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The remarkable story of Romanian women's struggle to manage their fertility
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  1. Mihai Horga1,
  2. Caitlin Gerdts2,
  3. Malcolm Potts3
  1. 1Senior Advisor, East European Institute for Reproductive Health, Tirgu-Mures, Romania
  2. 2Epidemiologist, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA
  3. 3Bixby Professor, Bixby Center for Population, Health and Sustainability, University of California, Berkeley, CA, USA
  1. Correspondence to Dr Mihai Horga, East European Institute for Reproductive Health, 1 Moldovei Street, Tirgu-Mures 540493, Romania; mhorga{at}eeirh.org

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Background

In 1957, along with many countries in Eastern Europe, Romania liberalised its abortion law. The Soviet model of birth control made surgical abortion easily available, but put restrictions on access to modern contraceptives, leading to an exceptionally high abortion rate. By the mid-1960s there were 1 100 000 abortions performed each year in Romania, a lifetime average of 3.9 per woman, the highest number ever recorded.1 In October 1966, 1 year after coming to power, in an attempt to boost fertility, Romania's communist leader Nicolae Ceausescu made abortion broadly illegal, permitting the procedure legally only under a narrow range of circumstances: for women with four or more children, over the age of 45 years, in circumstances where the pregnancy was the result of rape or incest or threatened the life of the women, or in the case of congenital defect.1

Just months after abortion was restricted, the number of safe, registered abortions had fallen 20-fold, and 1 year after the law took effect, the total fertility rate (TFR) nearly doubled (from 1.9 just before the restrictive law to 3.6 in 1967–1968). As women gradually …

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