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Introduction: General Data The social and political changes in Romania after 1989 created new concepts about the female, the family, pregnancy, solitary mothers and abortion: Abortion is purposeful termination of pregnancy with intentions to not produce a live born infant or to remove a dead fetus; or the purpose of the abortion is to avoid becoming a parent. Romania has the highest rate of mortality after abortion, five times higher than the median rate from European states. In the last years the rate of abortion has decreased, but on the international scale, Romania continues to be in the top of the list of the number of abortions, recording a rate of 3 abortions for every birth. (Of 1 million of pregnancies per year, more then 2/3 are ended with an abortion.) This happens because the older women didn’t accept the idea of contraception; which was illegal before 1989 (BMJ). In that period many women died because of illegal abortion. They suffered infections, septicemia, hemorrhages, embolism, sterilizations, and coma. A study of Romanian Population Services shows that 97% of the Romanians heard about a contraceptive method. However, for every 1,000 new born children with approximation there are 1,200 abortions. This data is only that which is centralized in state clinics and hospitals. A good part of women preferred to do the abortion in non-reporting clinics. In 1990 Romania had 1 million abortions. Romanian Population Services confirmed that there were 11 million abortions between 1989 and 2000, but the number does not include the abortions from the non-reporting clinics. From 1992, the government started sexual education in schools and familial planning units. The number of abortions decreased from 980,000 in 1990 to 254,855 in 2001, and the maternal mortality caused by abortion has decreased from 280 in 1989 at 35 in 2001. The population of Romania decreased by 1,400,000 from 1990 since 2002. There are recorded about 22 deaths caused by abortion per 100,000 births. Alarming is the fact that 20,000 girls aged 15 years old had an abortion in 2002. In 2003 the statistics recorded 224,807 abortions and in 2004 their number was 200,000. About 20% of women become infertile after an abortion. The mortality caused by abortion represents more than 50% of total maternal deaths. Romanian females have on average 3-4 abortions, versus Occidental European women who have less than one abortion in a woman’s lifetime. The number of the women who have had sexual contact before marriage has risen from 77% in 1999 to 90% in 2004. More than 50% persons who are sexually active and can have children didn’t want to become parents (2004). The total fertility rate remains at 1.3 births per woman. The specific rate of fertility has increased by almost 80% for those aged 30-34 years, remained stable for the 25-29 age bracket, and decreased for the 20-24 age bracket. The prevalence rate of contraception methods has tripled for women of about 15-44 years old. The most used method is the contraceptive pill which is used by 16% of women. Thirty six percent are still using the traditional methods like coitus interrupts, and 34% are not using any contraceptive methods. In Timis County the rate of abortion is high compared to other counties. In 1991 there were 27,066 abortions and they are decreasing over the years with 6,886 in 1998. There exist new opportunities, but all are they favorable for a healthy society?
We conducted a study to evaluate the actual opinion and attitude about abortion of young persons, students, and residents in medicine in Timisoara city. Because physical and social aspects differ between sexes, we tried to analyze data in accord with these parameters. Our research is a part of a larger ongoing study. We developed a questionnaire about abortion. We distributed the questionnaire to 400 people between the ages of 19 and 28 with higher education. They were medical students (312 persons) and residents in medicine (88 persons). We want to analyze aspects about abortion just for young persons who were children in 1989, without past influences, and who have sexual life developing in a “normal” society. The group had 320 (80%) women and 80 (20%) men. The mean age was 23.3 years (SD=3.7 years). The data were collected by anonymous questionnaires with the acceptance of collaboration. Incomplete answers were excluded. The initial number of participants was 423. We do not have data on: how many of them had been sexually active, or currently were sexually active, what contraceptive methods were used, and what their social status was. For these questions we did not obtain pertinent data or they refused to answer. The analysis of the results was performed in EPI 6 Info Program of the World Health Organization (frequencies, Odds Ratio, Relative Risk, Chi-squares, p-values). It was used with a 95% confidence interval.
All of the participants, know what abortion is. Most of the questioned persons consider that it is important to keep the pregnancy (258). Just 92 females agree with the idea of abortion, but the number of males was 50. More than 35% of all questioned persons accept it, understanding that it can be a necessity. 280 (70%) would regret it if they were personally implicated in the decision of making an abortion.
Abortion is considered a solution in some cases like fetal malformation (with no significance between sexes) and pregnancy resulting from rape or incest, by 380 (95%) persons. Females believe that abortion is rightly motivated in the second situation. Abortion is seen to be a necessity by 356 of the respondents in the case of parents’ exposure to mutagen agents, without differences between sexes. If the parents were exposed to mutagen agents the child can be born with malformations or different incurable diseases. In many cases the parents choose to do an abortion. They do not accept the risk of a malformed child. Pregnancy after rape or incest is considered a necessity (309 female versus 71 male). In this situation many women have an abortion because of a psychiatric cause: they see in the new born child the person that abused on them. Respondents feel that if the woman keeps the baby, it is very difficult to get attached to him, and the child will grow in an incomplete family. The men seem to be more attentive if the woman’s health is in danger if the pregnancy continues. Seventy two of them voted for abortion in this situation. And they are not prepared to be a “father” at a young age (42 persons, more than half of them), in a non-legitimate relationship (45% man versus 23.75% women). Men are not dreaming of a big family with many children. Thirty three of them prefer abortion in this case.
The reason respondents don’t agree with the abortion is especially their conscience 280 (70%) persons. To be afraid of the future 310 (77.5%), education 280 (70%) and religion 220 (55%) are not strong enough motives to avoid the abortion.
At the question “Imagine that you have done an abortion, would you repeat it?” 303 (75,75%) persons answered that they wouldn’t do it again, and 97 (24,25%) would repeat it if it is necessary. Two of them were afraid to repeat it because of the possible complications. 292 (73%) believe that they won’t need an abortion because they are sure that contraception is a sure method. The rest of them 108 (27%) would do it if the mother is in danger or if there are some fetal malformations.
Female are more likely to refuse abortion than males, in the face of unplanned pregnancy in a non-legitimate relation. More of them are also willing to accept the child if they are too young, if the baby is too early, or if their parents oppose keeping the child. When the female’s parents do not agree with the pregnancy it is very difficult for her to avoid an abortion, especially when she depends on them and lives with them. Some parents understand their daughter and they try to help and support her decisions. It is better for a child to grow in a complete family. The mother needs the support of her partner because it is difficult to raise a child all by herself. Taking care of a baby implies love, time, affection, financial support and the most importantly, to be prepared to be a parent. The young age of parents is not an impediment for having a baby if they know what to expect. If they are prepared physically and mentally, they can raise a child. Sometimes the woman’s health is in danger if the pregnancy continues, and in these situations it is rational to avoid the loss of the mother and to perform an abortion. The birth of a child is a moment of joy and happiness, but sometimes when the baby is malformed, or he has birth defects or severe medical problems, the sadness is bigger than the joy. The malformations make a harder life for the child and for his parents. The child feels that something is not right with him; he can’t do things like other children his age, others laugh and look strangely at him. He needs a lot of attention, special care and medicine. It is very difficult to see your child in this situation, to know that all you can do is not enough, to bring him to normalcy. You can’t know what is going to happen to him. The family is forced to take the hard decision to make the abortion if the child to be born has this kind of problems. According to medical ethics, a doctor can refuse to interfere in the process of reproduction, pregnancy interruption and abortion if this is his opinion; suggesting the patient ask for advice of other doctors (The International Conference of Orders and Organisms with similar attributions Paris, January 1987 art.18). Our conclusion is that young medical students and residents are not well prepared to face an unplanned pregnancy. They do not have the theoretical knowledge, they were not interested in discussing the topic of abortion, and in general they think that this is not their problem. Some of them consider abortion like “the last way” to follow, in some specific cases, motivated by subjective reasons. We have no answers for such a complex problem. But we know that the new generation in Romania have the right to choose for themselves and in general they fight for life.
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