Paper Presented at the EURESCO Conference
“Second Demographic Transition in Europe”
19-24 June 2003, Spa, Belgium

Some aspects of the demographic policy 
in post-communist Romania.
Jumping from the frying pan into the fire.

by Camelia Manuela Lataianu
Bureau for Social Research Bucharest, Romania

Statistical data provided by the National Institute of Statistics estimated the population of Romania at 21,6 million inhabitants in the year 2002. It means a decrease of population with 1,6 million in comparison with the year 1990, when Romania had 23,2 million inhabitants. The fact that the growth rate of Romania’s population has been negative over the entire post-communist period can be explained not only by the increase of death rate or emigration rate, but especially by the accentuated decline of birth rate. In keeping with the same statistics data, it is for the first time since the beginning of the XX-th century that a natural decline of population has been registered in times of peace. 
Could the birth rate decline be considered the result of typical behavioural changes associated with the “second demographic transition”? That is the question to which this short paper will try to find a possible answer. Therefore, it is necessary to make a short trip back in time.
It is well known everywhere in the world the draconian pro-natalist policy imposed by Ceausescu’s regime with the Decree no. 770 from 1966. Then the abortion and the modern contraceptive use were strictly prohibited. Accordingly, every woman under 45 years old had the patriotic duty to give to the homeland at least 5 children [Trebici 1991: 44]. In order to fulfil this objective the political power created a specialised service for controlling the activity of gynaecologists and nurses in maternity-hospitals.
All women were forced to go for gynaecological control every month, this monthly health control representing the requirement for receiving medical care [Johnson Alice K. et al. 1993: 492]. The detected pregnancies were monitored until term, annihilating in this way almost all the possibilities to provoke an empirical abortion. The law was extremely severe, numerous gynaecologists as well as women who resorted to this method paying with years of prison their trial to avoid it. 
At the same time, the law punished the sale of modern contraceptive means which, as a result, disappeared from the specialised shops. All persons over 25 years of age who were not having children (excepting those with valid medical infertility problems) were punished for celibate, paying 30 per cent tax on income. [Johnson Alice K. et al. 1993: 492]
There were only a few situations when the abortion could be realised in legal conditions: if the pregnancy put the mother’s life in danger, if a chronicle disease of mother could endanger the child health, or if the pregnancy resulted from rape. Specialised commissions, composed of gynaecologists assisted by a public prosecutor and a Secret Political Policy officer, were charged to approve the abortion [Trebici 1991: 44].
At least during the first years after implementation of this law, it proved to be extremely efficient. (see the Chart no.1) 

Ch.1: Total fertility rate (births per woman) 
In the next year, immediately after coming in force of this law, the number of babies born was almost double (being 93 per cent more than in the previous year). The cohorts 1967 and 1968 are the largest in the Romanian history and the children born during this period were informally called “ceausei” (Ceausescu’s babies). [Trebici 1991: 44]
But along the time people got used to and adapted to the restrictive settlements imposed by law, looking for new contraceptive methods and therefore, the birth rate started again to decline more and more during the 1970s and 1980’s.
However, the harshness and the brutal way of applying this law have had negative consequences on long term for Romania, their effects being visible even nowadays, after more than 35 years. Some specialists consider that the methods used by Ceausescu’s pro-natalist policy were those specific for animal breeding. [Trebici 1991: 44]
Firstly, the rate of maternal mortality – and especially that of maternal mortality caused by induced abortion – reached the highest position in Europe, being more than 10 times higher than in any other country of Europe (see the Chart no. 2). 

Ch. 2: Maternal mortality rate

(per hundred thousand live births)

Source: UNICEF; Innocenti Research Centre from Florence Italy – Social Monitor 2002. Social Trends in Transition. HIV/AIDS and Young People. Quality of Learning in Schools. – the Monee Project CEE/CIS/Baltics 2002

In this sense, Vladimir Trebici shows also that only between 1982 and 1988 (years for which there are available statistical data) 3360 women died, leaving 6880 orphans children; it means an average of two children per every demised mother. In numerous cases these orphan children remained in residential care till they reached 18 years of age.
Another consequence of this law was a high increase of the infant mortality rate. 340000 children out of 10 millions born between 1967–1989 died before reaching the age of 1 year. Demographers estimate that 20 per cent of children born in this period were under-weight or with congenital malformations, this fact affecting negatively the biological quality of population. [Trebici 1991: 44]
Not less important it was the appearance of a great number of unwelcome children. Liberalisation of sexual life, associated with the lack of sexual education and contraceptives, led to the increase of birth rate, especially among families with a lower standard of life and education. As a result, a generation of unwelcome children emerged. Some of them, born in unclear and unstable familial conditions, were abandoned from the beginning in maternity hospitals, or later, in hospitals for disable children. This can be one explanation for the large number of children in social care institutions from Romania.
Therefore, one of the first reparatory measures adopted by the new political power in the first days of the Romanian Revolution from 1989, was to abolish this law, that generated so deep humiliations for numerous generations of women, replacing it with another one that has made the abortion available on request before 12 weeks of pregnancy.
Unfortunately, as many other measures adopted during the post-communist period, this new law has had rather a populist character, being taken under the pressure of population, without consulting the specialists in demography and without thinking to the short and long term consequences of applying it.
That is why, by the new law Romania jumped from the frying pan into the fire. If the previous law led to the highest birth rate in the Romanian history, but also to the highest maternal and infant mortality rates, the new one has had as a consequence the highest abortion rate not only in Romania, but also in the whole Europe. As it can be noticed from the Chart no. 3, in 1990, immediately after coming in force of the new law, the abortion rate increased in a dramatic way, being registered more than 3 abortions for every live birth. 

Ch. 3: ABORTION RATE (abortions per hundred live births)

Source: UNICEF; Innocenti Research Centre from Florence Italy – Social Monitor 2002. Social Trends in Transition. HIV/AIDS and Young People. Quality of Learning in Schools. – the Monee Project CEE/CIS/Baltics 2002.

According with the Reproductive Health Survey realised in 1993 by the Institute for Mother and Child Care, 60 per cent of abortions were repeated abortions: 20 per cent were second abortion, 21 per cent were preceded by another three and 13 per cent, by four or more abortions. The same study shows that “67 per cent of abortion were performed for limiting or spacing childbearing, while 20 per cent for economic or social reasons (such as low income, crowding, fear of losing their job)”. [Reproductive Health Survey Romania 1993: 54]  It also worth mentioning that only 34 per cent of interviewed women had planed their last pregnancy while the rest of two thirds had considered unwanted or mistimed (wanted at a later time) their last pregnancy. 
As a consequence of this spectacular increase in abortion rate, the birth rate has drop out significantly after the replacement level.  (see Charts no. 4 and no. 5).

Ch. 4: CRUDE BIRTH RATE / CRUDE DEATH RATE IN ROMANIA
Source: UNICEF; Innocenti Research Centre from Florence Italy – Social Monitor 2002. Social Trends in Transition. HIV/AIDS and Young People. Quality of Learning in Schools. – the Monee Project CEE/CIS/Baltics 2002
Ch. 5: Total pregnancy rate, inDuced abortion rates

and fertility rates 1988-1992 (event/woman)
 
Source: Institute for Mother and Child Care – Reproductive Health Survey. Romania 1993.

But could this dramatic drop out of the birth rate be explained only as results of liberalisation of abortion?
The Second Demographic Transition theory claims that the decrease in birth rate is a normal trend everywhere in Europe, even in the most developed countries. It is true, but in my opinion this phenomenon in Romania is generated by different factors than in the developed European countries. We have the same effect as in the rest of European countries, only the causes are different. So, I will make further an attempt in explaining some of the causes that led to the highest decline of Romania’s population in times of peace since the beginning of the XX-th century. 
The transition to the market economy has generated new social and economic phenomena that have had a negative impact on the living standard of population. Emerging of unemployment (unknown before 1989) has conducted to a substantially reduction of the population’s incomes, putting in economic difficulty especially the families with children. 
Inflation and introduction of the free market have also contributed to deterioration of the population’s incomes, the real wage in 1997 representing a little bit more than half of its value in 1989. (see the Chart no.6) 

Ch. 6: Annual Inflation Rate and

 Annual Index of Real Wage (1989=100)

Sources: 1: for the annual inflation rate: Academia Romana – Raportul National al Dezvoltarii Umane – Romania 1998 – Editura Expert, Bucuresti, p.94
2: for the annual index of real wage: Central and Eastern Europe in Transition. Public Policy and Social Conditions. Children at Risk in Central and Eastern Europe: Perils and Promises. Economies in Transition Studies. Regional Monitoring Report no.4, Arti Grafiche TICCI, Siena, Italy, 1997, pg. 140.

The poverty has been accentuated not only as a result of increasing the unemployment or of diminishing the real income, but also as a consequence of augmenting the relative price of food. While the majority of countries from Eastern and Central Europe has managed to maintain the food price at the same value from 1989 or even to reduce it (the most spectacular is the Poland’s case that managed to reduce it with almost 25 per cent in 1995), Romania has registered an increase of it with more than 15 per cent in the same period. (see the Charts no. 7 and no.8)
Ch. 7: Relative Price of Food and

Non–Alcoholic Beverages (1989=100)

Ch. 8: Food Share 

(% of Consumption Expenditure Spent on Food)
Source: UNICEF; International Child Development Centre.  Central and Eastern Europe in Transition; Public Policy and Social Conditions (1997) – Children at Risk in Central and Eastern Europe: Perils and Promises – Economies in Transition Studies. Regional Monitoring Report; no.4, Florence, Italy
Insecurity of job and income has determined the young people to postpone the marriage. The crude marriage rate (marriages per 1000 mid-year population) has decreased from 7.7 to 6.1 between 1989 and 2000, while the average age at the first marriage has increased in the same period for men (from 25.3 to 26.9), as well as for women (from 22.1 to 23.6). [UNICEF2002: 108]
On the other hand, the dramatic fall down of birth rate and the huge abortion rate registered after 1989 could be also explained by the child cost, which has augmented significantly during the transition. During communism the State was granting subsidies for encouraging the family with children, such as:
•	Child allowance (representing 10 per cent of the average salary at the level of years 1980s; it was increasing with the child’s rank). 
•	Allowance that mothers were receiving at the birth of every child.
•	Allowance for the whole life granted to the mothers with three or more children.
•	Basic free education.
•	Subsidies for crèches and kindergartens. 
•	Free health services.
•	Priority for the families with children to obtain apartments from the State’s property. etc. [Lataianu 2001: 21]
But the scarcity of budgetary resources and the accelerated rhythm of inflation have affected negatively these types of subsidies, some of them being completely eliminated (as, for example, the allowance for mothers with three or more children).
It is true that, immediately after 1989, the maternity leave for caring the child was extended to 1 year, representing 65 per cent of the mother’s salary. Later, in 1997 it was prolonged to 2 years and its value augmented at 85 per cent of the mother salary. Anyway, the unemployment perspective determines numerous women to reject these facilities because, in spite of the law, some employers (especially those from the private sector) refuse to preserve them the jobs and to pay them the maternity leave for 2 years. That is why, in order to avoid such situations, employers prefer not to employ women at fertile age. In cases when the job is preserved, the woman has sometimes to accept an inferior position than she had had before the maternity leave. 
As regarding child allowance, the deterioration has accentuated more in comparison with other countries, and with other incomes. (see Chart no.9) 

Ch. 9: Relative Value of Child Allowance (1989=100)

1.	Source: UNICEF; International Child Development Centre.  Central and Eastern Europe in Transition; Public Policy and Social Conditions (1997) – Children at Risk in Central and Eastern Europe: Perils and Promises – Economies in Transition Studies. Regional Monitoring Report; no.4, Florence, Italy

 Excepting Poland, where the child allowance was almost doubled, it can be noticed a decrease of this item in all countries from region. However, in Romania, it reached in 1993 only 37.4 per cent of its value in 1989. The same child allowance, that was representing 10.5 per cent of the average wage in 1989, decreased to 3.6 per cent in 1995. [UNICEF 1997: 143] (see Chart no.10)

Ch.10: Child Allowance / Average Wage Ratio

Source: UNICEF; International Child Development Centre.  Central and Eastern Europe in Transition; Public Policy and Social Conditions (1997) – Children at Risk in Central and Eastern Europe: Perils and Promises – Economies in Transition Studies. Regional Monitoring Report; no.4, Florence, Italy

The subsidies for crèches and kindergarten have been also substantially reduced. The fees introduced instead of them have determined numerous families to renounce at such services, especially at the beginning of transition. However, according to the UNICEF data, the situation in this sector has been considerably improved during the last years. 
As concerning the compulsory education, due to the budget constrains, the schools are now encouraged to raise their own funds and to introduce fees for additional services (such as languages or computing science courses, hobby clubs etc.), while during the communism they were available free of charge.
So, the high instability of the future, deterioration of the population’s incomes, increase of the child’s cost correlated with the reduction of the State’s subsidies for families with children – all these factors have pushed Romanians to reduce the family size. Unfortunately, this was achieved mainly by abortion. 
Someone could ask why Romanians use the abortion for controlling the family dimensions?
As data provided by the Institute for Mother and Child Health Care have demonstrated, the abortion is associated with married women and has been considered mainly as the life-buoy in case of failure in using the traditional contraceptive methods (the calendar and withdrawal). And this is understandable if it is taken into account that during the communist regime the modern contraceptives and sexual education were prohibited. According to the Reproductive Health Survey from 1993: 
•	Both fertility and induced abortion were inversely correlated with education level. The highest increase in abortion rate was experienced by the least educated women aged 20-24.
•	57 per cent of women married or in union reported using contraceptive. 43 per cent used traditional methods and only 14 per cent used modern ones (mainly IUD, condom and pills).
•	The major source of information about any contraceptive methods was a friend or acquaintance (45 per cent), followed by mass media (19 per cent) and health care providers (10 per cent). Only 4 per cent of women mentioned their mother as the first source of information and less than 3 per cent cited the teacher.
•	The ideal number or mean desired number of children for all women was 2.1 children.
•	Numerous health care professionals were reluctant to accept and promote modern contraceptives due to their lack of training in family planing issues and limited access to updated medical literature.
For improving the population’s reproductive health, at the beginning of 1990s it was adopted the National Program for Family Planning.  As a consequence, in the year 2000 the abortion rate – still the highest in Europe – is three times smaller than in 1990.  
As the most recent Reproductive Health Survey (1999) shows, important achievements in using modern contraceptives have been also registered. Even if the traditional methods still predominate (especially among women from rural areas and those with a lower educational and socio-economic level), the percentage of modern contraceptive users increased from 14 per cent in 1993 to 30 per cent in 1999. The main factors that impede women to use modern contraceptive are the side effects (79 per cent), the partner’s preferences (57 per cent), the lack of knowledge on this issue (55 per cent), the high cost (42 per cent), and the lack of availability (36 per cent).
Regarding the sources of information about contraception, there are no significant differences comparing with the survey performed in 1993. Only 1 per cent more women have declared the health providers and teachers as source of information, while 3 per cent more than in 1993 named the mother as the first source. 
However, among the other Central and Eastern European countries, Romania shares with Russia the third position with respect of the need of modern contraception (29 per cent), after Ukraine and Bulgaria. [Reproductive Health Survey 1999: 188].
These data prove the necessity of training the medical staff in providing counselling services, as well as the teachers in spreading up the sexual education and information on modern contraceptives among youngsters.
For modifying the demographic behaviour of Romanians it is necessary not to prohibit the abortion, but to develop programs of awareness the population about the risk to which the woman’s health is exposed by abortion.
As well, it is important to extend the family planning services and availability of modern contraceptives for people from rural areas and for those with low educational and socio-economic status.
In designing an adequate demographic policy, a special attention should be paid also to the poor and marginal social groups. In spite of fact that these categories are the most numerous users of abortion, they have the highest fertility. As a study performed by the Institute for Researching the Quality of Life demonstrates, “fertility is very low at the middle and upper class, that could offer good conditions for the child’s development, while it is relatively high among poor and marginal social groups, where children have less opportunities for normal development” [Zamfir &Zamfir 1997: 39]. In this situation, a policy that supports exclusively the poorest families could generate their dependency on the children’ subsidies. This fact will determine them to have more children and, finally, to reproduce the poverty since they are not able to provide normal conditions of development for their children. On the other hand, taking into account the economic instability from Romania and the high cost of child, the middle and upper segments of population reduce their fertility if they are not encouraged to increase it. 
It is true that the birth rate decreased dramatically during the post-communist period and therefore Romania have to encourage the fertility. But in my opinion the quality of the next generations is at least as important as the quantity. I think that every child has the right to be not the result of the hazard and that is why, personally, I am for a policy that stimulates the parents’ responsibility for growing up their children. 

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