Radio România Internațional

Tag: contraception

  • Access to contraceptive methods in post-communist Romania: 35 years on

    Access to contraceptive methods in post-communist Romania: 35 years on

    Romanian society has a troublesome past regarding reproductive health. The country’s troubled past began in 1966. We recall that back then a decree was issued, targeting the Romanian population’s accelerated increase. For the previous generations of the communist regime, access to contraceptive methods was on the brink of illegality, while pregnancy termination was described as a crime.

    But what is Romanians’ relationship with the contraceptive methods, today?

    Andrada Cilibiu is a feminist activist for the FILIA Centre and an expert in sexual and reproductive rights. Here she is, with details on that.

    ” Given there is no free-of-charge contraceptive method especially for the most vulnerable of us women, there is no info or comprehensive sexual education in schools, therefore, it is all clear the use of contraceptive methods use is bound to be low. Which is worrying, considering two aspects: 1) an increasingly growing rate of sexually transmitted infections about which we do not speak that much as, unfortunately, in Romania, this topic related to reproductive health and sexual rights still is a taboo topic, while another aspect is related to teenage pregnancy, to the unwanted pregnancies and to a society that, unfortunately, describes contraception as being similar to abortion, and that is something we do not want.

    We want all women to have access, first of all, to contraception, to information, to sexual education and to safe pregnancy termination procedures. Yet we noticed that in the last 10 years, unfortunately, we have seen a throwback as compared to how Romanian society looked like a decade ago. “

    Andrada Cilibiu has told us how, in the years 2000, in Romania, a family planning network was established, offering access to individual discussions, with specialised physicians, about contraceptive methods, about fears and emotional deadlocks on sexual relations, pregnancy or other aspects of reproductive health.

    Furthermore, expert Andrada Cilibiu added, the network offered free contraceptive methods, while the discussion on sexual education was carried in rather more positive terms. According to the expert, what happened was that those medical doctors retired without training other specialists and without the network receiving other resources.

    Moreover, the years 2000 were marked by massive progress made in the preparation for gaining accession into the EU, which called for complying with certain standards. In another move, Republic of Moldova is mentioned as a positive example, with specialized clinics for youngsters aged between 10 and 24 who benefit from free-of-charge reproductive health services. When asked where we can borrow the good practices from, Andrada Cilibiu answered:

    “By all means from the comprehensive sexual education models we find in the Northern countries or in the United Kingdom or in the Netherlands where sexual education is made, in some of the countries, from the very early years, with info which is accessible to children, mainly laying emphasis on consent and on bodily autonomy, and then, taking one step after the next, as children grow, coming up with other pieces of info on healthy emotional and sexual relationships.

    We have examples of good practice regarding pregnancy termination also provided by the Netherlands, by France, a country which has fairly recently introduced, in its Constitution, the access to abortion rights. We also have Spain, for instance, with a very good programme of contraceptives distribution. But, in fact, most of EU member states have national contraception plans and offer free-of-charge contraception, especially among adolescents and young people, mostly, but also among vulnerable groups. Romania, in fact, is in this minority cluster of countries that do not have, do not offer free contraception at all.”

    In the spring of this year, the Filia Center launched the study “Care for democracy. The political interests of women in 2024”, with a chapter dedicated to the use of contraception by women in Romania today. According to it, 37% of respondents reported using contraceptive methods in the past 10 years, 62% said they had not, and 1% refused to answer. Of the group of women participating in the study who used a method of contraception, 63% used the condom, 55% the contraceptive pill, 42% the withdrawal method, 38% the calendar method, 24% the morning-after pill (considered more of an emergency measure) and in much smaller percentages more invasive methods, such as the IUD, tubal ligation, or contraceptive implants.

    At the European level, the World Health Organization is sounding the alarm regarding the worrying decrease in condom use by teenagers. The WHO study was conducted between 2014 and 2022, included more than 240 thousand adolescents from 42 European countries, and showed that condom use by 15-year-old boys decreased by 9% between 2014 and 2022 (from 70% to 61).

    For girls, the percentage dropped from 63% to 57% over the same time frame. The same study showed that 30% of girls and 22% of sexually active boys in Romania did not use a condom or any other form of contraception during their last sexual intercourse. Andrada Cilibiu says:

    “Unfortunately, I see many young people rather using pornography as a frame of reference on how to have safe sex. There’s a lot of confusion among them, and they end up believing a lot of myths and stereotypes and having a lot of anxieties about their body image, about the romantic or emotional relationships they get into, about sexual relationships, and so on.

    Having neither in the family nor, more importantly, at school, an authority figure to give them information validated by science, and that enters this area of comprehensive information about sex education, unfortunately we leave our young people to their own devices. As a result, they end up having sexual relationships, or enter into relationships where they do not recognize the violence, they do not recognize that what is happening to them is not ok. In this regard, we especially need compulsory and comprehensive sex education for everyone, without parental consent, youth-friendly sexual health services.”

    At the regional level, another study published in 2022 by the British medical journal The Lancet showed that, while the average choice of a condom as a contraceptive method in Eastern Europe (by those who choose to use one) is 37 .8%, in Romania, the percentage does not reach 31%. The calendar method, on the other hand, is used by 19.9% of Romanians who choose a contraceptive method, compared to 5.9% in Eastern Europe. The withdrawal method is preferred by 12.8% of Romanians, and by 10% of respondents from the region.

  • Mother-child or child mother?

    Mother-child or child mother?


    Dire poverty, lack of education, lack of interest,
    nobody to explain them how their own body works. These are the dismal
    ingredients of a failed life experience. Today we focus on very young
    pregnancies, reported for girls younger than 15, we’re speaking about systemic
    flaws and about what can be done to mitigate such a scourge. Romania is at the
    top of a European Union chart focusing on teenage mothers. Gabriela Alexandrescu is the Executive President of Save
    the Children.


    Gabriela Alexandrescu:

    I
    won’t be mincing my words and I shall tell you that a quarter of the European
    Union’s teenage mothers are from Romania. We all know that 23% of those young mothers who have not yet turned 19 are reported for our country. We are at
    the top of the table across the European Union regarding the number of mothers
    under 15 and 2nd-placed, after Bulgaria, according to the number of mothers
    under 19. In Romania, nearly 10% of
    the births are reported for teenage mothers. Quite a few of them come from
    localities with no family doctor for the community whatsoever, or where family
    doctors are in short supply. These girls resort to self-medication during pregnancy,
    they don’t see a medical doctor to get their name registered and their
    pregnancy monitored and just wait until things are rushing forward or their
    condition gets worse. Save the Children has been actively involved in the field
    of children healthcare from across Romania, we contribute to the provision of
    the right to live taking action along five directions. One has to do with
    supplying maternities, the paediatric and the new-born sections with state-of-the-art
    medical equipment, the second pertains to developing the specialised support
    networks for mothers and children in the rural communities, the third such
    intervention direction is the one by means of which we stage specialised
    courses of the teams of professionals (medical teams, mainly), through the
    fourth intervention direction we develop education-for-healthcare programs and
    research programs, debates with the authorities and specialists for the change
    of social policies and the laws, when needed. So far, we have worked with more
    than 56,000 pregnant females (children under 15) and we saw the change. Each
    year we work in 46 communities with mixed teams of specialists, with trained
    nurses, social assistants, psychologists who are familiar with the realities of
    those areas and address the specific reality of the young mothers and the
    children.


    Oana Motea is a UNICEF Health Specialist. She has
    drawn attention to the fact that the scourge of being pregnant when very young
    is transmitted from one generation to the next, within the family.


    Oana Motea:

    The conclusions of the Unicef – Samas report, launched earlier this year, has
    revealed that pregnancies of mothers older than 15 could be prevented through
    education and family education programs tailored according to the
    socio-cultural milieu those adolescents and the fathers-to-be live in. The
    phenomenon is cyclical, it tends to repeat itself in the same family, from one
    generation to the next and goes with the poor economic, social and healthcare
    condition. There is no clear-cut identification of the role the authorities
    play, and of their corroborated responsibilities, as regards reproduction in
    the case of the younger generations and the prevention of pregnancies in the
    case of underage mothers. There is a need for integrated public policies
    capable of targeting education for healthcare, awareness-raising efforts at
    community level and tailoring the adaptation of the interventions to suit the
    teenagers’ psychology and emotions.


    Mother-child or child-mother? It’s hard to tell.
    UNICEF’s data on Romania are quite baffling, at that.

    Oana Motea:


    In 2019, more than 16,000 pregnancies were reported
    among teenagers, down by 9% as against
    2018. Notwithstanding, with
    the adolescents who are younger than 15, we noticed an 11% increase in the north-western
    and north-eastern regions. These percentages reveal how serious the problem is,
    at once calling for educational action to be taken, capable of targeting all
    groups of teenagers, using specific communication channels, with different
    message presentation forms, tailored to suit their needs.


    A solution to mitigate the phenomenon, which tends to
    become a scourge? Doctors’ offices in the rural areas, targeted programs. There
    is no other way.

    Save the Children’s Gabriela Alexandrescu:


    As of late
    we have even launched a survey among adolescent girls in vulnerable
    communities, in partnership with the authorities in line, with the Romanian
    Senate, it was a survey targeting teenage mothers in rural and underprivileged areas.
    We did carry the survey over July-August 2021, in 46 communities across
    Romania and unfortunately, our survey has pointed to a worrying, chronic
    deficiency of the healthcare services for the teenage mother, also pointing to
    detrimental social aspects, relevant to that effect. We can say 16 years and
    three months is the average age when the first child is born, among teenage
    girls in the underprivileged rural areas. Those with more than one child are 18 and one month
    old when the second child is born, on average, and are 19 years and five months
    old when their third child is born. 40% of the mothers and the pregnant
    teenagers in the rural areas have stated they have never taken the medical
    tests recommended during pregnancy because they had no access to medical
    services or no financial resources to do that. 87% of them have never used and
    do not know any contraceptive method. 72% of the young women and girls have
    responded they lived in very modest conditions, in one, maybe two rooms,
    sharing the premises with people from other families. 55% of them have stated the
    money they got was not enough for the bare necessities, quite a few of them
    relied on their children’s allowance, while a great number of them responded
    the pandemic has negatively affected the adult’s chances to work for their
    families. There are mothers, who, not having turned 25 yet, have given birth to
    their fifth child already. And here we have a problem, a worrying situation.
    That is why we, those with Save the Children, need to get actively involved to
    alleviate the scourge in the underprivileged rural communities, deprived of
    material resources and information means. And we need to carry on with those
    information, specific intervention programs, aimed at facilitating access to
    socio-medical services.


    The good news is that the Save the Children
    Organisation has also expanded to Republic of Moldova. The successful programs
    Save the Children implemented there proved reliable.

    Gabriela Alexandrescu:




    The
    successful example we had in Romania, we’re also taking it to the Republic of
    Moldova, as there, we work with the Healthcare for Children Association and
    Children’s Rights Information and Documentation Centre in Chisinau. So as of
    this year, we have that integrated, community program covering 16 counties in
    Romania and 16 districts in Republic of Moldova. Our effort is essential, given
    that we’re all too familiar with the fact that teenage pregnancy is associated
    with higher pregnancy risks. High blood pressure, anaemia, premature birth,
    underweight new-borns, postpartum depression and suchlike, while on the other
    hand, premature maternity exposes the young mothers to the risk of school
    dropout, to the grim prospects of being engulfed by the vicious circle of
    poverty, with a transgenerational aftermath. As part of the integrated
    interventions we had in the underprivileged rural areas, advised by the local
    specialists are the teenage girls, but also their families. It is important
    that we have an unmediated communication with the girls.

    (Translation by Eugen Nasta)