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A Lesson from Romania

Before delving into the topic of this blog, I want to mention that my next novel, Unforeseen, will be released on August 18th. This is the third and final book of the Erica Rosen MD Trilogy. You can pre-order a copy wherever you normally order books. Pre-ordering information can also be found on my website at

As I wait for the publication date, I'm working on my next novel, a stand-alone medical thriller. I hope to finish the rough draft in around two months.


Is it my imagination, or is the news of the day more depressing than it's been for a long time? Some days I avoid hearing or reading about the news altogether to escape the onslaught. A partial list of current events includes:

The war in Ukraine

The January 6 insurrection

Mass shootings and attempts at gun control

Worldwide inflation


Natural disasters due to climate change

The overturn of Roe v Wade

The last on the list brought to mind the unintended consequences of a decision made by the leader of Romania some fifty-five years ago.

Nicolae Ceausescu, the communist strongman leader of Romania from 1965 to 1989, wanted to increase the population of his country. To accomplish this, he enacted Decree 770 in 1967. Before this, Romania's birthrate had been declining as more women were working outside the home, and the low standard of living made childbearing an expense many did not want to take on. Contraceptives were difficult to obtain, and abortion became the main methodology to eliminate unwanted births.

Ceausescu and his communist cronies decided to actively promote growth of the country's population from 20 million to 30 million. Decree 770 outlawed abortion and contraception, with the following exceptions: women over 45 (for a time lowered to age 40), women with four children already (raised to five later), women whose lives would be at risk by carrying a pregnancy to term, and women pregnant from rape or incest. Contraceptives, scarce before the decree, vanished completely from stores. Women were regularly monitored by gynecologists, and all pregnancies were tracked until birth. Motherhood was praised, and girls in school were taught that becoming a mother was very fulfilling.

You may now be wondering what the consequences were. Did the goal of populating the homeland become popular? Did the women forced to bear children eventually decide their lives were enriched by the extra mouths to feed? Did the population of unplanned progeny flourish?

As most people might predict, the answer to these questions is "No."

Shortly after the decree was passed, the birthrate in Romania increased dramatically. Thousands of nursery schools, then kindergartens, were built to accommodate the increase in children. However, as the children aged, government support waned. Classroom sizes increased, and schooling was curtailed to accommodate the expanded student population.

In the 1970s, the birthrate declined again despite the decree, as women found ways to circumvent the law. Wealthy women, as expected, fared best. They avoided pregnancy by buying contraceptives illegally or obtained abortions by bribing doctors to diagnose them with a condition qualifying for a legal termination. Poor women, on the other hand, could avail themselves only to unsafe methods of abortion, and countless numbers died. Many of the dead women left behind several children. Not surprisingly, the mortality among pregnant women became the highest in Europe.

Many of the decretei, as the children born during this period were called, were poorly cared for, leading to malnourishment and physical disabilities. Large numbers of parents who couldn't care for their children placed their offspring in orphanages, abysmal institutions where children were beaten, malnourished, subjected to sexual abuse, and injected with drugs to control their behavior. Disabled children received the worst care, housed in crowded facilities without adequate clothing, food, or heat. In at least one facility, children were reported to be eaten alive by rats.

As the economy declined, and the last hired were the first fired, the decretei were the first to be terminated, adding to their hardship. At least one study concluded that children born under Decree 770 showed increased criminality later in life.

In 1989 the Ceausescu regime was violently overthrown. Although Ceausescu and his wife attempted to flee, they were apprehended and executed. Most of the revolutionaries involved in the rebellion were around 22 years old, the age of the oldest decretei.

Will the US fare better than Romania with the institution of draconian anti-abortion laws? Without a doubt, although similar to Romania, wealthy women will be able to obtain safe abortions, while countless women without means will seek unsafe, illegal abortions, and many of them will die. Other poor women will be forced to have children they cannot afford, often with poor pre-natal care resulting in a higher risk of complications. As in Romania, many women who die will leave behind several children. Some children will be put up for adoption, but many will remain unadopted.

In contrast to Romania, however, parentless children here will be well-cared for. After all, foster homes in the US are known to be wonderful places, preparing children for a fulfilling life when they are booted out at age eighteen. No abuse (physical or sexual) or deprivation could possibly take place in this country. The larger number of disabled children resulting from the higher birthrate likewise will be well-cared for by social services for the rest of their lives as Americans typically favor tax hikes to support disabled individuals, ensuring top-notch facilities and generous salaries for those taking care of our most vulnerable. School crowding, of course, won't be an issue as tax increases to support schools are usually passed by a large majority of voters, funding modern, state-of-the-art classrooms and high teacher salaries. The increased number of criminals born won't be a problem even if they are the same percentage of their birth cohort. We'll just build more prisons.

As exciting as the prospect of protecting the lives of the unborn is, I recently started thinking we could do so much more. Perhaps, as long as we are willing to force women to give up control of their bodies by bearing children, with the inherent risk of death, need for a C-section, or post-partum sequelae, including life-long incontinence, uterine prolapse, hypertension, and adverse cosmetic outcomes, we could do more to save lives. I'm referring to the lives of children and adults, people who actually want to live (as opposed to the collection of cells that comprise an unaware fetus).

Starting off, we could compel everyone to donate blood. After all, it's a small inconvenience, yet so life-saving to those who need it. Compulsory donor registration for all healthy adults would potentially save the lives of many people in need of bone marrow or hematopoietic stem cell transplants. Those who match someone in need would be required to donate their marrow or stem cells. After a few injections, donors would just need to spend a little time having their cells harvested.

Why stop there? Many people die waiting for kidney or liver transplants. Everyone with two kidneys could be required to contribute one if needed. Similarly, people with a healthy liver could be required to donate a piece of that vital organ. It's exciting to think of all the lives that could be saved with these procedures, none of which are as intrusive as carrying a pregnancy for nine months and giving birth. I imagine those in favor of outlawing abortion will be the first in line to donate a kidney or portion of their liver.

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