A unique study published in today's edition of the Journal of Family Planning and Reproductive Health Care1, provides new evidence about the causal links between restrictions to abortion policy and maternal mortality. The study demonstrates that limiting abortion does not prevent women from seeking pregnancy terminations but simply increases the risks they face.

The study reveals women's fertility rate and abortion rates before, during and after the Romanian dictator Nicolae Ceausescu outlawed abortion in 1966 until his death in 1989. Prior to Nicolae Ceausescu's rise to power, access to surgical abortions had been easily available under the Soviet regime. Within days of the dictator's fall, the anti-abortion law was abolished and abortion was made available again on request.

The report's authors point out that the country's dramatic shifts in family planning policy offer a rare opportunity to study causal links between access to contraception and abortion and changes in reproductive outcomes. The two causal links that authors were able to surmise provide important lessons for all policy makers today:
  1. Restricting access to safe abortion in Romania caused a dramatic increase in maternal mortality driven solely by unsafe abortion-related death
  2. Increased access to modern contraception in Romania has not reduced fertility, but instead has reduced the need for women to resort to abortion
Professor Malcolm Potts, one of three authors and British director of the Bixby Centre for Population, Health and Sustainability at the University of California, Berkeley said:

"Countries that increasingly seek to restrict access to abortion and contraception should look and learn from Romania's example... All legislators in Britain and elsewhere who really care about women's safety - and, indeed, women's lives - need to pay attention to these findings,"

Key findings from the study reveal:
  • Nicolae Ceausescu outlawed abortion in order to increase Romania's fertility rate. However, after nearly doubling initially, it soon fell back to the level before abortion was outlawed as women gradually found solutions for regulating their fertility either through contraceptives procured illegally or through illegal abortions
  • For the 30 years abortion was outlawed, maternal mortality from unsafe abortion rocketed to an incredible 147 per 100 000 live births (see graph below and attached) before falling rapidly following the fall of Ceausescu's regime to 5.2 per 100 000 live births in 2010
Following the fall of Ceausescu's regime, the rise in contraceptive use has been accompanied by a decisive fall in the abortion rate from 163 per 1000 women in 1990 to 10.1 in 2010  

Ann Furedi, Chief Executive of the British Pregnancy Advisory Service (bpas) said: 'When women cannot obtain abortion legally in their own country, they either travel to countries where they can, or they risk their health by resorting to unlawful means at home.'  

Kate Guthrie, spokesperson for the Faculty of Sexual and Reproductive Healthcare said: "This study starkly demonstrates the risks, often with fatal consequences, that women will take to avoid unwanted pregnancy. Equally it shows the dramatic impact that easy access to contraception had on abortion."