the week after you find out you are pregnant you consult your network of acquaintances. Your husband knows someone who can put you in contact with someone who taught a colleague’s wife how to insert a probe. You get hold of a probe, a syringe, and physiological serum. You put the probe inside the vagina until you think it has entered the cervix, just as you were told. Then you apply the physiological serum, and wait.

A day passes, two, then three. Nothing happens. You try again. How many times can you try? Three, four times? Every time, nothing happens. You’re probably doing something wrong.

It’s been three months and you’re still pregnant. You are afraid to try another method of abortion, so you decide to continue with the pregnancy. You have no alternative. In Ceausescu’s Romania it doesn’t matter what you want. You are officially a pregnant citizen. One who will live in the coming months for fear of giving birth to a defective baby because of your potential mis-use of the rubber tube. 

The day you give birth feels like a fatality. You will never forget it. The pain is terrible, and the nurses yell at you for not trying hard enough. You faint from pain and exertion. A slap to the face wakes you up. The doctor is shouting at you: if you don’t push, you will kill the baby. And then you feel the elbow on your stomach. You feel it with your whole body. You scream in pain. Until then, you tried not to make a fuss. You are in the hands of the system, but you still want to live.

After your scream comes the baby’s scream. You can’t see it, you just hear it. Is it okay? Nobody tells you anything. Someone shouts that it’s a girl. That’s all you know. Then the baby disappears. She will only be brought to you the next day. Before putting her on your breast, they will wipe you with alcohol, so as not to infect the baby. They only leave her with you for a few minutes. Then they take her away again.

You get about a hundred days of maternity leave. The interval is strictly calculated: pre-birth days are included. Then you go back to work. You call in your mother from the countryside to help you out. Now you are five people living in the two-room apartment. The factory allows you a break to come home and breastfeed. You don’t use it. It would be impossible. It takes 30 minutes just to get home. 

After a month, your mother decides to go back to the countryside. The girl that you brought into the world, because this was what the Party wanted,  is four months old. You beg your mother to take the baby with you, because you can’t manage. You will go and visit her every weekend.

The Legacy of Decree 770

The Legacy of Decree 770

This script is not made up. It is the result of multiple testimonies, discussions that the reporters from the Decree Chronicles have had with doctors, nurses, midwives, social workers and mothers, women who have survived Decree 770 of 1966.

Any woman in Romania who wanted an abortion after the procedure was criminalized in 1966 can see herself in fragments of this script. Any woman who succeeded in having an abortion. Any woman who has given birth. Any woman who sent her baby to be cared for by the grandparents because she already had one (or more) at home and could no longer cope. Any woman that the communist system saw as nothing more than a child making-machine.

This was the social system that Decree 770 created and kept alive for 24 years.

The fall of communism and the switch to democracy did not bring the collapse of this abusive and dehumanizing system. Its effects are still present in hospitals today, in the social assistance system and in the way society perceives the idea of ​​motherhood.

The Decree Chronicles have set out to understand what Romania inherits from the traumatic social experience of Decree 770. The ban on on-demand abortions was repealed overnight in December 1989 with a simple scribble of the pen. But in all other ways, the country that contributed through its medical and social assistance systems to the implementation and enforcement of the draconian provisions of the Decree, continued to exist.

From a certain point of view, we are still dealing with its consequences.

The Post-1966 Rule: Don’t Get Pregnant

The Post-1966 Rule: Don’t Get Pregnant

For the citizens of communist Romania, Decree 770 of 1966 was the harsh reality at the beginning of their sexual life.

For many women in Romania, the post-Decree sexual era was marked by an obsessive concern: not to get pregnant. Sex education and contraceptives did not exist, and abortion was completely forbidden.

Doctor Bogdan Marinescu, who has been working at Giulești Maternity Hospital in Bucharest since the 1960s, remembers that he suggested more than once to communist authorities to allow access to contraception at least for women who had fulfilled their norm of four childbirths. This way, they could avoid having to suffer subsequent curettages. But the authorities didn’t accept this. Through such a refusal, the Ceausescu regime cemented the idea that, for women who had the right to abortion, this was the only method of contraception for them..

“[In the 1980s] The obsession of our youth was not to get pregnant. I think that was even more important than finishing college”

, remembers Ioana Luțescu, a gynaecologist in the private system, who has also worked at Constanța County Hospital.

The political and social context put women in a desperate situation that required desperate solutions. Illegal abortions were performed by medical staff in a few cases. A black market appeared in which even a metalworker could terminate pregnancies. The personal gains were huge, while the loss for society was incalculable.

A page from a communist-era newspaper (Flamura Prahovei, 1985) that tells the story of several illegal abortions. 

When medical staff performed abortions, their punishment was the harshest possible in order to send a message. Doctor Mircea Ungurean, who now works at Pantelimon Hospital in Bucharest, witnessed such an episode before 1989. He remembers the constant presence of the Securitate, Romania’s secret services. They came to check on the doctors. He spent six months out of his three years of internship in the Obstetrics and Gynaecology Department at Lugoj Municipal Hospital.

“I witnessed with horror I can’t forget to this day the public trial of a doctor who had performed abortions. The trial took place in the hospital, in the report room. The doctor was dressed in stripes, exactly like in The Most Beloved of the Earthlings [a popular Romanian novel], that was his costume. [It was a] Maoist type show-trial. The doctor didn’t say anything. It was just the prosecutor reading the charges.”

, remembers Ungurean.

Dr Bogdan Marinescu says he didn’t perform any abortions during communism. But he claims that he did teach the women how not to get pregnant if they didn’t want to. He practiced an early form of sex education.

“Every time I saw a young woman, I would tell her ‘I’d rather teach you how not to get pregnant than have you come to me for curettage’,” says Marinescu. “I would explain to them what the menothermal curve was, what the fertile periods were, what vaginal washing to do and so on.”

When abortion was liberalized after the Revolution in 1989, Romania found itself in the most unfortunate of situations. The Ceausescu decree was no more, but the country had no contraceptives, no sex education, and no health or social care system capable of managing unwanted pregnancies.

At the dawn of post-communist democracy, at Giulești Maternity Hospital, Marinescu recounts that there were 50 to 60 hospitalized women who wanted to terminate their pregnancies. Some of the women were seven months’ pregnant.

However, the liberalization of abortions did not mean that women stopped resorting to the black market.

After 1990, Mircea Ungurean was a general practitioner in the countryside: “What I noticed was shocking. Women distrusted the new reality. The underground [methods] were still used. [Due to these] I had cases of women who came with major complications.”

Ioana Luțescu saw the same phenomenon that Ungurean talks about at Constanța County Hospital. In the first years after the Revolution, she still encountered septic abortions. Experience showed her that, many years after the Revolution, contraception continued to be achieved through abortion. This post-communist phenomenon (in direct connection to the anti-abortion decree of 1966) can be seen in statistics.

Until 2003, the number of abortions exceeded the number of births in Romania. It was only in 2004 that the number of live births started exceeding the number of abortions. However, the reversal cannot be attributed to well-thought-out public policies, but to a natural balancing of the phenomenon. In the 15 years after the Revolution, the Romanian state did not know how to deal with the legacy of the demographic policies of communism.

It is true that the number of abortions in Romania is in decline today. But it is also true that we have many underage mothers, as well as on-demand abortions among minors. We do not have sex education in schools or sexual health services or family planning offices. More than 30 years after the liberalization of abortion, there are still women for whom abortion is a method of contraception.

Decree 770 has not had legal consequences for over three decades, but its effects can still be felt.

Pregnancy: A Mission of Honour

Pregnancy: A Mission of Honour

The Ceausescu era made pregnancy an obligation, and a woman’s duty to the regime and the country. The message was loud and clear in the party decisions:

‘The woman-mother fulfils a mission of honour, that of giving life, raising and educating children, the future builders of communism. The protection of the mother and the child is at the heart of our party’s and of our state’s concern.’ (Decision of the Plenary of the Central Committee of the Romanian Communist Party, 1973)

The duty stopped after the woman gave the country four or five children. Only after stepping over this numerical threshold was she allowed to have an abortion.

Propaganda page in one of the biggest newspapers (România Liberă, 1966) aggressively promoting maternity. 

In order to control the process, the regime set up compulsory gynaecological examinations in factories and institutions. Officially, they were for the prevention of cervical cancer, but the real goal was to find pregnant women and have the pregnancies recorded. It was no coincidence that these checks were made in large, enclosed spaces. They were also meant to send a message to women: if you are pregnant, you cannot hide it.

Today, Carmen Ungurean is a public health expert at the National Institute of Public Health who has lived through the era of the Decree. She believes that these types of checks perverted an important concept of public health. The mentality that developed is that screening is a check-up on pregnancy and not a screening for diseases such as cervical cancer. 

“At the time, screening meant ‘I looked at the cervix and it looked good’. There were no swabs or smear tests. Nothing. Occupational medicine clinics existed, and they could perform preventive control, but it’s important how you do the tests.”

, explaines Carmen Ungurean.

Romania does not currently have a screening program for the prevention of cervical cancer. According to data from the National Institute of Public Health from 2018, 7.5% of all new cases of cervical cancer diagnosed in Europe came from Romania – the incidence is more than three times higher than the EU average. 

According to communist law, from the moment the doctor registered the pregnancy, the woman was compelled to undergo regular medical examinations. The examinations were rudimentary, involving taking two blood samples for serological examination and monthly clinical examinations. Medical staff recorded the results in the register of pregnant women.

During the six months internship in the Obstetrics and Gynaecology Department, Dr Mircea Ungurean saw the conditions in which doctors performed these check-ups. Systemic scarcity was pervasive. Doctors were taking the used gloves, cut the fingers that were in good condition and for the next gynaecological examination they were using those fingers instead of a new glove.

Currently, pregnancy tracking is a much more complex process. But not all pregnant women benefit from it. Midwife Melania Tudose has been working in the medical system since 1983 and she has seen how pregnancy monitoring works. Pregnant women in the city go to the obstetrician. In rural areas, there are two categories of pregnant women. Those who go to the GP once, twice, or a maximum of three times during the pregnancy, and those who never get a check-up while pregnant. They give birth without any tests, checks or advice.

An effect of the 1966 decree is that pregnancy is approached from a strictly medical point of view, without any consideration for the natural and physiological implications. And overseeing the pregnancy is perceived exclusively as a doctor’s task. But the law states that midwives are responsible for overseeing the pregnancy and prescribing or recommending the necessary examinations in order to diagnose any risks as early as possible. The midwife does not remove the doctor from the equation. On the contrary, the midwife can make sure that a pregnant woman attends the ten recommended medical check-ups.

Irina Mateescu, midwife and consultant for WHO (World Health Organization), says that one in four women in Romania have fewer than three check-ups during their pregnancy. This situation leads to increased maternal mortality, and the statistics are unforgiving: in 2020, maternal mortality in Romania doubled compared to 2019.

The Doctors Were Not
Concerned with Malpractice

The Doctors Were Not Concerned with Malpractice

When midwife Adina Păun became pregnant, her mother congratulated her, then asked her one thing: not to give birth naturally.

As a midwife and breastfeeding consultant, Adina Păun has encountered many situations in which mothers who gave birth during communism beg their daughters not to go through labour because they will be treated like cows. The fear caused by traumatic birth and passed on from generation to generation is another legacy of the Decree era.

Adina Păun’s mother had one such birth at the end of the 1970s. She was in labour for 48 hours, and Adina, the five-kg child who was about to be born, was taken out with a forceps at the last moment. The doctors resuscitated the baby after a resident poked her with her finger and she reacted.

“Making it out of birth alive was no small feat. At that time, survival was much more important than “how I feel during birth”.

Adina Păun, midwife

“Medicine was practiced in a romantic manner, without protocols, defensively, letting the doctors manage with what they had. The system was not prepared in today’s sense. They could put four women on four tables in the same room. There was no legal or ethical constraint. They could adapt to any situation. They were practically forced to. The doctors were not concerned with malpractice”.

Carmen Ungurean, expert in public health

This kind of medical behaviour worked for decades after the Revolution.

For more than 20 years, important aspects such as caring for the mother, her needs and her mental condition, were absolutely secondary, if not completely non-existent, in relation to the imperatives of birth.

They continue to be secondary today, although the regime is no longer a communist one and no longer punishes medical staff for infant mortality.

Carmen Ungurean gave birth in the 1990s. The only moment she remembers is the elbow on her belly. She still remembers it because the pain was terrible. Ungurean attributes the brutality of gynaecologists to the patriarchal culture in which birth is a natural phenomenon, and this makes any care or attention to women to be considered a fad.

Overlapped with this patriarchal approach is the idea that childbirth is a woman’s duty. Both these attitudes led to the perpetuation of the idea that women don’t need any support from the medical sector during pregnancy, during birth or after birth.

We are dealing with a deficient birth system, is the conclusion of midwife Irina Mateescu. She has interacted with many women who complained about the way they were treated during birth. From her research, Mateescu noticed that there are hospitals in Romania that do not offer the option of epidural (anaesthetics) to women. Therefore, these hospitals deny pregnant women access to pain relief during labour.

The Child Does Not Belong to the Mother

The Child Does Not Belong to the Mother

After a traumatic birth, the woman faces another episode with a negative impact on both her and the new-born: the separation of the child from the mother.

Scene from a TV documentary made by the Romanian National Television about maternity in communist Romania. | Photo: TVR / Adevăruri despre trecut

Carmen Ungurean attributes this practice to the organizational culture inherited from communism, while Irina Mateescu believes this is due to medical staff’s  obsession with controlling the entire process of childbirth out of fear of facing consequences if something happened to the baby.

According to Decree 770, explains Ungurean, the hospital was a system of production. When you look at births in this way, you get a pragmatic approach towards the available resources. It was much easier to put all the children in one room than to leave them with their mothers. Such an arrangement helps make visits faster. Separation was a form of using space and staff efficiently, to the detriment of patientsaccording to Carmen Ungurean.

At the same time, the pronatalist policy of the Ceausescu era put all responsibility for infant deaths exclusively on medical staff. The effect of this phenomenon was the separation of mother and child immediately after birth. If the child was under a certain weight, it would stay in the hospital, especially when the doctor believed that there was a risk of something happening to the newborn at home. For any sign of illness, the child remained in the hospital. Separation from the mother became the way in which the medical staff protected themselves from situations where they could be accused or held accountable for negligence.

From the point of view of medical staff, any negative scenario had to be eliminated.

“They used to wipe mothers’ breasts with alcohol. They thought that was how you prevented and controlled infections, they thought they were doing it right. Plus, there was this obsession with everything being aseptic. They thought that this prevented infections and complications. But the infections came from the hospital. By taking the child from the mother, you expose it. If you leave the child with the mother, put it on her breast, you protect it even if there are infections in the hospital”

, says Mateescu.

Scene from a documentary about the “children of The Decree” [those born after Decree 770 was passed into law . | Photo: Decrețeii / Florin Iepan

Even after the fall of communism, the Romanian birth system did not end these practices. Midwife Mateescu recently conducted research that required her to do qualitative interviews and focus groups with doctors, neonatologists, heads of departments and nurses from several maternity hospitals. When she asked ‘who does the baby belong to?’, no one answered ‘to the mother’. They considered that the responsibility lies with the doctor, the neonatologist, the nurses, and/or the hospital. “They don’t mean harm,” believes Irina Mateescu, “it’s just the perpetuation of a mentality: the mother cannot do it, the mother does not know.”

After 1990, most hospitals continued to operate in the same old spaces and with the same resources. Few have made changes to allow the newborn to stay with the mother after birth. A study conducted in 2005 by the National Institute for Maternal and Child Health showed that most maternity/newborn wards were organized in a traditional system (without rooming-in), which encourages the separation of mother and child.

For example, at the Maternity Hospital in Buzau, the separation of mother and child continued for a long time after the fall of communism. Midwife Melania Tudose has been working at this hospital since 1986. At that time, there were wards with three or four crammed beds. Sometimes there were even two women in a bed. The children were kept in storage-like spaces, separated from their mothers.

“The space was too small, they used these storage spaces [to keep babies] because the wards were very crammed”

, says Tudose.

This arrangement remained in use until 2000, when the maternity ward managed to adapt the space and enable the child to stay with the mother. 

Since 2016, says Tudose, the town has had a new Maternity Hospital. Although the issue of space is gone, the baby is only brought and left with the mother two hours after birth. The magic hour of leaving the child with the mother immediately after birth is not put into practice.

In 2021, at Giulești Maternity Hospital, rooming-in is optional and restricted by lack of space. It is only available in three wards with four beds each.

The Protection of Mother and Child
is Central to the Party’s Programme

The Protection of Mother and Child
is Central to the Party’s Programme

During communism, the system’s care for mother and child immediately after birth manifested itself in rations of powdered milk and the construction of nurseries and kindergartens. After a maximum of three months, the woman who had given birth had to return to work. The state offered her the opportunity to breastfeed during her time at work. 

It was a concern manifested only on paper, thinks Carmen Ungurean, because it was impossible to leave work, take a bus while ready to breastfeed and then to return to work. In fact, the state discouraged breastfeeding.

“This affected the mother-child relationship. There was no time for the mother to develop a relationship with the child. She came home after eight hours of work to a crying child. Nobody taught her how to handle the situation”

, says Ungurean. 

The way the system was designed, Ungurean believes, did not allow for change after the Revolution. And this has blocked the evolution in childcare. The grandmothers kept coming to take care of the little ones, perpetuating childcare habits such as:

giving the child water and tea from the very first month

swaddling the baby so as not to have crooked legs\

taking the baby out of the water by the neck, to ensure a long neck

Page from a communist-era newspaper (Informația Bucureștiului, 1985) announcing financial support for women having several children. 

Any trace of care for the mother disappeared when the communist regime abolished the profession of the midwife, a few years after Decree 770 came into force. This was because midwives were singled out as those responsible for helping women have clandestine abortions. From the perspective of the regime, they endangered pronatalist politics. But they weren’t just performing abortions.

The midwife, says Adina Păun, was one of the three institutions of the village, along with the priest and the teacher. In the countryside, the midwife delivered the baby at home. In birthing homes, midwives attended the birth.

With the disappearance of midwives, birth came under the total control of the doctor.

The profession continued not to exist even after the fall of the communist regime. It was not until 2004 that midwives were again recognized and regulated.

There are 500 midwives in Romania today, says Irina Mateescu. Looking at the number of live births, they should be 12,000. When we look at the number of fertile women, they should be 20,000. In communism, midwives only had post-secondary education. Now they have university studies, even if only two faculties offer this specialization.

According to the Romanian legislation, the midwife has a series of responsibilities that involve not only assisting the birth, but also preparing future parents, overseeing the pregnancy, examining and caring for the newborn, caring for the mother, monitoring the mother’s progress in the postnatal period and providing all the useful tips on raising the newborn.

The existence of the midwife changes the system in two ways. Firstly, they humanize the process. A midwife also pays attention to the mother’s wellbeing. They provide support after birth. And they have the capacity to reduce maternal mortality, which is another area where Romania ranks in the top three in the European Union.

Although midwifery as a profession has been regulated since 2004, midwives cannot really do the job for which they have trained. As there is no mechanism for Romania’s  Public Health Insurance to cover the costs of their services, so the only option for midwives is to either open private practices or work with private hospitals in order to maintain their autonomy. The alternative is to be nurses following instructions, just like in communism.

There are exceptions, but they are to do with the hospital or the doctor. At Buzău Maternity Hospital, until two years ago, when the doctor changed, the midwives were allowed to do their job, at least during birth. They oversaw the stages of labour and birth. The doctor only intervened when necessary. However, the midwives did not have any pre-birth contact with the pregnant mother, which is customary in their profession.

In 1969 Romanian number 20 million was born. A state celebration was held. This is dictator Nicolae Ceaușescu holding the child. | Photo:  TVR / Adevăruri despre trecut

The communist regime considered that a woman had done her duty only after four or five children. Until that moment came, the woman went through the same thing over and over again: sex, pregnancy, birth, another birth. The cycle resumed in the same conditions. 

The women went through the same purgatory: the concern not to get pregnant, the attempts to have an abortion, superficially overseen pregnancies, zero preparation for what was to come. Then a traumatic birth, separation from the newborn and discharge without knowing what to do next. That lasted until the state finally allowed you to have an abortion, because there was no other method of contraception.

Women Didn’t Stand A Chance

Women Didn’t Stand A Chance

“It was a shock what I experienced in gynaecology hospitals,” says Doctor Gheorghe Peltecu, former Director of the Filantropia Maternity Hospital in Bucharest. In the 1980s, as a resident doctor at this hospital, he saw the tragedy experienced by women who became pregnant without wanting. They did not have any contraception.

Women resorted to illegal abortions. This despair, continues Peltecu, also left a mark on the medical world. There were also female doctors who got abortions, and some of them paid with their lives.

Not infrequently, the police officers assigned to hospitals would come incognito and interrogate the women who had undergone curettage procedures. The questions concerned those who had performed their abortions, but also whether they had “support” from medical staff in the hospital.

The curettage kits were kept in a metal locker with two padlocks. The Head Doctor held one key and the Head Nurse the other one. Everything was written down, including the time the cabinet was opened, and the time the kit was sterilized and put back.

Women who had attempted abortions delayed coming to the hospital. They knew that if they came too early, they wouldn’t get the curettage, explains the doctor. They thought that if they came later, the abortion would have to be finalised by the doctor. But they arrived with sepsis or kidney failure, and some of them died.

In terms of effects, Dr Peltecu says that Decree 770 brought about a pathology that wasn’t common before, which was infertility. The curettage compromised, in those who survived, the fallopian tubes, if not more of the system. Post-abortion infertility was another drama that had no solution in Romania. And the solution still didn’t exist immediately after 1990. Women have developed chronic pathologies related to post-abortion infections that led to other surgeries or chronic suffering.

Another consequence of the Decree that Peltecu still sees today is political interference. Political interference is the biggest risk to the medical system, believes the doctor.

He was convinced then and he is still convinced that it’s the women who should decide about their own body. Nobody else.

A propaganda article in a women’s magazine (Revista Femeia, 1986)

The Past Is Still Present

The Past Is Still Present

We are again in 1980. You are 25 years old, you live in a provincial town in a two-room apartment with your husband and two-year-old child. You are pregnant and abortion on demand is forbidden in Romania, and pregnancy is a duty to the regime.

But you don’t want to keep the baby. So you try to perform  an abortion by yourself. You try once, twice, three times. You fail. You end up keeping the pregnancy and fear that you may give birth to a defective baby because of all the failed attempts. 

Months later you give birth to a child with disabilities. One that the Romanian state labels as deficient and irrecuperable and places it in the public protection system. Birth statistics do not suffer: the child was born. Its survival is a whole other matter.

The legacy of Decree 770 of 1966 is the memory of all the women who fell victim to it. But it is also the memory of all those labeled as irrecuperable at birth. This phenomenon was first ignored and then forgotten in Romania after the Revolution, even if its consequences are still felt in the child protection system today.

In the next episode of the Decree Chronicles, we will try to face this historical trauma.

We don’t even need to get in a time machine.

The past is still present.

About the authors