The Situation of [622926]

The Situation of
Child Abandonment
in Romania

March 2005

Contributions: UNICEF Romania supported this project, based on an institut ional partnership
build with government and non-governmental institu tions, which included: the Ministry of Health
/ Mother and Child Care Institute “Alfred Rusescu”, the Ministry of Labor, Social Solidarity and Family / National Authority for Child Protectio n and Adoption, the International Foundation for
the Child and Family, the “Community Suppor ting the Child” Association, the Center for
Education and Professional Development “S tep by Step” Association, and the “Youth”
Association.
The team of expert s leading the study:
Project coordinator : Ecaterina Stativ ă
Project assistant: Tatiana Popa
Coordinators for the qualitative data: Carmen Anghelescu, Rodica Mitulescu, Mihaela Nanu
Consultative experts: dr. Alin St ănescu, dr. Alexandra Zugr ăvescu
Consultants for analyzing and processing data: Nina Stanciu, Dan Turcu
Consultants for data base, graphs and tables: Ioana Marin, Raluca Graur
Field operators: Mircea Anghelescu, Corina Bacalearos , Botonogu Florin, Maria Consuela
Ciobanu, Daniel Chirila, Oana Clocotici, Alina Cotan, Eftihita Craciun, Vasile Despan, Daniela
Gheorghe, Mihaela Ghergheli, Raluca Ghinea, Elen a Ionita, Oana Manta, Ioana Marin, Iolanda
Moroșan, Gabriela Oproiu, Ariana Popa, Sanda Fr ancesca Russu, Maria Sârbu, Florentina Sargu,
Gratiela Sion, Dragos Stanciu, Dan- Ovidiu Stativa, Maria Volintiru,
Authors of Report: Ecaterina Stativ ă, Carmen Anghelescu, Rodica Mitulescu, Mihaela Nanu,
Nina Stanciu

This research would not have been possible with out the friendly assistance of all individuals
devoted to their profession who were c ontacted for valuable input for the study.

We hereby convey our gratitude for the cordial as sistance offered by the directors of the County
Public Health Directorates, dire ctors of hospitals, chief of ward s, family doctors, professionals
from the medical sector. We would also like to address our thanks to all directors of the County Child Protection
Directorates, members of the Child Protecti on Commisions, professiona ls involved in child
protection services for their special support. We equally extend our gratitude to the mayors and Secretarie s of Local Councils, who kindly
allocated time and shared valuable in formations for the qualitative analysis.
Our special thanks is addressed also to all mo thers who expressed their availability and openness
for sharing useful information for this study. We also benefited from useful advice and obs ervations from the UNICEF team. Special thanks
go to Ms. Voica Pop, Child Protection Officer a nd Ms. Lorita Constantinescu, Child Protection
Consultant for efficient coordination of the wo rking group, for valuable idea and constant
support provided during the im plementation of activities.

4Content

Foreword Executive Summary
1. Chapter 1 – Context and justification
1.1. Historical background
1.2. Purpose of the project
1.3. Methodology

2. Chapter 2 – Children Abandoned in Maternity Wards
2.1. The rate of child abandon ment in maternity wards
2.2. General features of children abandoned in maternity wards 2.3. General features of parents of the children abandoned in maternity wards
2.4. Information on the request of child protection measures
2.5. Duration of the stay of children in Maternity Ward 2.6. Discharge from the Maternity Ward 2.7. Aspects relating to the organizatio n and operation of Maternity Wards

3. Chapter 3 – Children Abandoned in Ho spitals/Pediatric and Recovery Wards

3.1. The rate of child abandonment in hospitals, pediatric/recovery wards
3.2. Circumstances leading to the hospita lization of childre n in Pediatric
Wards/hospitals
3.3. General features of childre n abandoned in hospitals, pediatric/recovery wards
3.4. General features of parents of the children abandoned in hospitals,
pediatric/recovery wards
3.5. Information on the request for child protection measures
3.6. Duration of the children’s stay in the pediatric/recovery wards
3.7. The relationship between pa rents and children during the hospitalization period
3.8. Discharge from the pediatric/recovery wards
3.8.1. The children’s health at the time of discharge
3.8.2. Where did the children go after being discharged from
Pediatric/Recovery Wards
3.9. Aspects relating to the organization and ope ration of hospital a nd Pediatric Wards
3.10. Quantitative and qualitative information in observation charts of hospitalized
children

4. Chapter 4 – Children Who Have Been Aba ndoned in Places Other Than Medical
Institutions

4.1. Circumstances in which the child en ded up in an emergency service center
4.2. General features of children in emergency service centers 4.3. Duration of the children’s stay in emergency service centers
4.4. Discharge from the emergency service centers 4.5. Information on the emergency service centers

55. Chapter 5 – Route of the Child
5.1.Types of the routes
5.2.Type of protection measures in effect 5.3. Length of the routes
6. Chapter 6 – Mothers Who Have Benn Ab andoned Their Children in Medical
Institutions

6.1. General characteristics of moth ers who abandoned their children
6.2. Specific features regarding only mothers who abandoned their children in maternity
wards
6.3. Particular aspects regarding only single mothers who have abandoned their children
in maternity wards
6.4. Aspects relating only to mothers who abandone d their children in pediatric/recovery
wards
6.5. Family planning – aspects below refer to all categories of mothers
6.6. Overview of activities conducted by the County Departments for Child Rights
Protection in 2003 and 2004

7. Chapter 7 – Conclusions
8. Chapter 8 – Recommendations

6ACRONYMES

ANPCA National Agency For Child Protection and Adoption
DJPDC County Child Rights Protection Department
NGO Non-Governmental Organization
IOMC Institute for Mother and Child Care
IUD Intra-Uterine Disposal
SPSS S TATISTICAL PACKAGE FOR THE SOCIAL SCIENCES
FICF International Foundation for Child and Family
CNP Personal numeric code

7EXECUTIVE SUMMARY

1. Context
Much progress has been made in Romania in the pa st eight years in the area of the protection of
child rights. New central and local institutional structures have been created, as have services for
children and families in difficulty, and the pr evention of their ending up in difficulty.
In spite of these significant achievements, the problem of child abandonm ent, which came into
being and persists in Romania, is an issue whic h appeared and worsened prior to 1990. More or
less successful, child protection reforms did not act in this regard, leadi ng to the spreading and
increasing complexity of this phenomenon. Even in 2004 unwanted children are abandoned at birth in maternity wards, hospitals and
pediatric wards, or simply “left” by their parents for indefinite periods of time in these medical
units. The following conditions lead to these actions, at such a scale, to be classified as a phenomenon: the absence of community services for the prev ention of child abandonment, and the consent,
tolerance, and indifference on the part of institutions in which these events take place or those directly responsible for child protection.
The abandonment of children in health care ins titutions results in some of the most perverse
effects, including a variety that a ffect the development of the child at a time considered to be the
most important in his life. The separation of the child from his mother soon afte r birth or at a very early age in a health care
institution exposes the child for long and significa nt periods of time to an existence in which his
development needs are ignored. Likewise the ch ild is often moved to various unsatisfactory
locations until temporary measures are taken an d stable protection measures are enforced.

2. Justification
The persistence of this phenomenon in all its forms, and the direct long-term effects on the
chances of the child to a normal development has justified the initiation of a project which aims
to understand what and w ho makes this possible, and what can be done to decrease this
phenomenon. It is necessary to unde rstand the magnitude of this phenome non in order to assign a measure of
urgency and have a reference point to eval uate the possible progr ams for intervention.
The objectives of this study also include the understanding of the prevalence of the child
abandonment phenomenon by more rigor ous conceptual delimitations, and the diagnosis of the
most important dimensions of this phenomenon.

8
3. Methodology
A retrospective transversal st udy was conducted over a period of three months in 2003 and 2004
to carry out these objectives, and the reference po pulation was made up of ch ildren less than five
years of age temporarily or definitely abandoned/left, and their mothers.
A cluster sampling technique was used to obt ain a representative random group of abandoned
children and their mothers, based on the total number of these in the reference period. The
following selection method was used: Of the eight Romanian development areas (one of which is the area of Bucharest and Ilfov) two
counties (and two sectors, respectively) were sel ected at random. All health care institutions in
these counties and sectors were studied (70 mate rnity wards, 89 hospitals/pediatric and recovery
wards) and 25 emergency placement centers. Some 2,000 patient charts of under-five children we re selected, based on cr iteria adopted by each
institution in part to de fine an abandoned child.
The working definition of the concept of an abandoned child refers to a child whose biological
parents have relinquished their responsibility to care for and satisfy his basic development needs,
and who have physically separated themselves from him/her before this responsibility was taken
over by an authorized institution. This methodology was based on the fact that it woul d be possible to identify all children who had
been exposed for any length of time to abandonmen t, on condition that a record thereof existed.

Source of information
In addition to studying the medi cal records and, where appropriate, the files of the children,
investigations/interviews were conducted with th e mothers of children selected in the sample.
Focus groups were set up among health care a nd social welfare institution professionals to
verify, supplement and study the findings based on the quantitative data ; detailed interviews
were conducted with key indivi duals at various repr esentation and decision-making levels; case
studies on child abandonment.

Tools
Questionnaires, nine different forms, and interv iew and focus group guides were used to record
the data obtained from the documents a nd the above-mentioned individuals.

Data collection
The collection of quantitative da ta took place from August–S eptember 2004, while that of
qualitative data took place be tween October–November 2004.

Data processing
The data was processed using the Statistical Package for the Social Sciences (SPSS).

9
4. Summary of participants in the evaluation process
The UNICEF Office in Romania s upported this project, based on an institutional partnership,
whose mission is considered to be just at the beginning. The partnership includes government
and non-governmental institutions, of which we w ould like to mention the following: the Mother
and Child Protection Institute “Alfred Rusescu”, the National Authority for Child Protection and
Adoption, the International Foundation for the Child and Family, the “Community Supporting
the Child” Association, the Center for Educa tion and Professional Development “Step by Step”
Association, and the “Youth” Association.

5. Conclusions, lessons learned, recommendation s, use made of the evaluation to make
timely adjustments in program design a nd improvements in program performance,
possible wider relevance of the evaluation

Lessons learned
Although improperly considered as lessons learne d, it is worth pointing out that the data
collection teams faced a number of difficulties result ing from a lack of or disregard for archival
regulations for medical r ecords, or the incoherence of regulati ons on the safekeep ing of the files
of children by County Child Protection Departments. In some counties the filing of charts is based on admission date, while in others it is according to date of discharge. Some Child Protection Depart ments keep the files of children in their own
headquarters, while in other counties such files are scattered among the various protection units.
These inconsistencies impeded the planning of work time and material resources for data
collection, although the worki ng methodology had been pre-tested in two counties.

This study led to the establishment of a comprehe nsive database containing factors relating to the
medical and social welfare systems, other institutiona l factors, as well as to the human and social
behavior of the players directly or indirectly invol ved in the occurrence of the phenomenon of
abandonment. Much of this information exceeds th e delimitations strictly se t by the objectives of
the study.
Conclusions
Child abandonment in 2003 and 2004 was no different from that occurring 10, 20, or 30 years
ago. The magnitude of the phenomenon was determined by the rate of child abandonment (the
number of abandoned children per 10 0 births/hospital admissions).
The rate of child abandonment in maternity wards was 1.8% in 2003 and 2004, translated to an
estimated number of 4,000 children, while in hospitals and pediatri c wards, the child
abandonment rate was 1.5% and 1.4% in 2003 a nd 2004, respectively, or 5,000 children per year
at national level. The percentage of abandoned babies who are bor n underweight (34%) is four times higher than
the norm for Romania (9%).

10
A striking number of abandoned children have no identity when discharged from hospital.
According to data included in this study, the percen tage of such children can reach 64% at
discharge from maternity wards, 30% from pedi atric hospitals, and 10% for children from in
emergency placement centers. Regarding various aspects relating to the organi zation and operation of maternity wards, which
could encourage the observance of the rights of the child, it was found that most maternity wards
follow traditional patterns (no rooming-in/mot her and child wards), which encourages the
separation of the mother from the child. More than half of the institut ions do not respect the rules a pplicable to them by the Joint
Ordinance of the Ministry of Health and th e National Authority for Child Protection and
Adoption 2003, for the hiring of a social work er, and the reporting/recording of newborn on
family physician lists. Based on the succession of institutions the child has been in and the protection measures it has
had access to, indicates that two thirds of children abandoned in maternity wards are transferred
at least once to pediatric/recovery wards before any protection m easures are taken. A mere third
of all children abandoned in 2003 and in the first three months of 2004 were benefiting by the end of August 2004 from a final protection measur e (with their biological or foster family),
which shows that the child is subject to vari ous temporary protection measures for a prolonged
period. Furthermore, it was found that the hospital/p ediatric ward is the most available substitute
for accessible social welfare service, both for the parents who want to abandon their child
“temporarily” or “definitiv ely,” and paradoxically for the child protection services that use such
institutions to host children in difficulty wh ile they look for and find protection measures.

An analysis of the characteristic s of mothers who have abandoned their children revealed that
42.2% are illiterate, and 27% have not complete d Junior High School (grades 5-8); some 80%
are low socio-economic level mothers, 85% of mothers have unsure inco me; 28% were under 20
at the birth of the child. The rejection of the child is much more pron ounced in the case of mothers who resort to
abandonment in maternity wards, as they have already firmly made up their mind to put their
child up for adoption. Rejection is less severe in mothers who ab andon their children in pediatric
hospitals, as they c onsider these to be better alternatives for the upbringi ng of the child, believing
that their presence with th e child is facultative.
Mothers who abandon their children in pediatric hospitals are poor er and less educated than
those from maternity wards. Majority lives in unstable couples and has rroma ethnicity. They “choose” the hospital as an alternative for the upbr inging of their child, not necessarily as a form
of abandonment. Oftentimes both parents are c onvinced that the child will be better off in
hospital and that their presence is facultative. Th ey often “forget” about the child, and come to
see him only at the insistence of child protection services.

11And last, but not least, more than half of the mothers have heard of at least one modern method
of birth control to prevent unwanted pregnancies. The pill, the intra-uterine device (IUD), and inject able contraceptives are the most widely kn own methods (in that order). Use thereof is very
low. Roma women are less familiar with contraceptive methods.

Recommendations
In the definition adopted in this study for the abandoned child , the status of abandonment was
not conditional upon its duration. If the systema tic and unitary reporting of child abandonment
cases will be considered necessary and useful, this will require the accept ance of a single term
for abandonment.
Î In this sense, it is felt that the systematic and unitary re porting of abandonment cases is
necessary and useful, and that there is a need to have ac ceptance on a single term for
abandonment and abandoned child. The immediat e and strict implementation of the new
child rights legislation could lead to the statistical reporting of cases at the level of maternity wards.
The observance and implementation of legislat ive regulations is supported by scientific
arguments of child development theories, which can be debated and assimilated by the staff in
the course of continui ng education and training.
Î As such, the initiation of professional and institutional capacity development is
recommended in relation to the effective a nd efficient enforcement of new legislative
regulations.

Children’s files are incomplete and difficult to locate in child protection departments. There are
fewer social investigations than establishe d protection measures, which raises numerous
questions on the way in which protection m easures are periodically re-evaluated.
Î In this context, there is a need to come up with an operational computerized management
system of cases subject to child protection social services, so that all children can be located
at any time based on up-to-date information.
The prolonged retention of low birth-weight children without their mothers in health care
institutions is not in the best interest of the child. It is highly unlikely that these children will grow up at a normal rate in health care institu tions, without the presen ce of their mothers.
Î It is thus recommended that a low birth rate prevention program be initiated and supported;
such a program would decrease the risk of early separation of the mother and child and,
implicitly, of child abandonment.
One of the reasons given for leaving healthy childre n in health care institutions was their lack of
identity papers.
Î In this sense, it would be de sirable to make mandatory the de claring of the personal numeric
code of the child to the maternity ward in whic h the child is born, and th e registration of this
code on the child’s chart. Only after the child’s identity has been established can the chart be
filed.

12Î In connection with the identity of the child, there is a need to strictly regulate the complete
filling out of all columns in the chart, especially in case of the names, address, and identity
papers of the parents.
The current organization of maternity and pediat ric wards offers insufficient opportunity for the
development of an early bond between moth er and child, which is necessary for the
establishment in the child of basic mental h ealth and normal socio-affective development.
Î The sustained promotion of the rooming-in system is recommended, but the mother is
unlikely to instantly change her mind about abandoning her child, because this decision is
often made before she is admitted to the maternity ward. The rooming-in system should be coupled with new practices and attitudes for the mother and child to encourage constant
contact, support breastfeeding, and help th e new twosome to identify ways of forming
attachment and mutual support.
Î It is also recommended to initiate and support cont act with the mother or both parents, as is a
more flexible approach over old practices which are today scientifically invalidated.
In the case of children abandoned in or brought into medical units for social protection reasons, it
is essential that the staff understand that admission to hospital is not in the child’s best interests.
Î The competency of professionals at various de cision-making levels mu st be increased, to
shorten the periods of transfer abandoned child ren are submitted to before reaching stable
and final protection measures.
Î It is recommended that new, integrated servi ces be developed to guide mothers to chose
alternative protection measures, and eliminate the habit of believing that the hospital is an emergency shelter for any type of difficulty wh ich the child may encounter. The Acceptance
and perpetuation of such situations not only constitutes a violation of the law, but also an acute lack of understanding of th e child’s developmental needs.
Î This calls for the recommendation to provide su pport to community serv ices that can focus
their efforts on sustaining the retaining of the child in his family environment.
Î The diversification of various mother and fa mily support services is recommended, aimed at
meeting the needs of children. Existing day-care centers (not now available in rural areas)
could also develop services for disabled ch ildren, to prevent their separation from their
families, justified on the basis of such services not existing in the community. In rural areas, kindergartens (and even schools) not presently us ed to their full capac ity because of the drop
in birth rate, could extend thei r activities by providing services needed to keep children in the
family.
Î And not least, an important method for the pr evention of child abandonm ent is the promotion
of family planning programs, to reach high-ri sk populations, includi ng those with special
health issues: alcohol, mental problems, disabilities.
According to Law 272/2004 on the Protection and Pr omotion of the Rights of the Child, which
stipulates the obligations of local administratio n authorities to guarantee and promote the rights
of the child, it is recommended to support th e strengthening of prof essional capacities:
Î of staff working in the local institutions and services, through whom the importance of early
childhood and necessary child developmen t conditions can be transmitted;
Î of the specialists working in the Child Prot ection Commission, about the values of childhood
and the child, the recognition of the rights of the child, to make them responsible for issuing

13protection measure proposals, to enforce the la w in a specific and favorable manner for every
child, so that the law in fact supports the chil d to offer optimal satisfaction in terms of his
developmental needs, instead of regula tions which complicate his evolution.
In accordance with the law, the following should be functional, rather than merely formal:
Î the individual child protection plan by which indivi dualized and persona lized care for each
child is ensured; and
Î the service plan to prevent the separation of the child from his family.
In such circumstances, the UNICEF Office in Roma nia is prepared to provide the technical and
financial support needed to strengthen those institutional capacitie s responsible for the
implementation of this new approach legislat ed not only by Law 272, but also by the Convention
on the Rights of the Child. UNICEF is also ready to ensure the monitoring process of the rights
of the child, including the evolut ion of this phenomenon in time, and to promptly sound an alarm
when needed. The UNICEF Office in Romania wishes to initiat e and support programs which are adapted to
the Romanian reality in terms of the developm ent of certain indices, the promotion of the
monitoring system, and the support of evaluations for continuous im provement of basic services
for child and family. This initiative also incl udes a program focusing on the registration of the
birth of all children, thus fulfilling the rights of a child to acquire a name, a citizenship, and to
know and be cared for by his parents. The new program of the UNICEF Office in Ro mania for the period 2005-2009 has as its basis
the principle of ensuring and promoting a prot ective environment for the child and his family,
which requires a global and comprehensive appro ach of all issues. As such, the program
proposes the general framework for stage two in the child protection system reform process.

14CHAPTER 1 – CONTEXT AND JUSTIFICATION

1.1. Historical Background

Child abandonment (at birth) is a rudimentar y method of managing unwanted or unaccepted
pregnancies, for cultural and/or economic reas ons. Its existence or pe rsistence in modern
societies comes from the lack of certain services , functionality of some institutions, and a culture
relating to their use. As of 1967 Romania recorded a sudden rise in th e number of abandoned children, especially at
birth. The abandonment phenomenon, condemned by all governments, has be en poorly managed,
as its magnitude has not decreased for over 35 years. While there has always been some child abandonment in Romania, as there has been in other cultures, there was no significant magnitude in tim e and space, to this to become a part of
tradition or define a cultural spec ific of the Romanian people.
A pro-natalist demographic polic y decree was issued in Novemb er 1966, and as of June 1967,
children began being abandoned in maternity wards and hospitals/pediatric wards. As a result,
child abandonment was perceived as a direct outcome of the pro-natalist decree, and remained as
such in the collective consciousness until 1990. There has been insufficient study of this phenomenon that started in 1967, in the sense that to
attribute the appearance of abandoned children to the prohibition of abortion would imply that
their mothers would have obviously resorted to abortion to avoid gi ving birth to unwanted
children they would later abandon. For some mothers the resorting to abortion is considered a rather responsible attitude to
reproduction, within certain parame ters (in terms of values of th e respective timeframe). Based
on such logic, however, it is difficult to believe that a sub-category of women came into being
who replaced fertility control by abortion with child abandonment from this category of mothers
who use abortion to limit fertility. While one can presently find numerous similarities betwee n abandonment and abortion, their
association in 1967 was hardly acceptable in term s of values of those times, especially as
concerns abortion. Therefore one feels certain a bout the undoubted existe nce of other determinants or phenomena
that strangely combined with the pro-natalist decr ee to generate that particular segment of the
population that resorted to abortion. These may include the displacement of large segments of
the population due to industrialization, the failur e to morally condemn su ch behavior, or the
encouragement, for one reason or another, of the breach between mother and child, that
overlapped and crossed to produce such a brutal social level effect on children, especially in
terms of unwanted ones.

15Furthermore, it is believed that child abandonmen t at that time did not necessarily (or merely)
constitute a means for controlling fertility, but rather represented a means for collective reaction
to certain pressures aggressive ly promoted by a very harsh dictatorial political regime.
The imposition of the pro-natalist policy brought w ith it increasing repressive measures against
doctors because of infant deaths, with excessi ve (and exclusive) blame being heaped on the
medical sector, in lieu of attributing the re sponsibility of such cas ualties to parents.
This ill-fated balance initially resulted mainly in the acceptance of abandoned children being
kept in health institutions to prevent their possi ble death at home. Enquiries into the deaths in
hospitals were (obviously) less te rrifying for medical staff in such institutions than that in the
territory, where cases were attributed to negligence on the part of medical staff, and resulted in the punishment of physicians. This resulted in a trend to forcibly send children from the territory to hospitals for minor afflictions.

Staff responsible for announci ng the arrival of the child from th e hospital to the territory recalls
the refusal of medical staff to accept the child if its family did not offer sufficient guarantees for
risk-free care of the child.

The doubling of the number of births in a short period of time (for which the medical
infrastructure was unprepared) theoretically also meant a doubling in the number of “ normally ”
abandoned children, to which were added other pr oblems that come with the increase of the
number of such children. The management of these problems by the medical staff, in the
complete absence of social welfare services, generated a series of anomalies that were
perpetuated over the years, taking on a semb lance of “normality” and “acceptability.”
It was quite common for a mother to claim a lack of proper living conditions at home in order to
abandon her child in a health institution, and be s ubject to no consequences. The saying that “the
government wanted them, so the government shoul d raise them” was deeply entrenched in the
public consciousness, and became a cynical means for legitimizing such acts. It was equally common for medical staff to encourage mothers to leave their children in the care
of health institutions, claiming that this was best for these children, especially when there were any suspicions of risky home care. According to va rious studies, some 85% of children placed in
shelters and dystrophic wards in 1990 had been sent there on the basis of a physician’s
recommendation for institutionalization ( The Causes of Child Instit utionalization in Romania,
1991 ).
This “complicity” between the mother and the institutions, fostered by the belief that this is in the child’s best interests, also contributed to th e rise in, perpetuation a nd acceptance of the child
abandonment phenomenon in Romania, es pecially in health institutions.
The pro-natal policy was mainly implement ed by Decree 770/1966, prohibiting abortion upon
request, and progressively limiting the access of the population to any kind of contraceptives,

16including condoms. The demograp hic policy was politically jus tified, and the outlawing of
contraceptives was justified “scientifically”. Pol iticians and major part of the medical community
engaged in aggressive propaganda against family planning. Su ch counter-propaganda was only
possible due to the limited circulation of sc ientific information during the communist
dictatorship, including at the academic level. The unprecedented human developm ent recorded in the 80s in most European countries
remained unmatched in Romania. Important progress in understanding child development
resulted in new approaches for the child, with co ncentration on increased capitalization for early
childhood. Such progress was unknown in Romania, because of its isolation behind the Iron
Curtain, and due to the discontinuation of socio- human academic education at the end of the 70s.
The more than 20 year tolerance of the ab andonment phenomenon and the simultaneous and
progressive development by the communist govern ment of an institu tional child protection
infrastructure (for unwanted, abandoned and neglect ed children), entirely inadequate in terms of
the needs of the child, confirm the consequen ces of Romania’s isola tion as concerns such
knowledge, especially in the socio-human field.
A “natural” drop in the child abandonment phenomenon was exp ected in the 1990-91 period,
after the fall of communism, following the liber alization of abortion and free access to
contraceptives. But this did not happen. In the 14 years since 1989, ever more complex
justification was assigned to abandonment, which hindered the identification of solutions for
decreasing the number of abandoned children. The communist government had developed a
system of values for 25 years that undermined family ties, encouraged dependence on the state,
weakened the capacity of families to care for their children, and generally promoted the neglect by parents of their parental responsibilities and, so metimes, even of their own lives. Against the
backdrop of such a crisis of values, large segm ents of the population sa nk into deep poverty. At
the same time, the new social policies for the child in difficulty carri ed the mark of old
mentalities linked to institutional protection values , which were developed outside and with no
consideration for the importance of the family and the satisfying of the needs of the child.
Children abandoned in hospitals were left for long periods in these institutions. Their departure,
with the implementation of protection measures, c ould take from several months to 4-5 years.
Their normal development was jeopardized not only by illnesses but especially by the fact that
their developmental needs were ignored. The de layed implementation of protection measures
was circumstantially “justified” at various politi cal moments. Initially it thought that hospitals
had no qualified/designated staff to handle such problems, and the medical staff was limited in
terms of its ability to make any intervention. Since 1989, many large child protecti on institutions have closed dow n. Owing to the fact that the
magnitude of the abandonment phenomenon re mained unchanged, children stayed for long
periods in maternity wards and pediatric hos pitals for want of another place to go.
The subsequent closure of such in stitutions resulted in similar blockages, even while alternative
protection measures (foster parents, maternal ce nters) were being developed, because these could
not meet all the needs. Blockages are perpetuated, because few children leave the child protection system. The children stay with their fo ster parents for periods comparable to those

17spent in placement centers. Therefore, new cas es require the creation of new placement (new
foster parents).

The Literature of the child abandonment phenomenon
The magnitude of the child abandonment phenomenon was unknown prior to 1989, mostly due
to the fact that abandonment was not officially acknowledged.
A first study conducted in 1990 by the Institut e for Mother and Child Care (IOMC) and
UNICEF, entitled The Causes of Child Institutionalizat ion in Shelters and Dystrophic Worlds ,
drew attention to the fact that of the so me 9,000 children aged 0-3 years who had been
institutionalized in shelters throughout the coun try, 83% were coming directly from maternity
wards and hospitals, pediatric and dystrophic ward s. These children had be en institutionalized on
the basis of recommendations by a physician. Most children suffered from chronic medical
problems or disabilities, which th ey developed during their stay in the respective institution due
to a lack of proper attention, stimulation, exposur e to sunshine and adequate food. Few of these
were legally declared abandoned although they had been deserted. The causes for institutionalization were numerous, from a lack of social and mate rial support (single or teenage
mothers, absence of fathers or the extended family ) to problems related to extreme poverty (large
families, mothers with no babysitting support during work hours, alcoholism, prostitution, etc.). UNICEF, the International Foundation for Child and Family (FICF), and IOMC carried out a
second study in 1996 entitled The Causes of Child Institutionalization in Romania , which
indicated that some 70% of the children aged 0-3 years who had been institutionalized in shelters were coming directly from matern ities and pediatric hospitals/war ds. The survey showed that
child abandonment (in maternity and pediatric hospitals/wards) was the main cause of
institutionalization in the case of 51% of thes e children. It further evidenced that child
abandonment was considered to be the sole caus e for institutionalization in only 10% of the
cases, while the remainder pointed to other socio-economic factors.
Another study carried out in 1997 in seven mate rnity wards throughout the country and three in
Bucharest emphasized an average 1.61% rate of child abandonment between the limits of 0.75-
2.7% (I.M. Dambeanu, Petrone la Stoian and others: Child Abandonment as a Form of
Negligence , in the book entitled The Mistreated Child , 2001). The characteristics of the mother
who abandons her child were defi ned as being related to marital status (single mothers), age
(teenagers), and level of education (low).
In 2000 Iuliana Dombici, Minerva Ghinescu and others conducted a study entitled Maternal
Abandonment , which draws attention to a prevalence rate of child abandonment in maternity
wards of 0.7-2.5%, based on the number of i nhabitants of the communities in which the
maternity is located. The prevalence of child abandonment in maternity wards is similar in the above-mentioned
studies. There are no exact figures on the aba ndonment of under-five children in pediatric
hospitals and wards, although their presence is regularly reported in the hospital environment.

18Most of these studies we re conducted based on the analysis of documents and the interviewing of
maternity professionals. None made any attempt to understand the child abandonment phenomenon from the perspective of the mother. Although these studies have certain limitations because methodologies were used that do not
allow for the generalization of country-level re sults, they are valuable as case studies.
Similarly, it should be mentioned that while the la st two studies deal spec ifically with “child
abandonment,” one cannot find a definition of the notion or concept of child abandonment. As
such it is unclear what exactly the prev alence contained therein refers to.
The present study makes use of at least four approaches for understanding the context which
generates and determines the pe rsistence of the child abandonm ent phenomenon in Romania: the
health of the abandoned child, th e socio-cultural and ec onomic condition of the mother, the care
practices in health institutions, and the appropr iateness and accessibility of social and medical
services for the mother and child. The child abandonment concept: A historical and legal perspective

The rise in the number of abandoned children and the long periods th ey spend in health
institutions has led to the issu ing of a law that should provide solutions in term s of the newly
created situation. Law 3/1970 regulated “ the protection of certain categories of minors ”, and formed the basis for
the institutionalization of all these children in health care institutions. The decision for
institutionalization was made by a commission, usually upon r ecommendation of a physician,
and was based on the argument that the ch ildren’s development would have been “ jeopardized
within the family. ” According to this Law, the destination of such children was a closed medical
institution, known as a shelter (if the child had identity documents) or a dystrophic ward (for
children without identity documents). The notion of an abandoned child was entirely absent from this law, because the law “stipulated”
the separation of the child from his family and pa rents and his admission to an institution as one
of a series of opportunities ensuring that the child benefited from additional resources for its proper development. As such, these children were not considered to be in difficulty , nor was it felt that their rights
were being violated, but rather that their needs were being fully met within a collective
guaranteed by the state. The collective and the state were perceived as guarantors.
The provisions of this law illustrate the limited perspective of the deve lopment of the child,
which entirely ignored its relati onship with its mother/parents. The meeting of its needs was
extremely limited, only in terms of food and shelter, as it was believed that its educational needs
would “appear only after age 3.” This perspe ctive was similarly fostered among parents.

19This is how a law, aimed at saving children whose development was jeopardized within the
family , led to the development of a culture of institutional child abandonment, irreversibly
affecting their normal development , without this being ac knowledged as such.
The actions and behavior of those professionals who came in contact with these children, left
parentless in medical institutions or with social services, will be closely associated with this
culture for a long time to come. Law 3/1970 was in effect until June 1997, at which time Emergency Ordinance 26/1997 was
passed, mainly to regulate the protection of various categories of neglected or abandoned
children, either temporarily or pe rmanently, known generically as children in difficulty . This law
refrains from using the expression abandoned child due to the existence of another law (Law
47/1993), already in effect at that time. This earlier law aims to clarify the legal status of the
child that has been abandoned by parents in an institution. According to the pr ovisions of this
law, the court could declare such a child abandoned on the basis of previously established
criteria and conditions, to ensure that the child could benefit from certa in protection measures,
such as foster parents or adoption. When the above-mentioned law went into effect, ma ny child protection system professionals felt
that only children declared legally abandoned can be considered abandoned , and recommended
that other abandoned children be assigne d the less scientific appellation of deserted children.
The perspective that currently drives the designation of a child as either abandoned or deserted
relates to the mother/parent. Th is perspective ignores and fails to legally and morally sanction
practices that perpetuate the status of complete abandonment (for long periods and at highly
significant ages) of children in medical instit utions in which their normal development is
seriously jeopardized because their fu ndamental needs are not being met.
The authors of this study believe that children under the age of tw o, and especially newborns left
without their mother, constitute an emergency segment that requires immediate priority not be postponed. Immediate protection for such childr en must not be delayed for bureaucratic
procedural reasons, because their normal de velopment can be irreversibly harmed.
Law 272/2004 on the protection and promotion of the rights of the child , entered into force as of
1 January 2005, uses th e appellations of deserted child, foundling or child abandoned by its
mother strictly from the same perspective, without defining these.

Working definition of the abandonment concept

An abandoned child is one whose biological parents have relinquished the responsibilities of
caring for and meeting its fundamental developmen t needs, severing physical ties with the child
prior to such time as an authorized institution has been able to take over the responsibility.
The designation “abandoned” may be neither c onditioned nor amended by the duration for which
the parents have relinquished their responsibility or the location of the child at the time its
mother/parents resorted to such relinquishing.

20What is important is that all children suffering the (sometimes irreversible) consequences of
maternal deprivation in all its forms be includ ed, regardless of the durat ion of the separation.

1.2. Purpose of the Project

The research was undertaken aimed:
– To acquire knowledge on the pr evalence of the child aba ndonment phenomenon with the
help of more rigorous conceptual delimitations;
– To carry out an evaluation of the most im portant features of the child abandonment
phenomenon;
– To develop strategies and programmes, based on the assembled data, which may contribute
to the decrease of the child ab andonment phenomenon in Romania.

The objectives were:
1. To record and describe the various forms of abandonment;
2. To identify the causes which lead to the te mporary/permanent abandonment of the child;
3. To identify certain characteristics of children sel ected for this study, specifically in terms of
their health;
4. To identify various medical and socio-cultu ral risk factors among mothers who have
abandoned their children;
5. To identify certain perceptions concerning th e importance of the mother–child relationship
among mothers, and professionals and health care and mother and child social protection
sector decision-makers;
6. To evaluate various mother and child care practices in medical institutions, and the
accessibility of medical and social services for women.

1.3. Methodology
A transversal retrospective study has been pro posed within a three-month window (January-
February-March) in 2003 and 2004 has been used in order meet the objectives.
The reference population is made up of under-five children, abandoned/deserted temporarily or
permanently in 2003 and 2004, and their mothers. Such children can be found in Romania in
hospitals, maternity, pediatric and recovery wards, and in emergenc y service centers. The latter
may accept and shelter children that have been “f ound” parentless or that have been reported by
institutions or individuals as being in dange r, because their parents/legal guardians have
abandoned them. The study covered two years to capture differenc es or possible progre ss in terms of child
abandonment prevention due to the adoption of legal measures in this regard.

Sample
The study was conducted on a representative nationa l sample, initially estimated at some 400–
780 children, and on an equal number of mothers.

21Sampling process
The cluster sampling technique was used for th is study, in order to obtain a random group of
children and mothers, compared to their total number within the reference time frame. The
following process was employed for the selection of institutions: Of the 8 Romanian development regions (one of which is the Bucharest and Ilfov region) two
counties (and two sectors), respect ively, were selected at random.
The study involved all medical institutions (mat ernity and newborn wards, pediatric and
recovery hospitals/wards) and the emergency se rvice centers in these counties and sectors.
All under-five children from the above instituti ons were selected from the January–March 2003
and January–March 2004 periods, based on the following criteria:
Eligibility criteria for children from newborn wards:
– Newborn whose chart indicates “abandoned child”, “social cas e”, “runaway mother”, etc.;
– Newborn with normal birthweight (>2,500 g), who did not leave the mate rnity ward within
seven days, and is in hospital without his mother;
– Healthy newborn with normal bi rthweight (>2500 g), who is tr ansferred without his mother
to another pediatric/re covery hospital/ward;
– Newborn with low birthweight who, upon reachi ng normal weight, is not discharged and
continues to be in hospital without his mother;
– Newborn with non-life-threateni ng medical problems/malformations or disabilities, who can
be cared for at home, has not been claimed by the family, and is in hospital without his
mother.
Eligibility criteria for children in pediatric hospitals/wards :
– Children who have been transferred directly from a maternity ward, without their mother
and/or who are not visited by their legal guardians;
– Children under age five, in hospital without their mother, with no justifiable medical
diagnosis;
– Children under five in pediatric hospitals/wards , without their mother, and with no justifiable
medical diagnosis.

Eligibility criteria for children in recovery wards :
– Children who have been transfer red directly from maternity wards, pediatric hospitals/wards,
without their mothers, and/or have not b een visited by their mo thers/legal guardians;
– Children under five who are in hospital without their mothers/legal guardians, are not visited
by the latter, and/or are in hospital with no justifiable medical diagnosis.

Eligibility criteria for children deserted in othe r public and private places, other than medical
institutions:
– Children under five who have been brought in wit hout their parents/mo thers to emergency
service centers; children who have accidentally “gone mi ssing”, whose parent s have reported
them missing to the police, and are bei ng searched for, have been excluded.

22Eligibility criteria for mothers:
– The mothers of the children selected for the study, regardless of whether or not they were
living with their children at the time of data collection.
Identification of cases in cluded in the study sample was made as following:
– Children were identified on the ba sis of on-the-spot study of all observation charts available
in the maternity/newborn wards, pediatric hospi tals/wards, and recovery/dystrophic wards in
the January–March periods of 2003 and 2004, respectively, etc.
– Children enrolled in emergency service centers or identified with the help of the County
Child Rights Protection Departments (DJPDC ) following a study of files and of other
existing records for the reference period of the study;
– Mothers were identified on the basis of a study of observation charts and documents held by
the County Child Rights Protection Departments. The latter assisted with the contacting of
mothers and the surveys were carried out in their homes.

Sources of information
1. Medical records of the children from the above-mentioned medical institutions and social
protection services;
2. Inquiries/interviews with the mothers of the chil dren from the target group. Findings from the
quantitative data were veri fied, completed, and studied;
3. Focus-groups with professiona ls from medical and soci al protection institutions;
4. In-depth interviews with key individuals at various representa tion and decision-making
levels;
5 Case studies based on child abandonment cases.

Tools
Questionnaires, forms, and inte rview and focus group guides were used to collect the
information from the above-mentioned documents and individuals. The working tools for the collection of quantitative data are as following:

Chart 1 Data on the maternity ward – the tool for recording information on the location,
organization and operation of the mate rnity wards includ ed in the study.
Chart 1.1 Data on the newborn – the tool for recording information extracted from the
observation charts of newbor ns selected for the study.
Chart 2 Data on the pediatric hospital/ward – the tool for recording information on the
location, organization and operation, etc. of the institutions selected for the study.
Chart 2.1 Data on the child in pedi atric/recovery hospitals/wards – the tool for recording
information included in the observation char ts of children sele cted for the study.
Chart 3 Data on the emergency child reception services – the tool for recording the location,
organization and number of cases who have receiv ed such services during the reference period.
Chart 3.1 Data on the child that has had to have emergency child reception services – the tool
for recording information extracted from the f ile of the child who r eceived such services.
Chart 4 Data from the County Child Rights Protection Department (DJPDC) – the tool for
recording the number of reports, who made thes e reports, and the type of protection measures
taken during the reference periods.

23Chart on the child’s route – the tool for recording the information on the places the child has
been, the duration of his stay in each of these places, and the protection measures taken for the
child from birth until the moment the study was conducted. Questionnaire for mothers – the tool used during interviews with mothers of the children
selected for the study. Synthetic chart – summarizes the activity of the teams in each county.

Tools for the collection of qualitative data were as following:
Guide for discussions between the focu s group and health care professionals;
Guide for group discussions with child protection professionals; Guide for in-depth interviews with significant decision-making professionals; Guide for conducting case studies with mo thers who have abandoned their children;
All collection tools were pre-tested in counties that were not included in the sample, as such
being subjected to several changes be fore arriving at their final form.

Data collection
Data was collected by teams made up of two indi viduals. Staff was selected on the basis of
profession (social workers, psyc hologists, sociologists, and physic ians), relevant experience,
knowledge and interest in th e specifics of the project.
Each team was assigned one county. The teams participated in a sp ecialized two-day training sessi on, before the data collection
activities were initiated. The training was intended to teach integrated skills for interpreting and
collecting data from medical records and from DJPDC documents, and skills in terms of
interview techniques with the mothers of children from the target group.
Data collection activities we re supervised by the memb ers of the technical group.
The collection of the quantitati ve data was carried out from August–September 2004, while that
of qualitative data from October–November 2004.

Data processing The data was processed with the use of the th e Statistical Package for the Social Sciences
(SPSS).

24RESULTS

Identification and description of th e various types of child abandonment
The methodology employed to meet the objective wa s based on the premise that all children
exposed to abandonment would be identified, regardless of its duration, but on condition that
records existed thereof.
Locations for searching/identif ying abandoned children were maternity wards, pediatric and
recovery hospitals/wards, and emergency child reception service centers . For each of these
locations the data sources and selection criteria by which abandoned children could be
delimited were defined. In order to identify und er-five children who were abandoned in the January–March periods of
2003 and 2004, investigators studied all observation charts of children in maternity wards,
hospitals/pediatric and recovery wards, located on the territory of countie s/sectors included in the
sample. For the identification of children abandone d in places other than medical institutions,
files were studied of children who were received by emergency reception service centers of the
DJPDCs/organized private bodies (OPA), during this same reference period.

CHAPTER 2 – CHILDREN ABAN DONED IN MATERNITY WARDS

The eligibility criteria used to select cases were the following:
– Newborn whose chart indicates “abandoned child”, “social cas e”, “runaway mother”, etc.;
– Newborn with normal birthweight (>2,500 g), who did not leave the mate rnity ward within
seven days, and is in hospital without his mother;
– Healthy newborn with normal bi rthweight (>2500 g), who is tr ansferred without his mother
to another pediatric/re covery hospital/ward;
– Newborn with low birthweight who, upon reachi ng normal weight, is not discharged and
continues to be in hospital without his mother;
– Newborn with non-life-threateni ng medical problems/malformations or disabilities, who can
be cared for at home, has not been claimed by the family, and is in hospital without his
mother.
The investigations resulted in the identification of 617 abandoned children , of which 322 in
2003 and 295 in 2004 .

The risk that any given abandoned child should not be selected was rather low owing to the fact
that, in addition to the respecting of selection criteria, investigators consulted both maternity
ward staff and social workers, wherever these existed. As a rule, records of children selected on the ba sis of the defined criteria included a notation
“runaway mother”, “abandoned child”, or “ab andonment – social case” on the unannounced
departure of the mother from the maternity ward.

25Figure 1: Notations on observation charts regarding abandonment (n=617)

There were also cases at several county matern ity wards where the depart ure of the mother was
in no way recorded on the child’s observa tion chart. In such cases investigators looked for
notations on the changes in the child’s nutrition (the introduction of formula due to the departure
of the mother).
2.1. The rate of child abandonment in maternity wards

The rate of child abandonment was calcu lated by dividing the total number of abandoned
children in the reference period by the to tal number of child ren born alive.

Total number of abandoned children in 2003: 322
Total born alive in 2003: 17,904 Total number of abandoned children in 2004: 295 Total born alive in 2004: 16,246

According to this calculation, the 2003 and 2004 child abandonment rates were 1.8.
The rate of child abandonment in maternity wards differs according to the size of the
cities/communities in wh ich these are operating. Table 1 shows the distribution of abandoned
children according to community size of the of maternity wards.

Table 1
% (n=617)
County capital 75.0
Municipality 12.6
Towns 8.4
Communes 3.9
14.6% 66.9% 6.8% 3.6%
0% 20% 40% 60% 80% 100% Abandoned child Runaway mother Child abandonment risk No information on the mother’s
departure

262.2. General features of children abandoned in maternity wards

Following the selection of observati on charts of the basis of define d criteria, information on the
newborn and his/her pa rents were extracted.

a) Health condition
The children’s health was monitored on the basis of several indicators.

Table 2
Child’s condition at birth % (n=601)
Normal health at birth 86
Requires intensive care 14

Observation charts record a dichotomous descrip tion of the child’s condition at birth: “normal
health at birth” and “requires intensive care”. In addition, 9% of the children were born with congenital malformations.

b) Birthweight
As shown also by other studies, birthweight is on e of the relevant determinants for abandoning a
child. In the study sample, a mere 66.6% of ch ildren were born with normal birthweight – 2,500
g and above. The percentage of low birthweight of children is 34% which is very warring
because for general population this percentage is a bout 9%. Also, the average weight at birth is
only 2,700 g, compared to 3,200 g, indicated by studies conducted on normal population.

Table 3 “A child with malformations is more fre quently abandoned, because the mother is ashamed,
fears being judged by society and the ch ild not being accepted by society.
Roma families no longer abandon their disabled children, because they can get money and
other.

There are insufficient institutions for children with disabilities. The law to go into effect as
of 1 January 2005 calls for emergency training for professional matern al assistants (AMP)
for newborns up to age two. While there are enough institu tions, there is insufficient specialized staff for disabled
children.”
Interviews with directors of DJPDC

27Birthweight % (n=617)
Up to 1,000 g 3.9
1,000-1,500 g 3.5
1,500-2,000 g 10.5
2,000-2,450 g 19.4
2,500 g and over 66.6

This increased prevalence of low birthweigh t children may be explained from several
perspectives. Specialized literatu re supports the idea that unwant ed children are born with a
lower weight than that considered normal at bi rth. The mother’s failure to avail herself of
prenatal services, adopt a proper diet and an adequate lifestyle for the benefit of the child’s
development may contribute to th is defect. The high percentage of low birthweight children
might suggest that their mothers neglect th em as early as the intra-uterine phase.

c) The Apgar1 score
Most of the babies had a good or very good score at birth. Some 87% of babies had an Apgar
score of 8 and higher. It is to be mentioned that these high scores are not incompatible with the
data on low birthweight, as the score represents the general hea lth of the child at birth. There is
no Apgar score recorded in the observation char ts of 16.4% of the child ren, although a “mere”
10.7% of these were born at home.

Table 4
The Apgar score % (n=516)
3 2%
4 1%
5 2%
6 3%

1 Apgar Score is a number from zero to ten representing the summ of evaluation scores of five clinical indicators
(coulor of teguments, breath, reflex of iritation, musle tonus and motility, heart pulse) and reflecting the quality of
new-born adaptation to extrauterine life.
“The risk of abandonment is higher for the prematur e baby, especially if the mother has other
children at home; mothers run away from hospita l, some returning afte r a certain period (2-3
weeks). In other cases, the child is abandoned by its mother who fears not being able to cope with a premature baby requiring special care. We have a 19.3% premature birth index – many old mothers give birth to premature babies.”

Interviews with neo- natologists physicians

287 5%
8 23%
9 53%
10 11%

d) The birthing method
Some 90% of the children were delivered by na tural childbirth, 9% were born by C-section, and
relevant information is missing for 1.8% of the births.
Figure 2: Birthing method (n=617)

e) Gender
The table below shows the distribution of childre n included in the study sample by gender. There
is a slight over-representation of boys in the st udy sample (50.9%). This may be attributable to
the vulnerability of the health of boys at birth si nce, as health has also been revealed by other
studies as constituting a reason for abandoning a child in Romania
2. Qualitative studies have also
given rise to other explanations . Several single mothers indicated that they would have taken the
child home if it had been a girl: “ I would have felt bad if she had experienced the kind of
difficulties I had. ”

Table 5
The child’s gender % (n=617)
Male 50.9%
Female 49.1%
f) Parity (rank)
The table below shows that almost half of the chil dren in the study sample are ranked 1 or 2. It is
worth pointing out that in 5.2% of cases the ob servation chart contained no information on such
rank.

Table 6

2 Infant Mortality in Romania, Ministry of Health, 2002, page 7.
89,3%
8,9%
1,8%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
normal C-section unknown

29The child’s rank % (n=585)
rank 1 34%
rank 2 18%
rank 3 17%
rank 4 12%
rank 5 6%
Above rank 5 13%

Despite the assumption that Romania families w ith many children tend to abandonment their
children, this study shows that more than 50% of families which are abandon babies are the ones
with one and two babies (rank 1 and rank 2, 52%).

e) Models of care
Early bonds between mother and child are impor tant to discourage in tentions of child
abandonment. As such, it was inte resting to look for the models of care these children enjoyed
after birth. Figure 3 shows that only 13.6% of the children benefite d from the rooming-in
system.

Figure 3: Child benefiting from different models of care (n=617)

f) Breastfeeding
A mere 38.4% of children were breastfed by thei r mothers till they were abandoned (Figure 4)
and unfortunately, info from medical charts do not contain information with regards to the reason
for which breastfeeding was not occurring.
66.8%
13.6% 19.6%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Traditional system Rooming-in system Unknown
system The rooming-in system is very useful for preventing abandonment, as close bonding between
the mother and child is promoted from th e very first moments of the child’s life.
Interview with neo-natologists physicians

30
Figure 4: Was the child breastfed? (n=617)

g) Identity of the child
Respect for the right of identity begins with the recording of the child’s birth, which
subsequently leads to the issuing of its birth cer tificate. The existence of the birth certificate is
confirmed by the child’s personal numeric code (CNP) which, in for the selected cases, was
recorded on only 36% of observation charts, meani ng that same number of these children also
had birth certificates (Figure 5). This is a very serious matter, because without a birth certificate a person “does not exist.” There
was needed also to look for other sources to ensu re that the information is correct. As such, the
teams of investigators made inquiries at the birth registration office within the Maternity Wards
to ascertain whether ce rtificates acknowledging their birth had been issued for the selected
children, and to whom these certif icates were issued (Figure 6).
The information obtained confirmed that 36% of children had a birth certif icate. The Department
for Child Protection (DPC) undertook the necessary steps to obtain identity documents for a
further 21% of children, while for the remaining 43% of children such steps were not started.

Figure 5: Was a numeric personal code (CNP) record ed on the child’s observation chart?
n=617
38.4% 47.0%
14.6%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Yes No No information “We suspect that a mother who avoids breastfe eding her child or does not show up for all the
scheduled breastfeeding sessi ons is planning to abandon her chil d. In any case, mothers who
want to desert their child neither hold nor demonstrate any joy about the child. The physician
who assists the mother at birth should insist that she sees her child immediately at birth.”

Neo-natologist physicians

31

Figure 6: To whom was the certifi cate acknowledging the birth issued? (n=617)

nu s-a eliberat
43%
autoritatilor cf.
Legii 119/1996
21%parintiilor 36%

2.3 . General features of pa rents of the children aba ndoned in maternity wards

Information on the parents is important to id entify a child. The observation charts contained
limited information on the parents, and more data referred to the mothers than to fathers. The
lack of information was due, to a greater extent, to the negligence with which these charts were filled in.
a) Age of the mother
Observation charts indicated that most mother s who had abandoned their children in Maternity
Wards were under age 20 at the ti me the child was born (29%), fo llowed closely by those aged
20–24 years (Figure 7), while the average age was 22. Health care system professionals associate
child abandonment with teenag e mothers, aged 14-15, or very young. This perception was only
partially confirmed in the study. It is to be mentioned that some 8% of observation charts
indicated no age for the mother.
Yes
36%
No
64%

32Figure 7: Age of the mother (n=570)

b) The mother’s residence
Knowing where the mother lives and having her exact address is essential information to be able
to contact the mother/parents of the child. In the study, the residence was recorded in 85.1% of
cases.

c) The mother’s marital status
Information on the marital status of only 83.6% of the mothers who have abandoned their
children was available; such information was unav ailable for the remainder of mothers. Table 7
presents the distribution of mother s by marital status. The high percentage of 63% single mothers
is significant. It is possible th at this figure includes mothers who live in consensual union, and
did not properly declare their stat us on entering the hospital. Anothe r issue is that many mothers,
who were part of a union before getting pregnant , are left by their partners when they find out
about the pregnancy or about the time of the child’s birth.

Table 7
The mother’s marital status % n=516
Married 18.2%
Consensual union 17.6%
Divorced/separated 0.7%
Widowed 0.3%
Single (unmarried) 63.9%
d) The mother’s occupation
This is recorded in only 85.7% of cases. Only 5.8% of mothers are employed, 3.8% of these are
high school or university student s, and 90.4% of them are eith er housewives or unemployed.
(Table 8 ).

1.7% 27.3% 28.0%
19.0% 16.0%
7.0%
1.0%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
under 15 yrs. 15-19 yrs. 20-24 yrs. 25-29 yrs. 30-34 yrs. 35-40 yrs. over 40

33
Table 8
The mother’s occupation % n=529
Employed 6.6%
Housewife 56.1%
Unemployed 0.3%
Retired 0.9%
No occupation 31.0%
High school/university student 4.3%
Other 0.8%
e) Father of the child
Almost half of the observation charts do not contai n any information about the child’s father. On
charts containing this inform ation, there was found that a mere 34% of children were
acknowledged by their fathers.

2.4. Information on the request of child protection measures

A child who has been abandoned in a Maternity Ward is a case of extreme urgency from the
moment it is deserted, and the child protection services must take immediate action. The most
recent regulations attribute the responsibility of Maternity Ward staff to the heads of wards and
social workers to prevent a prolonged stay of the ch ild in that ward. The firs t step is to notify the
child protection services within 24 hours of ascertaining that the child has been abandoned.
According to the Joint Ordinan ce of the Minister of Health and the State Secretary for the
National Authority for Child Prot ection on the prevention of situat ions of children in difficulty,
the head physician of the ward is responsible for immediatel y notification and reporting in
writing to the specialized public child protection se rvice. This enables th e service to decide on
the placement measure within 24 hours in the event the child was deserted in the Maternity Ward
by his mother, provided the new born qualifies for hospital discharg e from a medical standpoint.
Although almost all children identified fell into this category, few observation charts contained
any record of requests by the mother or person s responsible for the Maternity Ward for child
protection measures. “Abandonment is more common among women who do not have a job, especi ally in the case
of single mothers.” “Some mothers who have abandoned their children ar e high school or university students. In
these cases, the causes for abandonment are the psycho-emotional immaturity of the mother,
pressure from the family who does not accept th e child, and the mother’s wish to continue her
studies without the respons ibility of a child.”
Obstetrician/gynecologist

34Table 9
Requests for protection measure %
The mother requests a protection measure (n=617)
8.9%
The Maternity Ward notifies the DPC to enforce a protection measure (n=617)
10.5%

Furthermore, instructions/decisions by DJPDC were found in 13% of the observation charts
studied, based on reported cases of child abandonment.

2.5. Duration of the stay of children in Maternity Ward

When analyzing the duration of the stay in the Maternity Ward , the study took into account cases
which involve children without a mo ther and/or justified medical di agnosis; this duration is also
one of the criteria for selecti ng children in the study sample.
As can be seen from this data, the duration of the stay continues to be significant; thus, 46% of
children selected in 2003 and 39% of children selected in 2004 spend more than 20 days in the
Maternity Ward. Also, almost a third of the children in 2003 and a quarter in 2004
“unjustifiably” spent more than one month in the Maternity Ward.
The ratio of children who stayed for a few days (4-5) in the Maternity Ward without their mother
and with no medical justification rose by some 5% in 2004, as co mpared to the same period in
2003.

Table 10
How many days did the child spend in the Maternity Ward? Year 2003 Year 2004
4-5 days 14% 18.6%
5-10 days 17.4% 16.9%
10-20 days 21.4% 24.2%
20-30 days 19.3% 15.4%
Over 1 month 27.9% 24.8%
Total 100% 100%

Such progress, while modest, might be linked to the regulation that Maternity Wards have a
social worker or another person assigned to carry out certain duties to shorten the duration of the
stay of children in the Maternity Ward.
“Abandoned children spend a lot of time in the Maternity Ward, first due to human
considerations, to give mothers the chance to revise their decision to abandon their children.
Then there are administrative considerations resulting from the birth recording and preparation
procedures for the child to be taken over by th e DPC. In many cases, there are also medical
considerations.”
Physician, OB-GYN Clinic and Maternity Ward

35
“Not always there is chance for integration with the biological or extended family; many of the
children have psycho-locomotor deficiencies which require care in a specialized institution.”
Deputy Director, DPDC

2.6. Discharge from the Maternity Ward

Where did the children go after being di scharged from the Maternity Ward?
Overall, such information was available only in the case of 88.9% of th e selected children,
because in 11.1% of cases this data, which is be lieved to be very important, is missing from the
observation charts of the childre n from the Maternity Wards.
Possible destinations for the children are: a) Home, with their biological parents or one of these;
b) Transfer to a Pediatric/Recovery ward; c) Placement Center ; d) Foster parent ; e) Placement or entrustment with a family with a view towards adoption; f) Maternal Center.

Figure 8: Where did the child go after being di scharged from the Maternity Ward?
by reference years: 2003 n= 294, 2004 n= 255

a) Home with the biological family
The information collected indicated that 39% of children were “integrated” into the family in
2003, directly from the Maternity Ward. This percentage increased to 46% in 2004. Therefore,
the percentage of children integrated into th e family in 2004 was higher by 7% than in 2003
(Figure 8). The word “integrated” is in quotes , because most of the children are “delivered”
home to their parents with no previo us preparation for such integration. 39%46%33%27%3% 4% 7% 6% 16%13%2% 4%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Home Recovery/Pediatric WardMaternal Center Foster parent Placement Cente r To a famil y
entrustment/placement/adoption
2003 2004

36
The collected data indicated that “integration” is not always pr eceded by an evaluation of the
situation, as stipulated by law. Many of the children are taken directly by ambulance to the door
of the house where the mother resides, a few da ys after birth, sometimes in the company of a
social worker. The very notion of integration is improper in such cases. With regard to the discharge of these children directly to the fa mily, investigators noted that most cases are
exclusively solved by the Maternit y Ward staff, sometimes also by the social worker, but without
notifying the child protection depa rtment. It us unknown whether th ese children are subsequently
monitored by the various protecti on institutions or by the family physician, especially since most
of them do not have any identity documents. The Joint Ordinance of the Ministry of Health and
the National Authority for Child Protection and Adoption of 28 July 2003 stipulates that within
48 hours the County Child Rights Protection Department should be notified about the above-
mentioned cases of children in Maternity Wards. The study of observation charts reveals that
DJPDC was notified of only 10.5% of the cases.

“Several years ago this is what I used to do as well. I would take the children by ambulance to
their mothers, who usually protested our “leavi ng” the children, and then we would rush away
for fear that she would give him back to us. In time, we understood that th is was not a solution,
because the mother would bring the child ba ck to the Pediatric Ward and would (re)abandon it
there. A few months would pass until a protecti on measure was taken. We had to assist in the
issuing of identity documents for most of the child ren, so that they could be placed in the care of
the child protection services. After the closure of shelters/Placement Centers for small children,
there were very limited places for such childre n, and we would keep them in the pediatric or
recovery wards.”
Social Worker

It was also found that taking the children to the mothers is often a process which involves
negotiations and threats. This take s place in the presence of the ot her children in the family and
the respective baby is perceive d as an object that can be given, taken or refused.
Because of the way they are transported and handle d, and wrapped in diapers so that their little
hands and feet are not visible, the image is far from that of a child. The staff transporting these
babies from the Maternity Wards to the homes of th eir mothers refers to them as “little loaves of
bread.”
b) Transfer to pediatric and recovery wards
It is known that, in many counties, and especially in Bucharest, Pediatri c Wards and particularly
recovery wards take on the children who have been abandone d in Maternity Wards, until such
time as a protection solution can be identified.

37It was noted that in 2003, the percentage of abandoned children who were transferred from
Maternity Wards to pedi atric/recovery wards was 27.5%, and 33.5% in 2004, up by 6%.
Placement centers for children below the age of 3 have been closed down in many counties, to prevent the serious consequences of institutional protection at a very young age. This process has
been progressively intensified. The reward for closing down such institutions came from intensified efforts to integrate children into their fa mily and to create a network of foster parents.
Demand cannot be met for want of foster parents, and as such pediatric/recovery wards become
the “intermediate stops” for children who have b een discharged from Maternity Wards, until
such time as a new slot becomes available or is created within the protection system. This also
explains the increase of tran sfers to pediatric and recovery wards in 2004. The fact that
residential institutions for very young children have been replaced with pediatric/recovery wards,
is considered a step backwards, because these are even worse than the shelters. This anomaly is confirmed by the fact that there are no beds fo r mothers in recovery wards (as is the case in
Pediatric Wards), so the destination of such children is very clear ( Box 3 ).

“Why are they left in hospital without any protection measure?
The Director of Child Protection Services told us he has nowhere to place them. There are no
more shelters, and foster parents do not want to take on dystrophic children. Look at him, he
weighs just 3 kilogr ams at 6 months.
Do you think their development would be better if someone were to hold and love them?
Certainly. The poor things cry all day and even all night. We have already become used to this
and no longer hear them.
Have the parents ever come?
Yes, some Gypsy parents have come, but they don’t want to take them hom e because they don’t
like how the child look.”
Di scussion between a field inves tigator and a pediatrician

c) Discharge to Placement Centers
In spite of pressures to avoid placing under-three children in residential protection institutions,
this has not been fully observed. The percentage of children who are discharged from Maternity
Wards directly into Placement Centers is still quite high, name ly 13% in 2003 and 16% in
2004.

d) Discharge to a foster parent
A small percentage of children go directly to a foster parent , 7% in 2003 and 6% in 2004. In
some counties the protection services and fo ster parents have re servations about the
placement/reception of children who are only a few days old. “Children who have been abandoned in Maternity Wards are taken over by the Department of Child Protection if they have identity documents, and they end up in pr otection institutions.
Those without identity documents are taken over two weeks to one month later, by the
Pediatric Ward, where they may stay until they are 3 years old. There are special rooms for
abandoned children in some Maternity Wards, where they stay for months until their identity
documents are issued, and they are taken over by a protection institution.”
Physician

38
e) Placement with families
A very small percentage of children, 2% in 2003 and 4% in 2004 were placed with families ,
sometimes in view of adoption. As of 2005, when Law 272/21.06.2004 goes into effect, this
protection measure and that of placement with a foster parent will become the only ones possible for neglected and abandoned children under the age of 2.

f) Maternal Center
Some 3% and 4% of children were placed in Ma ternal Centers with their mothers in 2003 and
2004, respectively. The destination of the child is also depending on the following factors: identity documents,
duration of stay in maternity, mothers appeal for a child protection measure, heath of the child.

2.6.1. Destination of the child at the time of discharge, depending on the existence of
identity documents?
Because a large number of children did not have a ny identity documents at the time of discharge,
their destination was identified after discharge based on this criterion. Most children without
birth certificates went to their biological fam ilies (45.3%). There is real danger in discharging a
child without identity documents, as they can be sold, trafficked, neglected and, in extreme
situations, killed, without any such act being legally reported. It should be underlined these
dangers, as there were no available informati on on children who were transferred to their
families, and because the DJPDCs and family phys icians were not notified about this transfer.

Table 11
Where did the child
go after discharge Has a birth certificate
% (n=161) Has no birth certificate
% (n=252)
To the family 37.9 45.3
To the Pediatric/Recovery ward 25.4 28.9
To a Maternal Center 5.1 3.5
To a foster parent 8.1 5.5
To a Placement Center 19.8 14.6
Placed with a family 3.7 1.5
Placed in view of adoption ____ 0.7

2.6.2. Destination of children at the time of discha rge, according to the duration of stay in a
Maternity Ward

It was noticed that most children end up with th eir biological families, provided their stay in
Maternity Wards does not exceed 1 month, and depending on the first destination following discharge. However, there is a slight drop in th e percentage of children who go to their families
based on the length of their stay in Maternity Wa rds. In the case of periods extending beyond 1
month, the situation changes, as most of thos e children are discharged to Placement Centers.

39Table 12
Days in the
Maternity
Ward Biological
Family Pediatric/
Recovery
ward Maternal
Center Professional
foster
parent Placement
Center Placement
with a
family Placement
in view of
adoption
4-5 days
(n=81) 56.7% 37.1% 1.2% 2.6% 1.2% –- 1.2%
5-10 days
(n=81) 59.2% 23.4% 7.5% 3.7% 4.9% 1.3% –
10-20 days
(n=99) 46.3% 31.3% 1.1% 3.1% 17.1% 1.1% –
20-30 days
(n=84) 39.2% 26.3% 3.6% 9.6% 15.4% 4.7% 1.2%
1 month
(n=26) 34.6% 23.1% 7.6% 3.9% 26.9% 3.9% –
Over 1 month
(n=97) 23.7% 24.7% 5.2% 13.2% 28.9% 4.1% –

2.6.3. Destination of children at the time of di scharge if their mothers appeal for a child
protection measure

The most frequent destination of children whose mothers appeal for a child protection measure is
a maternal center, followed by a Placement Center.
Table 13
Destination of children % (n=30)
To the family 13.3
To the pediatric/recovery ward 3.3
To a maternal center 30.1
To a foster parent 13.3
To a Placement Center 20.1
Entrustment/placement to a family 13.3
Entrustment in view of adoption 6.6

2.6.4. Where did the children with health problems go when discharged?
As determined from the records, at the time of discharge, some 83% of the children were healthy
and 14.4% were reported as having a variety of health problems.

Figure 9: The child’s health at the time of discharge (n=617)

40
Children with health problems were most often tr ansferred to pediatric/ recovery wards. Over
10% joined their biological family and some 7% were absorbed into the child protection system.

Table 14
Where did children with health problems go
when discharged from the Maternity Ward? % (n=67)
To the family 16.4
To the Recovery/Pediatric ward 74.8
To a foster parent 5.9
To a Placement Center 2.9

Some 1.6% of abandoned children di ed in maternity/newborn wards.

Figure10: Did the child die? (n=617)

83.0%14.4%2.6%
0% 20% 40% 60% 80% 100%Healthy Has health
problemsNo information
available
1.6%
No
98.4% Yes “Medical practices in some hospitals may s timulate child abandonment. It is possible that
pediatricians encourage the abandonment of th e child by frequently hospitalizing young
children without their mothers, or even by advocating hospitalization in cases which do not
require such a measure (bas ed on the child’s health).”
Pediatrician

41
2.7. Aspects relating to the organizatio n and operation of Maternity Wards

The study includes 70 Maternity Wards, opera ting in county capitals, cities, towns and
communes, as follows:

Table 15
% (n=70)
County capitals 18.6
Municipality/town 80.0
Commune 1.4

Information was collected from the Directors of the medical institutions visited during the study
and from the heads of Mate rnity and Pediatric Wards.
The information focused on the organization and ope ration of Maternity Wards, as it is believed
this may influence the child abandonment phenome non. Some of this refers to the organization
of the Maternity Wards in the rooming-in system. Figure 11 presents the organization of
newborn wards in the 70 institutions that we re included in the study. Thus, 27% are organized
according to the rooming-in system, 42.9% according to the traditional system and 30% have a dual system.
Figure 11: In what kind of system is the newborn ward organized? (n=70)

Discussions with newborn ward st aff demonstrated that the rooming-in system is not sufficiently
known, and that the idea that it might contribute si gnificantly to discouraging child abandonment
is not accepted.
27%43%
30%
0% 20% 40% 60% 80% 100%
rooming-in traditional mixed

42In many Maternity Wards that are organized acco rding to a mixed system, mothers at risk of
abandoning their children are hospitalized, particularly in th e traditional section, where the
separation of the mother and child is mo re pronounced because of continuous physical
distancing. In such a system, the child is “given” to mother pe riodically and for a very short
period of time, only for breastfeeding. There are many Maternity Wards in which newborns and
their mothers are kept on different floors.
“I had a baby in this Maternity Ward 26 years ago. I cannot believe that in such an important
city, where so many children have died in mate rnity/newborn wards, th ere is no rooming-in
system. In this hospital, the baby, tightly wrapped in diapers, is given to the mother in a ward
three floors down from that of the newborns, only to allow strictly scheduled breastfeeding, as
was the case 50 years ago”.
Story told by a field investigator

Some staff monitor the risk of child abandonment to promote the advantages of the rooming-in
system, and discourage the mother from resorting to abandonment.

Another interesting aspect is the observance of the Joint Ordinance of the Minister of Health and
the National Authority for Child Protection and Adoption dated 28 July 2003. The ordinance
stipulates that it is compulsory to notify, in writing and within 48 hours from the child’s birth,
the family physician whose patient list includes the mother, in order that the newborn may be
included on this same list. The ordinance further stipulates th at the County Health Insurance
Office and City Hall must be notified in the ca se of a child born by a mother who is not on a
family physician list, so that the child can be in cluded on such a list. The heads of the Maternity
Wards indicated that only 67.1% of the institutions included in the study notify the family physician at the time the child is di scharged from the Maternity Ward.

Table 16
Has the departure of the children in the field
been reported to the family physician?
%
Yes 67.1 “The mothers make up their minds early on in thei r pregnancy, deciding to leave their child
in the Maternity Ward , although not necessarily intending to abandon it… because many of
them leave convinced that they will return fo r taking the child, but then they just forget to
come back.”
Neonatologist physician
“We have organized the rooming-in system espe cially for mothers at risk of abandoning their
children. Although we are unable to organize a rooming-in system, we have set up something intermediary, namely a room for children between two wards for mothers. The children’s room has large windows to allow mothers to see their children at all ti mes, and the latter are
cared for by both the mothers and the Maternity Ward staff.”
Neo-natologist physician

43No 32.9

“The mothers go home with a newborn baby in a ll kinds of weather and sometimes without any
money. These are mothers we have identified as being at risk for abandoning their children, and
whom we have managed to get to reconsider le aving their children in the Maternity Ward.
How do they get home?
By bus, this only comes once a day. Our county is mostly rural, and many villages are located
dozens of kilometers from us. Travel is very diff icult as the roads are in a precarious condition.
How do you know that the mother will no t leave the child out on the street?
We don’t. There is no one we can notify about the child’s arrival. In many communities there is
no family physician or te lephone system, while in others, a ph ysician visits only once or twice a
week because (s)he is not a local reside nt. You probably find that hard to believe.
Do you discharge them even without a birth certificate?
Mostly we don’t. We explain to the mothers t hat without any identity documents they cannot
receive any allowances or additio nal assistance for the child.”

County hospital social worker

Of the 70 Maternity Wards included in the study, only 45.7% had a social worker or an
individual responsible for such duties, even though the above-mentione d Ordinance stipulates
that it is compulsory to employ a social worker or a person with similar responsibilities in all
Maternity Ward. Some 47% of currently em ployed personnel were hos pital employees, 31%
were employees of the County Child Rights Pr otection Department (DJPDC) and 22% were
employees of non-government al organizations (NGO).

Figure 12: The social worker is (n=32)

More than half of the Maternity Ward social workers have a university degree, 38% have post-
secondary non-tertiary degrees , 6% have undergone some trai ning courses, and 3% have no
specialized qualifications in this field.

Figure 13 : Education of the social worker (n=32) Hospital
employee
47%
DJPDC
employee
22% NGO employee
31%

44
Even though the work of social workers require s a distinctive space, only 55% of Maternity
Wards have set up such an area. The ability of social workers to prevent child abandonment or
decrease stay of a child in medical institutions is not always best used. In most Maternity Wards the social worker is notified about an abandone d child by the ward staff without having “his
own” right to identify child abandonment cases. So me of them informed us that they are not
notified immediately after a mother runs away, and at times they are forced to take the child
home by ambulance to make room in the ward. In the selected counties there are also comm unity nurses who have an important role in
managing the cases of families and children in difficulty. According to the statements of the
Directors and heads of wards, only 44% of community nurses are notified by the Maternity
Wards in the counties where such a network of community nurses exists.

“There are no laws to prevent child abandonment or to compel Maternity Wards to get involved
in the prevention of abandonment. Nevertheless, we are sensitive to child abandonment. We
must provide conditions which discourage mothers from deserting their children. Despite the
lack of legislation in this area, we take care of mothers who are at risk of abandoning their
children, looking for solutions an d answers to their problems. We tend to keep the children
longer in cases where the mothers claim to lack conditions for caring for the children, help them
record their children with the population records office, and offer solutions for children to be
cared for in the child protection system. Recently, we initiated two child abandonment
prevention programs. We have accepted several N GO professionals into our institution, who are
working to bring down the number of abandone d children. While resu lts are good, they are
insufficient”.
Physician – OB GYN clinic and Maternity Ward

“Current child protection legisl ation is not explicit about the way in which we should act to
prevent child abandonment in medical institutions. We initially involved ourselves in child
abandonment prevention or order to decrease the number of young, institutionalized children.
The legislation does not include any responsibilit y for our institution in terms of ‘mother and
child’ care practices. However, we became directly or indirectly involved in training programs
for Maternity Ward and pediatric hospital staff to ensure greater efficiency in child
abandonment prevention. We never miss an opportunity in our contacts with medical staff to
discuss bonding, fostering the rela tionship of mother and child, fa mily care of the child, and
other such issues.”
Director DJPDC
University
degree
53%college/post-secondary
non-tertiary
38% Training
courses
6% No qualification in the
respective field
3%

45
CHAPTER 3 – CHILDREN ABANDONED IN HOSPITALS/PEDIATRIC
AND RECOVERY WARDS

The following criteria were used for the selectio n of cases from Pediatric and Recovery Wards:
– Children who have been transferred directly fr om the Maternity Ward, without their mothers
and/or who are not visited by their legal guardians;
– Children under age five, in hospital without th eir mothers and a justif ied medical diagnosis;
– Children under five, who are in pediatric hospita ls/wards without their mothers and a justified
medical diagnosis.
– Children who have been transferred dir ectly from Maternity Wards, pediatric
hospitals/wards, without their mothers and/or who are not visited by their mothers/legal
guardians;
– Children under five, who are in hospital without their mothers/le gal guardians, are not visited
by these, and are in such an institution without a ju stified medical diagnosis.
The investigations indicated a total of 986 children , of which 508 in 2003 and 478 in 2004 .
The observation charts of children who have been selected from hospitals/pediatric and recovery
wards included notations such as: social case, abandoned child, runaway mother, child
abandonment risk, temporarily deserted by the mother .

Figure 14: Notes concerning abandonment on the child’s observation chart (n=986)

Unlike the Maternity War d, where the risk of missing a child for the study sample was rather
limited, in pediatric and recovery wards such risk was highly pr obable. As such, there were
included in the selection criteria children who were repeatedly hos pitalized for short periods of
time, many of whom were hospi talized and discharged on the sa me day (a practice “agreed
upon” with the health insurance office to ensure th at a certain number of hospitalization days are
not exceeded), with no justified medical diagnosis. Investigators had to monitor the child’s identity in order not avoid including the same child in the
study more than once, which would have led to an artificial incr ease in the rate of abandoned
children. A single chart 2 was filled out for any child hospitalized more than once.

15.0% 4.9% 4.7% 43.4% 32.0%
0% 20% 40% 60% 80% 100% Abandoned childRunaway mothe rAbandonment risk Temporarily abandoned
by the mothe rSocial case/
repeated hospitalization

46In some counties, if parents earn only a mi nimum guaranteed income the child’s observation
chart contains a “social case” notation, and such child ren were selected only if they also met the
remaining selection criteria. Investigator indicated that it was sometimes difficult to decide whether a child qualified for the
selection criteria, mostly because some hospitals cover up case s of child abandonment claiming
palliative or borderline treatment for a sick or healthy child.
Some counties use recovery wards as genuine so cial protection services for healthy children
under the ages of 2-3, without reporting such cases to the specialized ch ild protection services.

Staff working in these wards justifies such an anomaly by claiming that parents who request that
their children be admitted to recovery wards do not have proper conditions to raise them safely
while these are still very young. Th e children mostly stay in hospi tal for several months, with
very rare visits from the parents, or they ar e taken home for short periods of time. Discussions
with County Child Protection Services represen tatives revealed that they believe such a
compromise to be the best alternative, because limiting access to such services would determine
the parents to take their child ren home, and expose them to even greater health risks.
“Dystrophic recovery wards take in children shor tly after their discharge from Maternity
Wards, due to low birth-weight and/or slow ev olution of recovery of weight gain at home.
Children remain in these wards for several m onths, without being in adequate contact with
their families. Parents enquire about the childr en by telephone, sometimes taken them home
for a week, and then re-hospitalize them for a month. According to the regulations, these
children are not considered abandoned/deserted, but recovery wards are medical institutions,
with medical staff and spaces de signated for providing health care similar to those in a
hospital. As such, the hospita lization syndrome result s in major changes in both the physical
and mental development of these children. This has been researched since 1939 by R. Spitz
and was further documented in the latter decades of the 20th century by numerous specialists.
Such situations were also reported by the inves tigators involved in this study. During one of
our meetings with DJPDC staff, we raised the question of children subject to abuse and
neglect as a result of emotional deficiency. While this was a well-know n situation, no action
was taken as no report had been made to the Child Protection Commission, the only
institution authorized to decide on th e need for a child protection measure.
Some Commissions do not even have a single me dical system representative among their
members. Children who have spent long periods in pediatric hospitals are subject to similar situations.
There were no social workers in any of these in stitutions to intervene on behalf of the child’s
best interest .Self-inqui ry not a practice. ”
Observations on the field
by a psychologist

47
3.1. The rate of child abandonment in hospitals, pediatric/recovery wards

The average rate of child abandonment in pe diatric medical institutions was calculated by
reporting the number of abandon children to the to tal number of children entries in the hospital.

Total number of abandoned children in 2003: 508
Total number of hospitalizations in 2003: 33,411 Total number of abandoned children in 2004: 478
Total number of hospitalizations in 2004: 33,354

The 2003 rate was 1.5%, while that in 2004 was 1.4%, with limits ranging between 0.2% and
3.7% in 2003 and 0.1% and 4% in 2004. This is the minimum value, sinc e a child was counted only once, regardless of the number of
hospitalizations. Note: if the study had included 230 children previously reported in the total number of children
recorded in 2004, the rate of child abandonment would have been higher (2.1%).
As in the case of Maternity Wards, the highest percentage of abandone d children comes from
hospitals and Pediatric Ward s operating in large cities.
More than half, i.e. 55.7% of th e children in the sample, come from hospitals located in county
capitals, 24.1% from municipalities, 14.3% from cities and 5.9% from villages.

Table 17
% (n=986)
County capital 55.7
Municipality 24.1
Town 14.3
Commune 5.9

3.2. Circumstances leading to the hospitalizatio n of children in Pediatric Wards/hospitals
“Such a situation was reported in a recovery ward where there were over 230 children under the age of one, obviously without their moth ers. The children had been brought by their
mothers who claimed they did not have proper conditions to raise them at home (other older children). These mothers did not inform Child Protection Services so as not to lose the
allowance allocated for the child (in case a protection measure was implemented). The
medical staff sincerely believed that what they were doing was in the best interest of the child. They never thought that keeping the children for m onths in beds in white wards, day in and
day out, could be cause psychological damage. Such children, whom we considered to be border line, were not included in the category of
abandoned children, because there was some uncertain ty about whether or not they should be
included in our study.”
Observa ții pe teren ale unui psiholog

48After selecting the observation charts based on the above-men tioned criteria, information on
children abandoned in these institu tions and on their parents was extracted. The data processing
led provided data on circumstances of hospita lization and characteri stics of the abandoned
children.

Who brought the child in for hospitalization?
46.9% of the children were brough t in by their parents, 41.1% by an ambulance, 7.3% by other
persons, 4.5% by representatives of the DJPDC, and 0.2% by the police. This information
illustrates that more than half of the children came from their families.

Table 18
Who brought in the child? % (n=986)
The mother 31.0
The father 2.4
Another member of the family 3.9
Strangers 0.9
DPDC representatives 3.1
The Police 0.2
The ambulance 29.3
Neighbors 0.4
Transfer from the Maternity Ward 23.3
No information available 5.4
Most of them were probably sick because they were hospitalized either as emergency cases
(42%) or they had a written recommendation from a physician (28.2%). Some 21.7% of the
children were hospitalized as a result of an inte r-hospital transfer. Info rmation is missing on the
person/institution who hos pitalized 28.7% of th e children (Table 19).

Table 19
Type of hospitalization % (n=986)
Emergency 42.1
Recommendation from family physician 20.2
Recommendation from ambulat ory specialist physician 8.0 “Mothers who intend to abandon thei r children refuse to be hosp italized with them, invoking
family responsibilities, the exist ence of other children who need to be taken care of at home,
and the need to earn money in this period. These mothers are either negligent, or they do this on purpose, but they never have any
identity documents with them. They are poorly dressed and have precarious hygiene.
We noticed that mothers who intend to abando n their children show up at the Emergency
Room with no written physician’s recommendati on, and their children usually in critical
medical condition.”
Pediatric Physician

49Inter-hospital transfer 21.7
Upon request of the family 3.8
Other 4.3

43.5% of the cases that come reco mmended by a physician include the “social case” notation.
The fact that 89% of th e children had a medical diagnosis at the time of hosp italization and 11%
were hospitalized with no medical diagnosis confirms children with exclusively social problems
can be hospitalized in pediatric/recovery hospitals ( Table 20 ). This is all the more obvious since
over 40% of them also had a “socia l case” notation on their recommendation.

Table 20
Reason why the child was brought in? % (n=986)
Medical diagnosis 89.0
Abused/mistreated by parents 1.2
Neglected by parents 1.3
Left at home without supervision 0.5
Left in a public place 1.0
Abandoned in the Maternity Ward 7.0

General characteristics of children who have been selected in the pediatric/recovery ward
3.3. General features of children abandoned in hospitals, pediatric/recovery wards

a) Birthweight – it is to be pointed out that this information is missing in the case of 41.3% of
the observation charts studied. Th e percentage of low birthweight children is 34.2%, a value
extremely close to that of childre n abandoned in Maternity Wards.

Table 21
Birth weight % (n=578)
Under 2,500 g. 34.2
Over 2,500 g. 63.8

b) Congenital malformations
8.8% of the children have congenital malformations.

Table 22
Does the child have any congenital malformations? % (n=986)
Yes 8.8
No 90.3
Not recorded on file 0.9

50
c) The children’s age
Table 23 presents the distribution of the children se lected by age groups. Most of the children are
aged 13-24 months, followed by children under 12 months. The number of abandoned children
decreases as the age increases.

Table 23
Age % (n=986)
Up to 12 months 24.3
13-24 months 40.6
25-36 months 18.6
37-48 months 11.3
49-59 months 5.2

d) Gender
51.8% of the children are boys, and 48.2% are girls. It ca n be noticed the same over-
representation of male childre n, as in the case of the Maternity Wards (Table 24).

Table 24
The child’s gender % (n=332)
Male 51.8
Female 48.2
e) Parity (rank)
Over 50% of the children are ra nked 1 and 2. It is worth pointi ng out that in 27.7% of the cases
the child’s rank is not record ed in the observation charts.

Table 25
The child’s rank % (n=714)
rank 1 27.5
rank 2 24
rank 3 17.6
rank 4 11.3
rank 5 and higher 19.6
f) The residential environment
50.1% of the children reside in urban areas, while 49.9% are in rural areas. There is no
information available for 4.3% of the children.
e) The child’s identity
Almost one third of the children identified in the sample do not have birth certificates.

51Table 26
Does the child have a birth certificate? % (n=986)
Yes 68.2
No 31.8

3.4. General features of parents of the childre n abandoned in hospitals, pediatric/recovery
wards

The data which presented on the parents is merely informative, since for some 40% of the cases
there are none information recorded in the ch ildren’s observation charts. The name of the
mother is recorded in only 78.9% of the cases.

Table 27
Is the mother’s name recorded on file? % (n=986)
Yes 78.9
No 21.1

a) The mother’s age
Regarding the age, it was observed that almost one fourth of the mothers are under 20 years of
age. Compared to mothers who abandon their child ren in Maternity Wards, the percentage of
mothers under 20 is smaller. There is a lack of information regarding the mothe r’s age in the case of on e fourth of the mothers
of children identified in the study.

Table 28
Mother’s age % (n=723)
Under 20 24.3
20-24 29.4
25-29 20.4
30-34 17.2
35-40 7.0
Over 40 1.7
b) Marital status
With regard to marital status, over half of the mothers are married or live in consensual unions
(Table 29 ). As compared to the mothers in the Ma ternity Wards, the percentage of mothers
living in stable and unstable consensual unions is much higher, namely over 50%.
Such information is recorded in only 57.8% of the cases.

Table 29
Marital status % (n=587)
Married 24.3
Consensual union 29.4

52Divorced/separated 20.4
Widowed 17.2
Single (unmarried) 7.0

c) The mother’s occupation
Over 90% of mothers have no occupation (they ar e unemployed). Information is available on in
58.7% of the cases.

Table 30
Mother’s occupation % (n=579)
Employed 5.0
Housewife 49.1
Unemployed 0.5
Retired 0.5
No occupation 44.5
High school/university student 0.5
Prostitution 0.6
d) Residence recorded
The mother’s residence is recorded in 90.6% of the studied cases.

Table 31
Is the residence recorded in file? % (n=986)
Yes 90.6
No 9.4

e) Information on the father
Almost 40% of the observation charts cont ained no information on the child’s father.

Table 32
Is there any information on the father recorded on file? % (n=986)
Yes 60.6
No 39.4

3.5. Information on the request for child protection measures
As in the case of children who have been abandoned in Maternity Wards, there were atempts to
establish if there is any inform ation on reports made to the competent authorities regarding the
abandonment of the children and/ or a request that they prov ide child protection measures.
A small number of observation ch arts contained had a request for child protection measures
recorded, both with regard to the mother, as well as the authorities within the Maternity Ward).

Table 33

53 %
The mother requests a protection measure (n=986) 1.7
The Maternity Ward notifies the DPC to take a protection measure (n=986) 2.6

2.7% of the observation files studied cont ained decisions/reque sts by the DJPDC.

3.6. Duration of the children’s st ay in the pediatric/recovery wards
The duration of the children’s ho spitalization in pediatric/rec overy wards is presented in Table
34 for the two years included in the study. It is noted that th e situation was better in 2004,
compared to 2003, in the sense that the percentage of children who are in pediatric/recovery
wards for less than 10 days is higher in 2004 and the percentage of children who are there for 20-
30 days or over 1 month is lower.

Table 34
How much time did the child
spend in the
Pediatric/Recovery Ward? Year 2003
(n=508) Year 2004
(n=478)
4-10 days 32.2% 43.2%
10-20 days 17.2% 14.4%
20-30 days 10.9% 11.2%
Over 1 month 38.9% 28.8%
Until present 0.9% 2%
There are no explanations regarding the decr ease of the length of hos pitalization for those
children who meet the selection criteria requirem ents. The association of such improvement with
the activity of certain social workers is unlik ely as only 20% of these institutions employed
social workers.
“The children have no identity documents, the pr ocedures for placing them in families or in
institutions are lengthy and bureaucratic.”

Pediatric Physician

3.7. The relationship between parents and ch ildren during the hospitalization period

The hospitalization of the mother with the child
8.4% of the mothers were hospitalized with th eir child, but only for a short period of time,
because they left the medical instituti on without notifying the medical staff.

Parental visits to the children dur ing the hospitalization period

54It is to be mentioned that only 5% of the childr en were visited at leas t once by their parents.

3.8. Discharge from the pedi atric/recovery wards

3.8.1. The children’s health at the time of discharge
In the case of 74.5% of the child ren, the observation charts incl ude notes that the child was
healthy at the time of discharge from the hospita l, while 25.5% of the children showed various
health problems.

Table 35
The child’s health at the time of discharge % (n=986)
Clinically healthy 74.5
Has health problems 25.5

4% of abandoned children died in hospitals / Pediatric Wards.

Figure 15: Abandoned children who died in pe diatric/recovery wards (n=986)

3.8.2. Where did the children go after being discha rged from Pediatric/Recovery Wards
Table 36 presents the destination of the child ren after being discharged from the
pediatric/recovery wards. Almost half of the children went home after bei ng discharged from the hospital, both in 2003 and
2004. As in the case of children who were discharg ed from Maternity Wards directly to their
families, most of the children from the pediatric/ recovery wards were taken home to their parents
by hospital staff, without notific ation to the child protection services. This can be dangerous
because 95% of the children were never visited during their stay in hospital. There was no information with regards to their monitoring after discharge. One thing is certain: most of them
are brought back to th e Pediatric Ward.
Almost 30% of the children selected in the study sample did not have birt h certificates at the
time of discharge from the hospital, and regardless of their destina tion, these children can get lost
or be declared lost. Some 25% are taken to Placement Centers after being discharged from hospital. Yes
4%
No
96%

5513.4% of the cases in 2003 and 18.3% in 2004 were tran sferred to other medica l institutions or to
recovery wards within the same hospital. Some 4% of the children were given for placement with a foster parent, and a small percentage
went to relatives and other families, for placement in view of adoption.

Table 36
Where did the children go at the time of discharge
from the pediatric/recovery wards? Year 2003
(n=352) Year 2004
(n=298)
Home 49.7 49.2
Pediatric/recovery wards 13.4 18.1
4th degree relatives 1.2 0.2
Maternal center 1.2 2.1
Foster parent 3.9 3.3
Placement Center 27.9 24.1
Placement/adoption with a family 1.9 1.0
Still in that ward 0.8 2.0

When comparing the situation of cases discha rged from Pediatric Wards in 2003 and 2004, one
can see that the difference is not significant enough to determ ine whether progress has been
made in the area of child protection. Some observation charts contain a notation of social case or social problem added to the
secondary discharge diagnosis (48.4%). The destination of these children was no different from that of children for whom there was no
such mention (the data is not presented).

3.9. Aspects relating to the organization and op eration of hospital and Pediatric Wards
89 hospitals/Pediatric Wards were included in th e study. 22.2% of these institutions are located
in county capitals, 76.4% in municipalitie s and cities, and 3.4% in communes.

Table 37
% (n=89)
County capitals 20.2%
Municipality 76.4%
Commune 3.4%
“The children who are included in the child protection system are perceived as being “suited for this process”, as they are unwante d, have an unknown father, are the product of
rape, are HIV-infected, and have physical or me ntal disabilities. Some are Roma or Roma-
Turkish children from large families.”
Professional DJPDC

56The data collected on the hospitals and Pediat ric Wards revealed that up to 90% of these
institutions allow the hospitaliz ation of mothers together with under-five children. However,
there are conditions in certain hospitals in terms of the mother being allowed to stay with her
child, namely the seriousness of th e child’s condition, severe disabili ties, payment of a fee, or the
availability of beds for mothers. It is surprising that 37.1% of th e hospitals/Pediatric Wards never allow mothers to visit to their
children.

“We have no responsibilities related with ab andonment according to the organization and
operating regulations of the hospital; rather we assume human, unwritten responsibilities.

Once we solve the child’s health problems, we notify the Child Protection Department of the
presence of an abandoned child in the hospital. Th is institution takes the appropriate steps and
moves the child to a Placement Center. At first , we provided Child Pr otection Department staff
with all the information on the child and the moth er, to regulate the ch ild’s legal status.

Our Ministry assigned us a series of responsibi lities in this area; we are unable to fulfill these
because we have too many responsibilities in ou r own health sector. Often recommendations
received are left in a drawer, among other unres olved papers. We don’t have time to do it all.
Recently, we hired a social worker and he started taking care of social cases. He is trying to
make the mother aware; he is encouraging her to breastfeed the baby in order to create a bond.”

Pediatric Physician

3.10. Quantitative and qualitative information in observation charts of hospitalized
children
With regard to the source of information on chil dren in Pediatric Wards/ hospitals, investigators
noticed the scarceness of information on the child’s situation, due either to a lack of interest on
the part of the person filling in the chart or a lack of cooperation between the various hospital
services. The number of observation charts whic h do not indicate where th e child is going after
being discharged is unacceptably high, especially since there is extremely limited information to
identify the child and the family’s residence. This situation is aggravated by the fact that almost
30% of the children do not have birth certificates, t hus being in effect “non-existent”, and subject
to become possible future victims no one would ever find out about.
Also, there are no standard country -level pediatric observation charts . Sometimes, the use of files
not specifically designed for children allows for th e omission of certain essential information that
could be used to track the child, because ther e are no specific fields for such information.

57CHAPTER 4 – CHILDREN WHO HAVE BEEN ABANDONED IN PLACES
OTHER THAN MEDICAL INSTITUTIONS

It was considered that those children who were abandoned by their parents in places other than
medical institutions could be found in emergency service centers. However, it was difficult to
assess how inclusive this service is for the “ab sorption” of abandoned children, or to know how
many of them never received such servic es and are truly abandoned.
For the selection of abandoned children in the emergenc y service centers, all the names of
children under five who received such services during the two referen ce periods were listed.
Subsequently, the information was extracted fr om their files and thus, able to identify the
following: children under five who were brought w ithout their parents/mother to the emergency
service center (children who were accidentally “l ost” by their parents, whose disappearance was
reported to the police, and who were being looked for, were excluded).
During the reference periods 140 children in 2003 and 192 in 2004 were identified.

4. 1. Circumstances in which the child ended up in an emergency service center

Where did the child come from?

More than half of the children, namely 59%, were abandoned in medical institutions. A
significant percentage, namely 27.1%, were children brought from home due to serious neglect.
Some 10.5% of children were brought in o ff the street or public transportation.

Table 38
Where was the child found? % (n=322)
Abandoned in medical institutions 59
Home of the biological family 27.1
On the street 8.4
On public transportation 0.3
Other 5.1

Who brought in the child?
42.8% of the children were broug ht in by DJPDC representati ves, 21.7% by an ambulance,
13.3% by parents/legal guardians, 11% by other au thorities (physicians, mayors, etc.), 2.1% by
the police/public guards, 2.1% by strangers, and 1.5% by relatives .
Table 39
Who brought in the child? % (n=322)
DJPDC representatives 48.2
Ambulance 21.7
Parents/legal guardians 13.3
Other authorities (mayor, physician, etc.) 11.0
Police/Public guards 2.1
Strangers 2.1
Relatives 1.5

58
Reason for which the children were brought to the emergency services center
Most children were brought in from the Mate rnity Ward in which they had been abandoned
(44.6%). About half of the children had either been neglec ted by their parents, or the parents did not have
the necessary means to raise them.

Table 40
The reason the child was brought in % (n=322)
Abused/maltreated by parents 6.3
Neglected by parents 22.3
Left in a public place 1.8
Parents arrested 2.1
Parents did not have necessa ry means to raise him 22.9
Abandoned in a medical institution 44.6

4.2. General features of children in emergency service centers
a) Health
The study of documents in the children’s files indi cated that more than 17% of them displayed
symptoms of inter-current diseases, 2.1% showed signs of physical abuse, and 0.8% were in
shock . 7.2% of the children had vari ous forms of disabilities.

Table 41
% (n=322)
Displays symptoms of inter-current diseases 17.8
Shows signs of physical abuse 2.1
Is in shock 0.6
b)The child’s identity
Over 90% of the children hospitalized in emerge ncy service centers had identity documents.
Authorities had not initiated any pr ocedures to establish the identi ty of 8.7% of the children who
were without any form of identification.

Table 42
Does the child have a birth certificate? % (n=332)
Yes 91.3
No 8.7

c) Gender

59It was noticed an over-representat ion of boys compared to girls in the case of children who were
abandoned and brought to emergency service center s, and this over-repre sentation is highest
when compared to the situation in maternity and Pediatric Wards.

Table 43
The child’s gender % (n=332)
Male 55.7
Female 44.3

d) Age
Among under-five children, most abandoned children in emergency service centers are under 12
months (Table 44). This can be explained by the fact that over 59% were children who had been
abandoned in medical institutions.

Table 44
Age % (n=332)
Up to 12 months 48.5
12-24 months 32.2
24-36 months 10.2
36-48 months 3.2
48-59 months 5.9
e) Information on the parents
What is surprising is the fact that th e parents of over 95.5% of the children are known, since 59%
of these are coming from Maternity Wards where an emergency measure was undertaken.
Table 45
The parents are: % (n=332)
known 95.5
unknown 4.5

4.3. Duration of the children’s st ay in emergency service centers
The data collected showed that most children spend at least two months in these emergency
service centers, but there are children who stay there for a year or more ( Table 46 ). This is in
direct contravention with the provisions of curren tly enforced legislation. The law stipulates that
the child’s stay in this type of service should not exceed 15 days and, in exceptional cases, 30
days.
Table 46
How long did the child receive this service? % (n=332)
Up to 1 month 34.0
Between 1-3 months 28.0
Between 3-6 months 12.3
Between 6-12 months 4.2

60Between12-24 months 1.2
To this day 20.2

4.4. Discharge from the emergency service centers
Unlike the other two groups of abandoned children, most children from the emergency service
centers go into the child protection system, ei ther to a foster parent (43.7%) or a Placement
Center (23.2%). Their return to their biological fa mily is much less frequent than in the case of children who have
been abandoned in medical institutions. The in tention to abandon the child is probably less
masked than in the other cases (Table 47), although 30.7% of them have been visited during their
emergency placement, especially by their mothers (Table 48).

Table 47
Where did the children go at the time of discharge
from Emergency Service Centers?
(n=332)
Home 17.5
Relations to the fourth degree 0.9
Maternal center 0.6
Foster parent 43.7
Placement center 23.2
Placement for adoption with a family 7.2
Adoption 0.9
Still on the ward 6.0

Table 48
Who visited the child? % (n=93)
The mother 77.4
The father 12.9
Relations to the fourth degree 6.4
Other people 3.3

4.5. Information on the emergency service centers
Emergency service centers may opera te either at (traditional) lo cations which have distinctive
staff and responsibilities, on the premises of Placement Centers, or through the foster parent
institution. In counties included in the study 25 such services were identified. Few counties have more than
a single such service on their territory (with the exception of those counties in which these
services are operated through a foster parent). Most are located in county capitals. As a rule these services are being run on the premises of
Placement Centers.

61Table 49
The service is located in % (n=25)
County capital 80.0
Municipality/town 16.0
Commune 4.0

Such services are created both by the speciali zed public services and by authorized private
bodies, and are developed as modules within Pl acement Centers and with foster parents.

Table 50
The emergency child protection institution is located at % (n=332)
Emergency Placement Center 30.1
Social Protection Service –
Placement Center with an Emerge ncy Placement Center module 50.0
Authorized private body –
Placement Center with an Emergency Placement module 6.0
Social Protection Service – Foster parent 10.8
Authorized private body – foster parent 3.0

62CHAPTER 5 – THE CHILD’S ROUTE

Information was sought in the records of the C ounty Child Protection Serv ices for all children
identified in Maternity Wards, hospitals/pediatric and recovery wards, as well as in emergency
service centers. This was done to identify the route the children followed and the type of the
protection measures they benefited from. The r oute is important because it provides information
on the quality and appropriateness of protection services for the child’s development needs. The
route describes the places the ch ild spent time at from the time it was abandoned by its mother,
and the temporary or permanent protection solutions it has been assigned up to date of collecting
data. It is worth to point out that informa tion and files were found for a mere 694 of 1,935
children.
5.1. Types of the routes

48 types of routes were identified fo r the children in the study sample.

Table 51
The child’s route
Percentage
Maternity Ward – Pediatric Ward – Family 6.6
Family – Pediatric Ward – Family 7.2
Maternity Ward – Pediatric Ward – Placement Center 1.6
Family – Pediatric War d – Placement Center 5.5
Family – Placement Center 8.2
Maternity Ward – Placement Center 13.1
Maternity Ward – Pediatric Ward – Professional Foster Parent 2.7
Family – Pediatric Ward – Professional Foster Parent 8.1
Family – Professional Foster Parent 3.7
Maternity Ward – Professional Foster Parent 12.5
Maternity Ward – Pediatric War d – Family – Pediatric Ward 0.3
Maternity Ward – Family – Pediatric Ward – Family 1.2
Maternity Ward – Adoptive Family 2.4
Maternity Ward – Pediatric Ward – Death 0.3

63Family – Pediatric Ward 1.4
Maternity Ward – Pediatric Ward 1.3
Maternity Ward – Family – Pedi atric Ward – Placement Center 0.4
Family – Pediatric Ward – Death 0.1
Family – Pediatric Ward – Placem ent Center – Adoptive Family 1.7
Maternity Ward – Family 6.5
Family – Placement Center – Professional Foster Parent 3.3
Family – Placement Center – Family 1.7
Maternity Ward – Pediatric Ward – Adoptive Family 0.3
Maternity Ward – Pediatric Ward – Plac ement Center – Professional Foster
Parent 0.6
Maternity Ward – Maternal Center 0.3
Maternity Ward – Maternal Center – Adoptive Family 0.3
Maternity Ward – Maternal Center – Family 0.1
Family – Pediatric Ward – Placement Center – Professional Foster Parent 0.6
Family – Pediatric Ward – Adoptive Family 0.7
Family – Pediatric Ward – Professional Foster Parent – Adoptive Family 0.1
Maternity Ward – Placement Center – Professional Foster Parent 2.3
Maternity Ward – Family – Pediat ric Ward – Placement Center –
Professional Foster Parent 0.4
Maternity Ward – Family – Pediatric Ward – Professional Foster Parent 0.1
Family – Maternity Ward – Placement Center 0.3
Maternity Ward – Pediatric Ward – Prof essional Foster Parent – Family 0.1
Maternity Ward – Family – Pediatric Ward 0.1
Maternity Ward – Placement Center – Family 0.3
Maternity Ward – Family – Profession al Foster Parent – Placement Center 0.1
Maternity Ward – Family – Placement Center – Professional Foster Parent 0.1

64Maternity Ward – Placement Center – Professional Foster Parent – Family 0.1
Maternity Ward – Maternal Center – Placement Center – Professional
Foster Parent 0.1
Maternity Ward – Family – Placement Center 0.4
Family – Maternity Ward – Placement Center – Professional Foster Parent 0.1
Maternity Ward – Pediatric Ward – Placement Center – Family 0.1
Maternity Ward – Placement Center – Pediatric Ward 0.4
Family – Placement Center – Pediatric Ward – Professional Foster Parent 0.9
Family – Placement Center – Pediatric Ward 0.4
Maternity Ward – Pediatric Ward – Plac ement Center – Adoptive Family 0.1
Total 100.0

The most frequent routes were:
• Maternity Ward – Placement Center: 13.1%,
• Maternity Ward – Professi onal Foster Parent: 12.5%
• Family – Placement Center: 8.2%
None of these routes end with a definitive solution for the child (biological or adoptive family).

The routes of abandoned children in Maternity Wards

The “ideal” route, namely from the Maternity Wa rd to the family, occurs in only 6.5% of the
cases.
In 13% of the cases, beginning in the Maternity Ward and ending in the family, there is an
intermediate stage in the Pediatric Ward (s ometimes also the Placement Center or the
Professional Foster Parent). There are routes which illustrate that the child was subjected to re-abandonment in a Pediatric
Ward after it had been integr ated into its family upon discha rge from the Maternity Ward:
Maternity Ward – Family – Pediatric Ward: 2.3% The routes of abandoned childre n in Hospitals/Pediatric Wards the most frequent routes
were: Family – Pediatric Ward – Professional Foster Parent: 8.1%, Family – Pediatric Ward – Family: 7.2%, Family – Pediatric Ward – Placement Center: 5.5%, Family – Pediatric Ward: 1.4% Of these routes, a single one ends with a definitive solution for the child.

65
The routes of the children identified in emergency service centers rarely included periods in
medical institutions.

Of the total 48 routes, 28 contain a “stop” in the Pediatric Ward.
The analysis of routes highlights the fact that the Hospital/Pediat ric Ward is the most handy and
accessible service for both parents who wish to abandon their child “temporarily” or
“permanently”, as well as, paradoxically, for th e Child Protection Services, which employs the
Pediatric Hospital to host children in difficulty until the protection measure is identified.

Eight of the routes include three different lo cations without reaching a definitive form of
protection, another eight routes have four stops before a de finitive form of protection is found,
and one route has five stops without ever reaching a definitive form of protection.

An analysis of the child’s route shows that 28,1% were in their biological family, almost 9%
were in adoption, 37,8% were in maternal as sistance and 19,6% in a placement center. Other
19% were at their relatives , o,1% in maternal center or in medi cal units (3,5%). From the files of
the routes was revealed that 9.5% of the children were eligible for adoption, meaning there was
parental consent for adoption.
Table 52
Where is the child at present? % (n=694)
Biological family 28.1
National adoption 8.9
Fourth degree relatives 1.9
Professional Foster Parent 37.8
Placement Center 19.6
Medical institution 3.5
Maternal Center 0.1
Dead 0.1

5.2. Type of protection measures in effect

According to the longer or shor ter routes, at the moment of collecting data, the children for
whom such routes could be identified were in the following stage in term s of protection measure:

Table 53
Type of protection measure enforced % (n=460)
Placement 69.3
Entrustment for adoption 12.8
Emergency placement 7.5
Entrustment in view of adoption 10.4

66
The number of days the children spent in medica l institutions until a protection measure was put
in place is very high. Almost half of th e children spend more than 50 days in medical
institutions without their mother , awaiting a protection measure.

Table 54
Number of days spent by children
in medical units % n=694
1-25 40.1%
26-50 11.3%
51.100 35.2%
101-150 6%
151-200 2.6%
201-300 1.6%
Peste 301 3.3%

In order to determine the length of the child’s route until its departure from the last form of
protection and entrance into a permanent form of existence (biological or adoptive family), a
series of mortality table type analyses (Kaplan Meyer) were conducted. The length of routes was
studied on the basis of several parameters.
5.3.Length of the routes

In order to determine the route of the child st arting from the place was abandoned till entering in
a final protection measure (biological family or adoptive family) the methodology used was
several types of "event history analysis". Those techniques are applicable for situations which
fulfill several criteria as it follows: (1) There is a certain number of subjects (in our case the children) which pass through a certain
number of situations (maternity wards, medical units, placement centers, maternal assistant,
biological gamily, adoptive family, etc); (2) Situations can happen in any time; (3) Time criteria which influence those events (e xample of children which started their route in
maternity wards, parents gave their consent for adoption, the number of days spent in hospital
wards); The main non-parametrical methods which can desc ribe longitudinal data are the Kaplan Meier
ones and the mortality tables.
Analysis 1 – Length according with the star ting point, maternities or other places.

The analysis revealed the following conclusions presented in the figures below. Children who begin their route in a Maternity Ward are more likely to end up with a permanent protection
measure, as opposed to those who begin their route in other places.

Table 55

67The ratio of children who did not end up in a bi ological or adoptive fa mily and whose route
began in a Maternity Ward or in another place, in accordance with the length of the route
(in number of days)
The route started in

Route’s length
-in days- Maternity Ward
% Other location
%
151 57.0 67.4
301 55.9 66.3
451 48.3 55.9
601 47.0 54.5
This data shall be interpreted as follows: Example 1: 57% of children who began their r oute in a Maternity Ward did not end up with a
permanent form of protection (biologi cal or adoptive family) after 151 days.
Example 2: 47% of children who began their r oute in a Maternity Ward did not end up with a
permanent form of protection after 601 days.

Figure 16

Kaplan-Meier survival estimates, by inma t
analysis time0 500 1000 15000.000.250.500.751.00
inmat 0inmat 1

In the Figure 16 the re presentation indicates:
– (1) on the ax Ox I the time of the entry in the r oute till the final protecti on measure or till end of
September 2004 (end of collecting data). Once the lin e is flat – see the extreme right – it means,
that all children from this category (those whic h started their route in maternities) reach a
definitive protection measure or it is September 2004 (end of data collection). This is showed by
the table also (see Table 55) by the fact that after 601 days 47% children which started their
routes in maternities didn’t reach a definitive measure of protection.

68Analysis of the other ax (equivalent of Oy) repr esenting the probability of child existence in the
route (can be observed also in the table, as fo r example after 151 days 56% of the children which
started their routes in maternities didn’t reach a final measure of protection). At the beginning of
the route, when there are all the children, the probability is 1. After 151 days, 57% of children
started their route in maternities didn’t reached a final protection measured.
Analysis 2 – Length of the route accordi ng with the consent of the parents.
As can be seen in the Figure 17 below, there is no difference between the two categories of
children in the first 100 days. A difference begins to show only after 301 days, in the sense that
50.8% of the children whose mo thers gave consent for adopti on did not yet end up with a
permanent form of protection, while during th at same period 63.3% of the children whose
mothers did not give consent for adoption had not yet ended up with a permanent form of protection. The difference decreas es more significantly after 601 days, when 30.4% of the
children whose mothers gave consent for adopti on did not end up with a permanent form of
protection, as compared to 53% of children w hose mothers did not give their consent for
adoption (see Table 56).
Table 56
Consent for adoption

Route’s length
-in days- was given
% was not given
%
301 50.8 63.3
600 30.4 53

Figure 17

69Kaplan-Meier survival estimates, by cons
analysis time0 500 1000 15000.000.250.500.751.00
cons 0
cons 1

Analysis 3 – Length of the route according with the number of days in the medical institutions
(1= <=30 days, 2= 30-60 days, 3= 60-90 days, 4= 90-180 days, 5= >180 days) As can be seen in the graph, most of the children who end up with a permanent form of
protection are those who spend the fewest days in medical institutions (days 1), followed by days 2, days 3, days 4 and days 5. In other words, the less they stay in medical institutions, the higher are their chances of ending up in a permanent form of protection (biological or adoptive family).

Figure 18

70

Kaplan-Meier survival estimates, by days
Analysis time0 500 1000 15000.00 0.25 0.50 0.75 1.00
days 1days 2days 3days 4days 5

71
CHAPTER 6 – MOTHERS WHO HAVE ABANDONED THEIR CHILDREN
IN MEDICAL INSTITUTIONS

Following the identification of children in accordan ce with their medical observation charts and
emergency service center entry records, there was also an attempt to identify their mothers. In
comparison to the number of children who were identified as being abandoned, namely 1,935,
the number of mothers who were id entified and located in order to be interviewed was less than
20%.
For this reason, the level of repr esentation is questionable. The id entified sample is outsized in
the case of mothers from rural areas, and those who took th eir children home.
There are several explanations fo r the fact that only a limite d number of mothers were found.
1. Operators identified children who were abandoned by their mothers, either temporarily or
permanently, during the observation period, rega rdless of whether or not these children
subsequently ended up with their bi ological families. In the case of temporary abandonment ,
many of the children in the records cannot be found in Child Protection Department records,
because their abandonment was not reported by the medical institutions. As such, it was difficult to identify them on the basis of the address reco rded in the observation
charts, since a great deal of information was incomplete. The information was found in
Department records if during th e observation period the mothers re-abandoned their children in
Hospitals/Pediatric Wards, or if the mothers requested a protection measure.

2. Name changes resulting from ma rriage also made the identification of the mothers difficult.
3. Some Child Protection Departments keep the file s of all children at their headquarters while
others keep them at the Placement Centers where the children are located. This made extracting
information from Child Protection Department documents on all institutionalized children (and
on his mother, respectively) impossible, because the depl oyment of teams to various
communities where Placement Centers were located had not been initially planned.
4. Addresses were false or not update d, especially in large cities.
5. Temporary/seasonal absences from the residence locality. 6. Hospitalization or arrest. 7. Serious mental illnesses or disa bilities making communication impossible
8. Refusal of certain Child Protection Depart ment staff to cooperate with the teams
9. Refusal of certain Child Protection Department s to cooperate for the visit of some categories
of mothers who had given their consent for adoption.

“Of the 58 cases selected in the given timefr ame I only managed to lo cate and interview 28
mothers, because 10 mothers were out of town for an extended period of time (nobody knew
where), 7 (Roma) mothers had moved abroad with families, 10 mothers had given the hospital a
false address and were not listed in the records of the Child Protection Departments, 1 person,
although acknowledged by the Child Protection Department, denied she was the person in
question.

72Of 37 mothers identified, 3 were out of town engaged in begging, 1 had been arrested, 7 were
out of town (in Ia și, Bucharest, Timi șoara), 1 was mentally ill, 1 was engaged in prostitution, 3
had moved out of town, and 1 had left for Spain.”
Excerpts from field investigator reports

The questionnaire used to interview mothers is a modular one, containing both general and
specific questions for various sub-groups of mo thers. The idea behind the creation of such
modules was the need to understa nd the context and motivations of the mothers who decide to
abandon their children.

Initially, there was an intention to structure the presentation of data according to three categories
of mothers, delimited according to the place in which they had abandoned their children. Because there were no distinctive cases for the third category (places other than medical
institutions), the presentation of results will be structured only according to two categories of
mothers: those who abandoned their children in Maternity Wards and those who abandoned their
children for the first time in Hospitals and Pediatric Wards. Qualitative data will be introduced along with the statistical presentation of quantitative data.

6.1. General characteristics of moth ers who abandoned their children

Case study

Child abandoned in a Maternity Ward

My name is A.M. I was born in 1982 in the city of R.V. where I spent my entire childhood. In
addition to my mother and fa ther, I have a younger sister.
I am now 22 years old, and have been living for about 6 months with my child in a Maternal
Center in the city. The child has not been acknowledged by his father.
When I was young, as late as 8th grade, I had everything I needed. I went to the seaside, to the
mountains, would spend my holidays with my grandparents, especially my paternal
grandfather, who loved me very much.
I was never beaten. I was rarely punished. My parents made enough money, they both had
jobs.
Even now they have a good financial situati on. My father works abroad, he comes home
every three months. With the m oney they earn they are building a house in my father’s native
village, they have enough money.
When I was living with my family, I had a lot of gold, as did my mother and sister.
When I grew up and went to vocational school, my parents, especially my mother, treated me
very harshly. They kept me mostly in the house. I was rarely allowed to spend time outdoors
with other youngsters my age.

73

For a while I got along well with my mother, but I never had any discussions with her about
boys, or sex…

She loved my sister more than she loved me. My father also noticed and confessed that he too
loved my sister more than he loved me. My sister was more the way they wanted. She was
nice, obedient, and studied hard. I was more of a rebel, was less obedie nt, and liked to have
fun. I always argued with them about this. On ce, a neighbor childhood fri end of my mother’s
witnessed an argument between my mother and I about going out. I heard her stand up for me
and telling my mother: “Do you think you’re a ny better?”. I don’t know what she was trying
to hint at. Probably it was one of their secrets from childhood.
I did not meet any boys other than my current partner.
He was my first boyfriend, and then he became my life partner.
I met him on the street in our city. I was with a school friend who introduced us.
I started my sex life when I was 19; at that time I was a night student in an industrial High
School.
After I met my partner, I asked my mother if I could go with him to a disco. That’s when I
introduced him to my mother , because she always liked to control everything.
She did not like him and forbade me to go out w ith him again. She insisted that he was older
than me, that he is a Roma, that he is “not for me”. In spite of my mother’s feelings, we
continued to meet in the street, go to pubs, have conversations. What attr acted me most to him
was the fact that he knew how to listen to me wh en I had a conflict with my parents and sister,
and he never hid any of his prob lems. He was in the process of divorcing his wife, with whom
he had a child, and he was involved in a fair ly complicated propert y settlement trial.
That’s when the fights with my mother star ted, the beatings, the pr ohibition to leave the
house.
One day, when my parents were at work, I deci ded to leave with him for good. I moved into a
rather poor apartment. The apartment, subject to the property settlement trial, was dirty, had
no windows, was unpainted, and unfurnished. I did not care about the conditions, for me it
was important that I was with the man I loved, the man w ho understood me. After running
away from home, I dropped out of High School because I had found my freedom.
“My husband” criticized me for dropping out of school.
Some two months after I left my parents’ home, I called them to ask whether I could stop by
to pick up a check and a few things. They let me in, but you could see in their eyes that they
did not approve of my behavior, an d that they did not care for me.
That’s when I realized I di d not need their money, thei r gold, but rather their love.
The partner I live with is 11 years older than I am. What attracted me to him was his
seriousness, his maturity, and the confidence he gave me when I told him about the conflicts
with my parents.
Although he is a Roma, he is well respected in town, and has relations mostly with
Romanians.

74

He only finished four grades. He has no occ upation, but is a good businessman. He used to
have a company which made him a lot of money. He was in the scrap metal business, and sold
car engines. The company is now experiencing financial difficulties, an d is on the verge of
bankruptcy. He works on his ow n, in a makeshift workshop. He make thermal insulated
windows. He does not earn much at presen t, not enough to support me and the child.
“My husband” is very mature, he taught me a lo t of things about sex, about everything else,
he is “worldly-wise”, he can answer every question I have.
He is emancipated. He speaks nicely. You cannot tell he is a Roma except by his complexion.
After I moved in with him, I became pregnant but terminated that pregnancy because we
realized we did not have what it took to raise a child. I f ound out about the pregnancy after
taking a test, and then had an abortion.
When I became pregnant a second time, with th e child we are talking about, we were both
upset. It was an unwanted child bo rn at an inappropriate time.
I was certain that I was pregnant at about 2½ – 3 months. I talked about this with “my
husband”, and he suggested I ha ve an abortion. I was not very lucky because the holidays
were coming, I postponed the abortion, time we nt by, and the child started to kick.
I did not see any physician during my pregnancy. I have a family physician but went to him
very rarely. I was told family physicians pres cribe medication and I am against this. I have
heart and liver problems but am trying to treat these with he rbal concoctions.
I have a weak nervous system. When I get angr y, my head shakes and I believe th is is the
result of emotional stress and fear in the family.
I did not prepare anything for the child’s birth, no diapers, nothing. I did not pay any attention
to this aspect, especially since the money wa s very limited. During the pregnancy there were
days when I would only eat bread. At the time we were trying to survive and could not care
for a child.
I did not hide my pregnancy, but when we were going out, I did not feel comfortable when
mutual friends or acquaintances looked at me.
I gave birth to the child after 8 ½ months in another count y. The birth, which took place in the
city of C. was not premeditated. It was unexpected.
Because we had no money, one day “my husband” de cided to sell the car we owned at a very
large car fair, some 200 km from R.V. Becau se the roads were very bad, my water broke.
That’s when I decided to go to the Ma ternity Ward to avoid having problems.
I was admitted to hospital with only the clothes on my back.
At admission I was asked to present my identity documents. I did not have them on me, and
neither did my husband, because he had forgotte n them at home, even though he would have
needed them in order to sell the car. I told the truth, that I was from out of town, and
unmarried. The Maternity Ward susp ected that I wanted to provide a fake ID. I gave them my
parents’ address. When I was hospitalized, and after putting me in the ward for pregnant
women, the nurses spoke to me harshly, even i gnoring me. The girls in the ward received
attention from the medical staff. For instance, I heard that if they give you an enema the birth
is much easier, but th ey didn’t give me one.

75
The pain started after they gave me an IV to induce labor. An Arab doctor assisted me at
birth, and he treated me very well. He enc ouraged me. When the doctor would leave, the
nurses treated me with indifference. After the birth, the child was taken to the nursery. I was
not given any information on the child, apart from the fact that it wa s a boy, that he weighed
2,800 grams, and that he received a “9 A pgar score”. I asked whether he had any
malformations, because I knew from watching TV that many unwanted children have
malformations. No one answered my question, and when I first breastfed him I was not
allowed to remove the diaper wrapping.
There were eight women in the Maternity Ward , and the children st ayed in the nursery.
After I got better I breastfed him be cause that was what all women did.
After the delivery, I did not re ceive enough food, no one paid any attention to me. I asked the
other girls in the room for a towel, some co tton, for other things, and even food. They would
get these from home, and had plenty of food.
I would eat using the spoon of one of the girls, from the cup of another girl, it was not
pleasant. They did not seem too friendly to me, either.
I did not know how to care for the child. I was afraid at the thought of leaving the Maternity
Ward because I did not know how to feed him, how to care for him.
On the third day, “my husband” visited me and I ran away from the Waternity Ward, leaving
the child behind.
When the other girls went to breastfeed their chil dren, I left the ward, and ran into the hospital
yard in the robe and slippers the hospital had provided. There were lots of people in the
hospital yard. I went out gate, nobody stopped me. It was customar y for the girls to go out to
shop at a nearby store. They would buy biscuits , candy and others such things. “My husband”
was waiting ten meters from the hospital gate in a parked car. We talked in the car for several
minutes, and decided to leave the child in hospita l and to go home. We left in the car he could
not sell. My boyfriend reminded me that we were very short on money and that the apartment
where we were leaving was not appropriate for the child. He told me that after his business
revived, we would look for him, and take him home.
We went home, and after more than a mont h somebody came to my apartment door saying
they were from the Child Protection Department . We talked and I admitted I have left my
child in the Maternity Ward in the city of C. They found me because my mother had given
them my address. That’s how they found out wh ere I was living. They to ok care of the child’s
identity documents. The boy now has a birth cert ificate. The Ma ternity Ward staff gave him a
name which I don’t like. It is too similar to the one of my partner’s former wife.
After some time, the social worker told me th at the boy was moved to a shelter and that if I
wanted, I could visit him.
I went there several times, sometimes every da y, if there was no quarantine. At the shelter I
was encouraged to come as often as po ssible, to hold my child in my arms.
I do not know much about contraceptives. I’ve heard about them, I don’t know exactly which
pills make me put on weight, might deform me, and I have absolutely rejected the idea of
using them. We use the calendar method, and other methods known by my boyfriend.

76

6.1. Features of the mothers
Age of Mothers

According to information obtained in interviews with mothers, 27.6% are very young mothers
under 20, throughout the study sample, with an importa nt variation between the two categories of
mothers (36.8% and 16.7% respectively) ( Table 57 ). It is to be mentioned that throughout the
sample, the average age of the mothers was 24, with extreme limits between 14 and 43 years.
Some 6.5% of mothers were under-16 at the time of the child’s birth (the da ta is not presented).

Table 57 The social services people tried to arrange for me to be reunited with my family.
They told me that my parents would accept me with a child, but without my partner.
I don’t want to go back to my parents’ home, because they would take me to another county,
so that people would not find out I had a baby with a Roma man. They would lock me up in
the house they have built in that village. They are saying that I am a woman with poor morals.
I know that my husband is not perfect, but it is “t he person” that counts. He is a good thinker,
doesn’t steal, he’s a well-respected man.
My in-laws do not accept me either. They want their boy to ma rry a Roma woman.
I do not visit them because they live in a gypsy neighborhood. My husband keeps telling me
to stay away from some evil gypsies.
The child is very important to me. I am now in a Maternal Center because I visited my child
very often at the shelter. When they saw that I love my child, they proposed that I stay with
the child in the Maternal Center.
My husband comes to the Maternal Center, but he can’t do that all the time, because he travels
outside the county.
“One of the causes of child abandonment is mothers are very young. These mothers begin
their sex life very early, at about age 13-14, when they have no capacity for discernment. It is
an age at which they cannot begin living on thei r own with their child. Other people make
decisions for them, usually their parents or lif e partners. Mothers aged 13-14 do not have
maternal instincts and are not averse to advice to leave their child in th e care of the state.”

Physician

77

Ethnic Origin
Throughout the sample, it can be noted that mo st of the mothers who have abandoned their
children in medical institutions are of Roma ethnic origin (56.7%). According to the two
categories, one can see that almost half of th e mothers who abandon their children in Maternity
Wards are of Roma ethnic origin, and the othe r half are of Romanian and Hungarian ethnic
origins. Over 60% of the mothers who have abandoned thei r child in Pediatric and Recovery Wards are
of Roma ethnic origin ( Table 59 ). The over-representation of mo thers of Roma ethnic origin
abandoning their children is obvious if it is taken into account that this ethnic group makes up
less than 10% of th e general population.

Table 58
Ethnic origin Total
(n=350) Mothers who have abandoned
their children in Maternity Wards
(n=201) Mothers who have
abandoned their children
in Pediatric/Recovery
Wards
(n=149)
Romanian 41% 48% 29.5%
Hungarian 1.7% 0.9% 2.6%
Roma 56.7% 51.1% 66.4% Mother’s Age
Total
(n=361) Mothers who have abandoned
their children in Maternity
Wards
(n=206) Mothers who have
abandoned their children
in pediatric/recover y wards
(n=155)
Under 20 27.6% 36.8% 16.7%
20-24 26.3% 20.8% 31.6%
25-29 23.3% 21.4% 25.3%
30-34 13.3% 12.3% 13.5%
35-40 7.6% 6.7% 8.4%
Over 40 1.9% 1.9% 4.5%
“Roma women give birth from the age of 14-15 to 40, deliver babies they do not take care of
(the children raise each other), and it is not uncommon for the parents to leave them at the
door of the hospital.

In fact, Roma children are born to be exploited by their parents . When they grow up, they are
sent out to steal. Society is likely to blame because the Roma have been marginalized. They
must be helped, because they are human, and must be integrated into society.”

Medical assistant

78Turkish-Tartar 0.6% –- 1.5%

When matching age and ethnic origin, it is noticeab le that most of the under-20 mothers in the
sample are of Romanian ethnic origin.

Table 59
Mother’s age Romanian
(n=144) Roma
(n=199)
Under 20 29.8% 26.1%
20-24 21.5% 28.1%
25-29 20.8% 25.6%
30-34 13.8% 13.2%
35-40 11.4% 5.5%
Over 40 2.7% 1.5%

The Residential Environment of Mothers
Over 60% of the mothers who could be tracked a nd interviewed were originally from rural areas.
When comparing this figure to the information from observation charts of the children it is to be noticed that rural area mothers are over-represented in the sample.
The teams who participated in data collection me ntioned in their reports that in mothers from
large cities were rarely found. Many addresses were either no longer valid, or were fake.
Although the percentage of mothers residing in rural areas is larg er than that of mothers who
have abandoned their child in Pediatric Wa rds, the differences are not significant ( Table 60 ).

Most women from rural areas, who want to ab andon their children, delive r these in Maternity
Wards located in large cities, in order to cover their tracks more easily.
Table 60
“Although statistics do not show a difference between villag e and city, child abandonment is
noted more often in medical institutions in urba n areas. This conclusion is often erroneous,
and is based on the fact that many mothers from rural areas come to urban hospitals to deliver their babies.”
Director DJPDC

79
Total
(n=350) Mothers who have
abandoned their children
in Maternity Wards
(n=201) Mothers who have abandoned
their children in
Pediatric/Recovery Wards
(n=149)
Urban 38.2% 38.8% 35.5%
Rural 61.8% 61.2% 64.5%

Marital Status
The table below draws attention to the very la rge percentage of moth ers who are living in a
consensual union or are single (Table 61). Most single women are included in the category of
mothers who have abandoned their children in Maternity Wards.

Table 61

Total
(n=350) Mothers who have
abandoned their children
in Maternity Wards
(n=201) Mothers who have abandoned
their children in
pediatric/recovery wards
(n=149)
Married 21.7% 17.4% 28.1%
Consensual union 55.3% 54.2% 57.1%
Divorced 0.6% 0.7% 0.6%
Widow 0.6% 0.9% –
Single 21.9% 26.8% 14.2%

By comparing the two ethnic origins, it can be noted that in both cases , consensual unions are
predominant: over 65% among Roma, and not exc eeding 43% in the case of Romanians.

Table 62
Mother’s marital status Romanian
n=144 Roma
n=199
Married 23.7% 20.1%
Consensual union 43% 65.3%
Divorced/separated 0.7% 0.5%
Widow 1.3% ___
Single (unmarried) 31.3% 14.1%
“Consensual unions are very often accepted in environments where children are abandoned.
Short-term consensual unions often result in an unwanted pregnancy an d the start of another
relationship because the partner does not want to be involved in bringing up a child whose father he is not. The pregnancy between two short-term consen sual unions often ends in
children being abandoned in Maternity Wards, Pe diatric Hospitals, Dystrophic Wards, etc.”

Professionals of DJPDC

80Religion
The distribution of the sample by religion shows that over 63% of mothers declared they were
Orthodox; attention was given to the high percen tage of mothers who indicated they were
agnostics, 15.1%, and to the over -representation of Muslim moth ers (2.8%), something that can
be explained by the fact that the sample of counties included the only one in which this religion is better represented.

“No doubt the economic and material situation of mothers cont ributes to abandonment, but not
fundamentally. These become factors towards the end of the process, once the family, school and
religion have failed to fulfil their duties.”
Statement of a Child Protection Commission Director

Table 63
Mother’s Religion Total (n=351) %
Orthodox 63.2
Roman Catholic 6.6
Greek Catholic 2.3
Protestant 3.4
Neo-Protestant 4.3
Muslim 2.8
Agnostic 15.1
Other religion 0.9
Did not know/answer 1.4
Education /Schooling
The level of a mother’s education was perceive d by participants in th e qualitative studies,
professionals and decision-makers, as constituti ng a synthetic risk factor which has a major
impact on child abandonment, because this educa tional level determines the social and economic
status, with all the consequences whic h this has on all life components.

A precarious education, due to insufficient scho ol of mothers, was continuously mentioned as
being among the major causes/risk factors in the making of a deci sion about abandonment.

Overall, the percentage of mothers with no edu cation or very little schooling is very high, at
70%. “The main cause for child abandonment is ignorance. Contraceptive measures are presented in school , and are a subject as commonly debated as
teeth brushing. Unfortunately, th is very information on contracep tives does not reach the most
vulnerable segment of the population t hat has not had any form of schooling.”

Obstetrical – Gynecologist Physicians

81
If considered separately, mothers in maternity wa rds are somewhat more educated than those in
the pediatric ward (see Table 64).

Table 64

Total
(n=354)
%
Mothers who
abandoned their
children in maternity
wards
(n=205) % Mothers who
abandoned their
children in
pediatric/recovery
wards
(n=149) %
No education 42.2 38.2 47.6
Primary School
incomplete 27.1 24.3 30.3
Completed
Primary School 13.4 16.6 8.2
9-10 grades/
Vocational school 14.3 15.8 11.7
High school 2 4.3 1.3
Post-secondary non-
tertiary education/
University education 1.2 0.8 1.2

According to ethnic orig in, the percentage of il literate Romanian mothers is 16.6%, while that of
Roma mothers is over 60%.
Table 65
Mother’s education Romanian
(n=144) % Roma
(n=199)
None 16.6 61.4
Primary School incomplete 25 27.6
Primary School completed 23.6 6.0
9-10 grades 19.4 2.5
Vocational School 7.6 2.5
High School 4.8 –-
Post-secondary non-tertiary education 1.5 –-
University education 1.5 –- “Most mothers who abandon their children are ill iterate, and have no skills to raise the
children.”
Obstetrical – Gynecologist Physician

82
Living Conditions
As can be seen in Table 66 , most of the mothers live in so-called dwellings with yards (42.7%),
followed by shacks (35.9%).
It was decided to consider a dwelling with a yard any small construction intended or adapted as
living space, and in rather pr ecarious condition, with a form al or informal yard. By shack it is
meant mean a very dilapidated living space, made of clay, and usually with a single room.
Some 8.8% of mothers live in ex tremely precarious conditions, in improvised living space, i.e. a
variety of shelters made of cardboard or other ma terials, in garbage dump s, in metal structures,
etc. Some 0.6% of mothers live in houses, classified as larger buildings designed for living, with
more than 3 rooms, and in very good condition. There are also mothers who have no living space at all (1.4%), known as “homeless” and usually
mentally retarded, who sleep in parks or the se wer system, and were former street children.
Considered in terms of these two categorizations, the living conditions of mothers who have
abandoned their children in maternity wards are be tter than those who ha ve abandoned these in
pediatric wards.
Table 66

Total
(n=354)
% Mothers who
abandoned their
children in
maternity wards
(n=205) % Mothers who
abandoned their
children in pediatric/
recovery wards
(n=149) %
Apartment 10.5 10.7 11.4
Dwelling with yard 42.7 48.8 35.4
House 0.6 1.3 –-
Improvised living space 8.8 7.8 9.3
Shack 35.9 30.3 42
Homeless 1.4 1.1 1.9

Case study

T. M .L. – Commune C – County A

“I met mothers in hospital who sa id they were going to abandon their children. Not just me, but
everyone in the ward begged them to see thei r children. They didn’t want these children,
especially if they were boys. They had more pity for the girls.”
“If City Hall gave me two rooms, I would take my children home. I don’t know how to soften
the heart of the mayor. I went to his office w ith Antena [TV station] and Curierul [daily
newspaper], but he is afraid of no one.”

83“The lack of a home is the only reason I decide d to leave my children with a foster parent.”

My name is TML, and I come from commune C in county A. The commune is 37 km from the
city of P. I am 25 years old, and finished eight grades in my village. I have given birth to 3
children, two boys and a girl. Two of the childre n, one aged 2 years and 5 months, and the other
almost one year, are in the care of two foster parents.
I come from a large family with 5 children. I am the eldest, and the only girl of my mother’s 5
children.
My parents divorced when I was 11 years old. Th e children all ended up in my mother’s care.
She had a hard life, and she wanted mine to be better. I was a good girl, and my mother and
especially my grandmother told me I was pretty.
Both my parents remarried, and my father has another boy with his present wife, another boy,
who is now 14. I don’t remember why my parents got divorced, and don’ t know whose fault it
was. My father had been adopted by an aunt who could not have children.
When I finished eighth grade I started working da ily in the village, in the homes of various
people, digging fields, or cutti ng corn or wood. My parents we re not and are not now rich
people. I lived with my mother after the divorce in a two-room house. The first part of my
childhood I spent with my parents, then I went to live with my paternal grandparents. It is they
who taught me to work and earn money. They lived in a nearby village.
I met a boy from a rather well-to-d o family in the village of my grandparents. He was 3 years
older than me. I loved him and I think that he loved me too. When I turned 17 we decided to
move in together in my grandparents’ house, wi thout being married. His family did not approve
of our decision, because I was too poor. We lived together for a while and then he went back to
his parents. When we broke up I was 4 months pregnant. He never ac knowledged the baby, who
is “registered in my name” only. All three of my children were bo rn at home, as had beem my
brothers. I was the only one of my mother ’s 5 children born in a maternity ward.
I delivered my first child alone, and my husband he lped me with the other two. After each birth I
took the child to the maternity wa rd, because that is the rule.
After giving birth to my first child, I met my pres ent husband in the hall of the hospital, and he
immediately accepted my child. We became friends, and I moved in with him and my child, as
he was living in a room in the hospital. They tolerated him there because he had no parents.
Shortly after, we were legally married. I had two more children, but these two are in the care of
Child Protection foster parents.
After living for some two years in the hospital, my husband lost his job because he had too many
diabetic comas. We moved in with my mother’s family, but the house was too crowded.
I left my last two children in the maternity ward, I did not r un away, I did not abandon them. I
spoke each time with a social worker. I didn’t take the children home because I did not have the
proper conditions to raise them. Both children we re transferred from the maternity ward to a
shelter, where they stayed for some three months , until foster parents we re found to raise them.
My husband and I both agreed that the children shoul d be raised by foster parents. That was the
advice I had received from the social worker , the family physician and from my husband.
I knew from my husband, who had lived in an institu tion in the town of R., that life was not good
there. He told me that it was better for the childr en to be cared for by a foster parent. There are
many children in institutions and the staff cannot take care of them all. I vi sit my two children at
the re-integration center about every two months.

84I now live with my husband and my first child in a room in the village cultural center. We have
no electricity, running water or sewerage system. The room serves as bedroom, kitchen and
wood storage. It is very shabby.
We got this room from City Hall, we do not pay a ny rent or other taxes for it, but it is not safe.
We live in fear that we will be kicked out, although we live there because we were granted
approval by the Mayor. The living c onditions are bad and that is w hy I went to City Hall to ask
permission to move into a smaller but better ro om in the same building, but was turned down.
We live on 1,800,000 [Lei] in social welfare an d on an allowance for the oldest child.
I earn about 100,000 lei a day and food when I work in the village. In the summer months we
have about 4-5 million [Lei]. We don’t do too badly money-wise, but much of it is spent on
medication.
My husband is very ill. He is a diabetic. He has been insulin -dependent since he was 6 years old.
At this moment he is in hospital, where he un derwent surgery for perit onitis. He is not feeling
well. The were complications because of the diabetes.
We petitioned City Hall for some land, but they didn’t give us any. Th ere are some fields
available in our village, where we could grow vegetables, but the Mayor did not give us his
support for this.
The room in which we are living is not safe. Th ere are other much better rooms available in the
village cultural center. But the Mayor won’t agree to us using these. We could move into a room
with electricity. I don’t k now why the Mayor keeps turning us down. If we could have a contract,
we would feel more secure about our dwelling, we would be able to take better care of it. The
Mayor does not only treat me like this, but acts the same way whenever anyone in the village
asks him for something.
My memories of my childhood are very vague. I only remember that I liked to stay with my
grandparents.
My mother gave me the freedom to do what I want and she always respected my decisions.
I visit my brothers and my mother on a weekly basi s. I even keep in touch with my father. They
cannot help me. They have their own problems.
We don’t have any friends in the village. We don’t go to parties, to weddings. My husband
doesn’t like this sort of entertainment.
I don’t want to have any more children. I took contraceptives for a while, but I stopped them
after a year because I heard they are can cause brain damage. That’s when I became pregnant
with my last child. Now I use the cal endar method because it is the best.
I know about the availabili ty of abortions, but I have never ha d one because I always got to the
doctor too late. I had easy pregnancies and deli veries. I get along well with my husband, I take
care of him, and we consult each other. I have more courage, he has less.
Whenver I came to the maternity ward with the ch ild I had delivered at home, the medical staff
treated me very nicely. They knew my husband.

Income
The ratio of mothers with relatively secure incomes does not exceed 15% in both groups. It is
significant that occasional work is an important source of income for at least one third of the
mothers ( Table 67 ). The minimum guaranteed wage, as a source of income, is mentioned by
about one third of the mothers in the study sample. This is someth ing that was also observed in
other studies focused on extremely socially di sadvantaged individuals. The authorities have

85stressed that such income requires a person to have a fixed and legal residence in one place, and
that such an income must be requested.

Table 67

Total
(n=354)
% Mothers who
abandoned their
children in
maternity wards
(n=205)
% Mothers who abandoned
their children in pediatric/
recovery wards
(n=149) %
Salary 14.8 15 15
Pensions 10 11 8
Profit – – –
Renting land 1.7 2 1
Agricultural activities (crops) 5.4 2 3
Agricultural activities (livestock) 3.1 4 2
Occasional labor 35.9 35 37
Trade in recycled materials 7.4 7 7.7
Own trade 1.1 2 1
Unemployment benefits 2 2 3
Minimum guaranteed wage 33.9 34 32
Adult allowances 5.4 4 8
Child allowances 62.4 62 63
Begging 7.1 5 10
Child-raising allowances 7.1 6 5
Socio-Economic Status
In order to assess the socio-economic status of the families, information was collected on
ownership of certain household applian ces, presented in the table below.
Table 68
Appliances %
Cooking stove 28.5
Refrigerator 13.7
Washing machine 8.3 “The cause of abandonment is the precarious financial situation of these mothers. They have
no job, earn no money, and have no skills. These mothers are often unable to make decisions
because they have no independence in terms of income and accommodations.
Another cause is the status of the woman comp ared to that of the man. Women who end up
abandoning their child cannot decide, are s ubmissive to, do not have the financial
independence, and are strictly obe dient to the opinion of men.”

Family Doctor

86TV set 24.2
Telephone 3.4
Vacuum cleaner 2.8
Car 2.0

The most common appliance is the cooking stove (28.8%) and the TV set (24.2%), the latter the
most common appliance among the general population (98%).

The socio-economic indicator was calculated by assigning equal values (1 point) for the
possession of each of the following appliances: cooking stove, refrigerator, washing machine,
TV set, telephone, vacuum cleaner, and car. The tally for each family was somewhere between 0
and 7. This tally was sorted according to four levels to establish the lowest socio-economic
indicator for the possession of 0 to 1 appliance, a low indicator for 2 to 3 appliances, a medium
indicator for 4 to 5 appliances, and a high indicator for 6 to 7 appliances. As a whole, the ratio of
families whose socio-economic status was very low reached some 80%.

Table 69

Total
(n=350)
% Mothers who
abandoned their children
in maternity wards
(n=201) % Mothers who
abandoned their children in
pediatric/recovery wards
(n=149) %
Very low 78.2 76.6 80.5
Low 16.5 18.4 14
Medium 2.6 2.5 3.5
High 2.7 2.5 2

Health
Some 80% of the mothers declared they were healthy, while the remainder indicated they have
occasional illnesses. It is worth mentioning that some 10% of all mothers have a mental
disability, and 3.45% suffer from mental illne ss. This information was obtained by social
workers ( Table 70 ) and confirmed by persons conduc ting the qualitative studies.

Table 70
Mother’s health condition Total (n=351) %
Healthy 80.1
Physical disability 3.1
Mental disability 9.1
Sensorial disability 2.6
Tuberculosis 2.3
Type A Hepatitis 0.3
Type B Hepatitis 0.9
Type C Hepatitis 0.6
HIV/AIDS 0.3
Syphilis 1.7

87Mental illness 3.4
Neurological illnesses 1.4

Antecedents of Mothers Regarding Deliv ery and Institutionalized Children
Some 10% of mothers had their first pregnancy be fore the age of 15. Over 50% of them had their
first pregnancy between ages 15–19.

Table 71
Age at the time
of first
pregnancy Mothers who abandoned
their children
in maternity wards
(n=201) % Mothers who abandoned
their children in
pediatric/recovery wards
(n=155) %
Under 15 11.4 10.9
15-19 66.9 61.9
20-24 16.4 19.3
25-29 4.9 7.3
30-35 0.4 0.6
Some 6% of mothers had their first child when before they were 15, while over 60% of them
gave birth to their first ch ild between the ages of 15–19.

Table 72
Age at the time
of first
child Mothers who
abandoned their children
in maternity wards
(n=201) % Mothers who
abandoned their children in
pediatric/recovery wards
(n=155) %
Under 15 6.5 5.6
15-19 65.2 62
20-24 21.5 23.9
25-29 5.9 7.8
30-35 0.9 0.7
As concerns the number of children born, there is a marked difference between mothers who
abandoned their children in maternity wards and t hose who did so in pediatric/recovery wards.
Thus, most mothers (34.4%) who abandoned their ch ild in a maternity ward have given birth to
one child, while those abandoning ch ildren in the pediatric ward ha d more than four children
(36.8%). This information suggests that the re asons for abandoning children in maternity and
pediatric wards may differ.

Table 73
Number of children born Mothers who abandoned
their children in
maternity wards
(n=201) % Mothers who abandoned their
children in pediatric/recovery
wards
(n=155) %

881 child 34.4 14.1
2 children 15.9 19.3
3 children 11.4 18.1
4 children 11.9 11.7
More than 4 children 26.4 36.8

Number of institutionalized children
About 41% of the mothers have at least one ins titutionalized child (including the child in this
case study). Of these, 65.9% ha ve one institutionalized child, 19.1% have two institutionalized
children, 8.8% have three institutionalized children, and 6.2% ha ve more than three children in
institutions.
Table 74
% n=147
1 child 65.9%
2 children 19.1%
3 children 8.8%
More than 3 children 6.2%
Circumstances in Which Children Abandoned In Maternity Wards and Pediatric
Hospitals/ Wards Were Born
Mothers who were identified were asked to answer s certain questions pertai ning to the history of
the pregnancy and birth of the child temporarily or permanently abandoned.
When asked whether they had wanted the children they abandoned, only 29% of these stated that they had not wanted the child.
Figure 19: Did you want this child?

This figure, which may or may not be realistic, is very high for Romania, in conditions in which
causes have been insufficient research, it was ob served (also in other studies) that very few
mothers admit they did not want their child or had an unwanted pregnancy. Yes
71%No
29%

89Of those that stated they did not want the pr egnancy, only 7% claimed to have used some
contraception (pills, condom, calendar method, etc.), while 93% of the mothers did not use any form of contraception to prevent an unwanted pregnancy. The mothers claimed they realized they were pregnant based on th e signs and symptoms
presented in the following table (Table 75). More than 50% of these were familiar with the most
important sign of a pregnancy, name ly the absence of menstruation.

Table 75
% (n=343)
I missed my period 54.5
My breasts hurt 3.3
I was nauseous/vomited 18.9
I was sleepy 2.5
I had an unusual appetite 0.5
My stomach expanded/I put on weight 13.4
I felt it moving/that I was going to give birth 6.9

Some 57% of mothers realized they were pr egnant up by and in the third month, while 43%
became aware only as of the fourth month. One per cent of the mothers stated they were unaware
of being pregnant until th e moment they gave birth. “I found myself in labor and had no idea I
was pregnant.”

Figure 20: In what month did you realize you were pregnant? (n=351) “These mothers are not familiar with the si gns of pregnancy, and the pregnancy becomes a
certainty for them only when the child begins to move.”

Obstetrical – Gynecologists Physician
“These mothers go to see a doctor only if they are in pain or feel unwell. They do not register
as pregnant women. They have no idea about the symptoms of a pregnancy and consequently
realize that something is happening to them only in the fourth or fifth month.”

Obstetrical – Gynecologists Physician

9011%25%
21%25%
12%
3% 2%1%
0%5%10%15%20%25%30%35%40%45%50%
1 luna 2 luna 3 luna 4 luna 5 luna 6 luna 7 luna 9 luna

At the time they learned they were pregnant , over 70% of the wome n were involved in a
relationship, either married or in a consensual union.

Table 76
What kind of relationship did you have with the child’s
father when you realized you were pregnant? (n=351)
%
Mere acquaintances 11.4
Friends 15.1
Fiancées 0.6
Common-law marriage 55.8
Marriage 16.2
Other 0.9

Over 80% of the fathers learned of the pregnancy at the same time as the mother ( Table 77 ).
Their reaction was most often one of rejection, refusal or denial of such a situation, with greater
or lesser violence ( Table 78 ).

Table 77
When did you tell him you were pregnant? (n=351) %
As soon as I found out 83.6
When the pregnancy became visible 11.9
After the birth of the child 2.7
Towards the end of the pregnancy 1.8

Table 78
What was his immediate reaction? (n=327) %
He was happy 59.6
He was indifferent 18.9

91He denied it was his child 7.3
He recommended an abortion 7.3
He physically/verbally abused me 3.9
He threatened to leave me 2.1
He was angry 0.9

As a result, over 30% of the mothers were left by their partners (Table 79).

Table 79
How did the relationship de velop during your pregnancy? (n=337) %
We stayed together 69.7
We stayed together on conditi on that I abandon the child 1.6
He left me/kicked me out 27
Other 1.7

Over 60% of the mothers never had any pre-natal medical examination.

Figure 21: Did you have any pre-natal medical examination? (n=349)
Child abandonment occurs when his parents do not participate equally in the “ritual of the
child’s intra-uterine developm ent and delivery.” In normal couples, responsib ility for the
mother’s pregnancy is accepted by both partners, and the father “participates” in the child’s
intra-uterine development and the joy of his birth.”
Director DJDPC “Women with unwanted pregnancies do not communi cate with their partners, but rather
themselves take on all the conse quences of this situation. Thei r partners distance themselves
from the problem and fail to prov ide any support for making the right choice in the child’s
best interest. This is one reason why the partne rs often deny they are the children’s fathers. “

Obstetrical – Gynecologists Physician

92

Most mothers did not feel ve ry well during their pregnancy.

Figure 22: During the pregnancy peri od I experienced: (n=155)

6.2. Specific features regarding only mothers who abandoned their children in maternity
wards

Most of the mothers in this category were hospita lized on the very day they gave birth or even a
few minutes before delivery (Table 80). Over one third were not accompanied by anyone at the
time they admitted to hospital (Table 81).

Table 80

Table 81 When were you admitted to hospital,
in relation to the time of delivery? %
(n=201)
2-3 days before 26.3
On the same day 55.8
A few hours/minutes before I gave birth 17.9 Yes
39%
No
61%
88.3%
67.1%
15.4%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Nausea Dizziness Bleeding

93Who accompanied you? % (n=201)
The child’s father 29.7
My mother 15.8
Relatives 10.3
Friends 2.6
Acquaintances 4.5
Nobody 37.1

Some 16% of mothers provided no identity documents when admitted to hospital.

Figure 23: Did you provide your identity documents? (n=201)

All the mothers arrived at the maternity wa rd with the thought of abandoning their child
temporarily or permanently. However, 33% of the mothers stated that the child’s birth led to a
change in their decisi on to give up the child.

Figure 24: Did the child’s birth change your decisi on to temporarily or permanently give
up the child? (n=201)
Yes
84%No
16%

94

Some 36% of mothers stated that they shared the same room with their baby after delivery.

Figure 25: After birth, did you share the room with the baby? (n=201)

Almost half of the mothers never breastfed their child.

Figure 26: Did you ever breastfeed the child? (n=201)

Yes
33%
No
67%
Yes
36%No
64%

95

According to their declaration, more than a third of the mothers leave the maternity ward within
the first two days of the birth, over 20% leave after 3-4 days, and the rest after five days.

Table 82
How long after the birth
did you leave the hospital? (n=197) %
1-2 days 34.9
3-4 days 21.3
on the 5th day 13.7
after 5 days 10.0
Do not recall 20.1

The reasons invoked by mothers for abandoning thei r children provide some indication of their
despair when faced with a situation for whic h they consider there is no solution, and in
connection with which they feel they r eceived no support from those around them.

What were the main reasons which de termined you to abandon your child?

– They would not take me in at home with the child.
– I had nowhere to go with the child.
– I did not want to abandon him, but rath er just leave him for a short while.
– I did not have suitable living conditions.
– I don’t know.
– My depression caused by the child’s condition.
– I had no money to pay for the hospitalization.
– Large family. Financial difficulties.
– Lack of identity documents.
– I was discharged from hospital.
– I had other small children at home, and there was no one to care for them.
– I did not paln to abandon him permanently, just for a while, because I had no money, and my
boyfriend did not car e about the child.
– I did not know where I would get the money to raise my child, my husband does not help me
at all, we always fight.
– I am single, my boyfriend left me, I am t oo young, I have no way of supporting the child.
Yes
51%No
49%

96- When my father learned about th e child, even he refused to take me in with the child, as did
my brother.
– I did not want him because I am single, my pa rents were against my having a baby, I have no
job, I cannot handle having a baby.
– Lack of living conditions
– The health condition of the child in the family.

Most mothers claim they did not appeal for ch ild protection services because they were not
aware of their existence.

Why did you run away from the maternity wa rd and not appeal for child protection
services?

– I did not know who to appeal to.
– I did not know of the existe nce of protection institutions.
– I thought I would come back.
– I did not know what to do.
– I was frightened.
– I did not think about this.
– I did not want to abandon him for good, only for 2-3 months.
– I did not run away. I went home to talk to my husband about what we should do with the
child.
– I left without the children because they were young.

Nevertheless, 82% of the mothers claim they di scussed their decision to abandon the child with
someone, most of which are members of the medi cal staff in maternity wards, and sometimes a
social worker.
Figure 27: Whom did you talk to? (n=88) “These mothers have no information on the servic es they can call upon in the case of an
unwanted pregnancy. The abandonment of the children immediately after bi rth or in pediatric hos pitals is also due
to the fact that mothers are unfamiliar with procedures by which th eir children can benefit
from services provided by the Child Protect ion Department. They firmly believe that the only
and safest solution is to abandon the ch ildren in medical institutions.”

Director DJPDC

97
The mothers claimed that only half of these people proposed a solution to prevent the
abandonment of the child. Solutions propos ed are presented in the figure below.

Figure 28: What were the solutions they proposed? (n=48)

An equal number of mothers claim there were people in the maternity wards who supported the
idea of their abandoning thei r children (Figure 29).

“Many physicians come to work as they did in the time of Communism, they do their work and
leave. They do not get involved in the children’s social problems.”

“Disinterest of the medical st aff; they do not know about the ways of solving such cases, and
treat mothers at risk of abandon ing their children with contempt.”
Physicians, County Hospital

“I doubt that the medical staf f contributes much to the moth er’s decision to abandon her
child. This decision is “reasone d” by the mother before she is admitted to hospital. The cases
in which mothers are labelled are isolated.
44.3%
22.7% 27.2%
4.5% 1.3%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Physician Midwife/
nurse Social
worker Current
husband/ partner Others

37.5%
43.7%
18.8%
0% 20% 40% 60% 80% 100% To take the child home To request a
protection measureTo request material
assistance

98“Some mothers recount their life story, their difficulties, the fact that they have no husband,
that they lived in a common-law marriage that they have no job th at they do not know what to
do with their newborn baby. They seem to expec t confirmation from those listening to them
that their departure from the maternity ward w ithout the child is rightful, justified. Such
mothers are the easiest to work with, as they listen to advice and often renounce the
temptation to run away.”
Medical Assistant The language used by medical staff is someti mes too straightforward, and at other times too
technical. I feel the medical staff should insist more on the fostering of a relationship between
the mother and the newborn, a bond between moth er and child, the involv ement of the mother
in the direct care of the newborn child.”

Interview with a physician – Obstetric & Gynecological Clinic and Maternity

As concerns persons whom mothers indicated as having encouraged them in their decision for
abandonment, 80% were medical staff, and 12% were social workers.

Figure 29: Who encouraged you in your decisi on to abandon the child? (n=48)

Declaring the child
Failure to declare the children is one of the major causes for their prolonged stay in medical
institutions. Some 89% of mothers claim they declared their child at birth. Th is information is questionable
because the child was (most likely) declared once the authorities contacted the mother ( Figure
30).

80%
12%
8%
0% 20% 40% 60% 80% 100% Medical staf f Social worke rNGO

99

“The procedures for the placement of children without identity documents with families or in
institutions are lengthy and bureaucratic. ”

Physician, Pediatric Hospital

Figure 30: Was the child declared? (n=188)

Mothers were asked to identify the way in which they were contacted by the authorities to decide what decision should be made about the ch ild and the issuing of identity documents.
Yes
89%No
11%“Mothers with no identity documents are at ri sk of abandoning their child. “Patients with no
identity documents make a statement about their identity at admission to the maternity ward,
but such statements may include false inform ation.” Some of these women run away from
hospital immediately after the birth.
In some maternity wards, mothers may be discharged with their baby even if their identity documents are expired, or after making a statement. In other maternity wards, the children of
mothers without identity documents stay in hospital until the situation of the mother’s
documents is clarified and the child is declared.
Even the bureaucracy involved in obtaining the mother’s iden tity documents and implicitly in
declaring the child, constitutes a risk factor fo r the abandonment of the child in the maternity
ward.”
Obstretical – Gynecologist Physician
“There are many women who have no identity doc uments, and in such cases the institution
cannot issue birth certificates for the children. The identity document issue is a serious one in the case of the Roma, we notify the Police and
the Child Protection Departm ent = risk of abandonment.
There are birth certificates that ha ve not been claimed for many years.
There are cases of children with no birth certificate at home with their parent. If the mothers
do not have any identity documents, they are not allowed to leave with their child.”

Neonatology Physician

100Although half the mothers claimed they came of th eir own volition, the soci al workers indicated
that they came on their own after being summoned by variou s institutions (Figure 31).
Once the mother has run away fr om the maternity ward, obviously without declaring her child,
the authorities of the medical a nd social protection in stitutions and community-level institutions
attempt to locate her.

Figure 31: How did the authorities cont act you in order to decide the child’s situation and
issue his identity documents? n=201

The above figure illustrates the non-involvement of these author ities and institutio ns in finding
the mothers. Almost 50% of the mothers claime d they presented themselves voluntarily, but
Child Protection Department social work ers often contradicted this statement.

At the time the authorities contacted the mothers, some 75% of children were still in maternity
wards ( Figure 32 ). Over 20% had been transferred to pe diatric and recovery wards, and in 3.5%
of the cases a protection measure had been instituted for the children.
Figure 32: Where was the child when the auth orities contacted you? (n=201)
49.5%
6.9%
25.7%
1.7%
8.9%
6.3%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% I went there on my own The Police found me The Child Protection
Department found meThe representatives of the organized
private body found meThe city hall social worker found me The physician/nurse found me

101

After being located, almost 50% of the mothers took their children home or the child was taken
home to them; 41.6% of the mothers requested a child protection measure and 7.4% gave their
consent for adoption.
Figure 33: What was your decision con cerning the child’s fate? (n=201)

Mothers who took their children home felt greater support th an those who te mporarily or
permanently gave up their child.

Kindly justify the decision concerning the child:

1. Decision to take hi m home to his family:
– I love him.
– I changed my mind and wanted to take him home.
– He is my child, I must raise him

75.6%17.0% 3.9% 3.5%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% In the newborn
ward In the pediatric
ward In the recovery
ward In a Placement
Center

48.5%
41.6%
7.4%
2.5%
0% 20% 40% 60% 80% 100% I took him homeI requested a
protection measureOther
I gave my consent
for adoption

102- I regret having considered the possibility of abandoning him, he also is my child.
– If I can feed 5 mouths, I can handle an other two more. These are my children too.
– He is mine, I didn’t have the he art to ruin the child’s future.
– My mother would not let me abandon the child.
– When they brought him home to me and I took h im in my arms for the first time, in spite of
the problems I could not give him up

2. Decision to give up the child, either temporarily or permanently
– I could not get used to the Maternal Center.
– I want him to have better conditions in which to grow up.
– I couldn’t raise him, I didn ’t have the financial means.
– He is a sick child.
– No money.
– I do not have the means to raise him, no money, my parents are separated.
– I had nowhere to go with the child, my par ents would not take me in with a child

Interviews with mothers

The investigative teams were surprised to learn that a mere 46% of mothers stated they knew
what protection measure was taken for their child. Furthermore, according to the statements of the mothers, only 40% of the fathers were aware of
what kind of protection measure was taken for the child.
Figure 34: Is the child’s father aware of the prot ection measure undertaken for the child?
(n=129)

At the time of the interv iew less than half the children aban doned in maternity wards were with
their biological families, for over one third of various protection measures had been taken. Here again the high number of mother s (18.8%) who do not know where th eir children are is startling.

Figure 35: Where is the child? (n=129)
Yes
40% No
60%

103
It is to be underlined again to the fact that the information presented in this figure is not
representative for the entire group of children who were abandoned in maternity wards. This is
because mothers interviewed constitute only 20% of the total number of mothers, selected not
scientifically, but rather on the ability of invest igators to locate these mothers. For this reason
these are the most stable, easy to identify, quite un characteristic for rest of the group of mothers.
Mothers giving up their children in all counties were special cases. Th ey would always find
mothers who “wanted their children back,” who claimed they had not given their consent for
adoption. Further investigation of such cases revealed that these mothers had in fact given their
consent for adoption, but the civil servants and not sufficiently explained to them what they were
signing and what are the legal ra mifications of their signature.

Mothers who requested a permanent or tempor ary adoption measure we re asked what their
thoughts were concerning the child’s future. They were equally accepti ng of taking the child
back home to the family and keeping him in th e child protection system (this data is not
presented). The types of answers are presented in the box below.
What are your thoughts concerning the child’s future?

– I want him to have a family.
– It is better for him to be raised in a secure family.
– I want to raise my child.
– We will visit him and if we can we will take him home in future.
– I want him to have a good family that will raise him well.
– If our financial situation improves we will take him home.
– I will keep him.
– I want to take him home.
– I will try to take him home at some point.
– I want them to raise him until he turns 18.
– I don’t know.

43.4%
20.6%
12.9%
0.4%
3.9%
18.8%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% At home With a foster parent In a Placement Center With relativesAdopted Do not know

104- I want the child to be placed in a center or receive some form of protection measure for his
own good.
– I want to raise, care for and educate the child so that he does not grow up to be irresponsible.
– I would like to know him, to see him occasionally, I am sorry I gave up the child.
– I would like to raise them, to care for them, they are all mine.
– I would like him to have a father.
– I would like him to stay in the family and be raised here by us.
– I want him to be adopted.
– I want him to be healthy, to have a good future.

6.3. Particular aspects regarding only single mothers who have abandoned their children in
maternity wards
A sub-category of mothers who have abandoned thei r children in maternity wards is made up of
single mothers who were not previous ly been in a couple relationship.
These mothers are at greatest risk of abandoning their children.
Some 93% of these mothers met their partners in places of entertainment, or by chance in public
places, such as the street or on public transporta tion. They began having sexual relations shortly
after their meeting. These relationships were usua lly very short-lived, resulting in their early
break-up. Only 44% of these girls discussed pregna ncy with their mothers, and the latter usually
entirely rejected these pregnanc ies. A very small number of girl s had discussed their pregnancy
and the future child with their fathers.
“Many mothers receive no support from their paren ts or their older sib lings to overcome the
difficult situation they find themselves in. They are rejected, and are threatened that they will
be kicked out of the house.”
Family Physician

Only 14% of them requested support from the ch ild protection services, es pecially in order to
give up the child.
“Child abandonment right after birth is also du e to the fact that mothers are unaware of
procedures by which their children can benefit from the services provided by the Child
Protection Department. They are convinced that th e only and safest option is abandoning their
children in medical institutions.”
DPC Director

Some 30,5% of mothers claim they wanted to raise their child. 10,8% planned to request a
temporary protection measure, while 58,7% wanted to give up the child ri ght after birth and put
him up for adoption.
Tabel 83
What did you think to do with the child
after birth ? %

105To raise him 30.5%
To ask a temporary protection measure 10.8%
To abandon/give him in adoption 58.7%

The mothers justify their decision to abandon th e child citing a lack of solutions and support
from those around them.
– Nobody wanted him at home.
– It was cold in the shack in which we live and we could not raise him ther e; he was well taken
care of in hospital; the doctor told me there was no need for me to stay with the child.
– I have no financial means to raise him.
– My mother told me she would not allow me back home with the child, I am in school, I have
no income, I have no support.
– My parents would not accept him.
– I have no place to raise him.
– I had no place to go with the child from the ma ternity ward. That is why I went to the house
of a friend to give birth and left the child there.
– I had no place to go or any money to pay the rent.
– Even though I had not wanted him, it broke my heart to think I had no place to take him, I
was frightened.

Case study

My name is SM and I was born in 1986. There are 4 people in my family: two parents, myself,
and a brother three years younger, who is a studen t in the High School in the same locality. My
mother works in a textile factory. She makes about 3 million Lei. My father is a qualified
worker, but lately, since I have grown up, he has not had a steady job. He does not contribute to
our care.
My parents are separated but not divorced. The separation took pl ace when I was sixteen and a
half; my father was away from home for long periods of time. Because we had no money when I
was in 9th grade, I spent one year in a Placement Ce nter, a former boarding school. They provide
free housing and meals. I have pleasant memories of the Placement Center, and I would go home
every weekend.

I supported my mother’s decision to separate from my father because he was violent, drank, did
not work, did not earn any money. This made our living condi tions very tense, especially us
children. Shortly before he left, my father ha d begun beating me and my younger brother as well.
When I was little, I loved my father very much and I think this was why my mother postponed
her separation from him. My father disappointed me very much, because he is a weak person,
who was unable to give up drinking, in spite of realizing that alcoho l brought him nothing but
trouble. When I was about sixteen I began taking my mother’s side, and even encouraged her to
make the decision to separate from my father.

106I was raised by both parents, but my mother was the primary caregiver. I lived with my mother
and brother until about 2 months ago. I moved away and I am now living alone in an apartment
that belongs to an acquaintance. I have no obligation to cover th e maintenance expenses of this
apartment, but committed to take care of the apartment so that thieves are not tempted to break
in. I have no legal documents to justify my current residence.

I have very good relations with my mother, she al ways supported me in difficult times. She gave
me good advice, even though I never took it. Sh e is understanding, good, and forgiving. I loved
my father more, but now I want to forget him.

My maternal grandparents were no longer a live when I was born. I know my paternal
grandmother, but she never loved me, never hugged me, never said nice things to me, she was a
mean woman, and very distant to me.

I have no news of my father for about 2 months ,. He does not know that I have given birth to a
child.

I started my sex life when I was 16 with my bo yfriend, someone my family knew, and who was
13 years older than me. I would often go visit him. I got along well with my boyfriend’s family,
made up of two children and the mother, I felt accepted and protected by them.

I am from the countryside, from a villag e close to the city of B. I am an 11th grade student in a
very good High School; when I graduate I will ha ve a secure and beautiful profession. I am
single and I have a 7-mont h-old boy. I gave birth to him in th e local maternity ward before I was
18. The child was born at 7 months, weighing 2,000 grams, and has a disability, a split in his
upper lip, a malformation know n as a “cleft lip”.

I felt very well throughout the whole pregnancy, had no morning sickness, and only felt sleepy. I
didn’t eat very well during the pregnancy. I ate a lot of apples because I knew this was good for
me. I did not speak to anyone about being pr egnant. I hid the preg nancy by wearing baggy
clothing so that it would not be visible. I realized I was pregna nt from the very first month,
because I had very regular periods, but I was hoping it was a false alarm, and postponed the
decision until the child began moving. Afterwards, I started having feeli ngs for the child and
became attached to him. I tried to make contact with the child’s father by phone but he never
answered. I suspected he was not answering because he was expecting such news. I felt
abandoned and alone, but knew there would be some salvation for me.

I went to school until the very last moment, be cause I did not want to drop out of High School.
During the pregnancy I never went to see a docto r, I did not have any blood tests. My mother
found out about the pregnancy two days before the child was born. She was the one who helped
me get to the maternity ward. She was very understanding and reminded me that she had gone
through the same thing with her first child, who unf ortunately died at six months. It is an old
story I knew from the family, but especially from my father’s family wh en there were fights and
misunderstandings.

107Soon after the child was born, my teachers, classmates and many others found out about it. This
was the second most difficult moment for me, becau se some of the teachers were very hostile
and suggested I drop out of school because I was not a good example for the other girl students. I
felt that some of the other teachers, especia lly the younger ones, were sympathetic to me.

My classmates supported me, both the girls and the boys. I remember the time when I was called
up before the School Board to explain my behaviour . I “pleaded” to be allowed to continue my
education, in spite of having given birth to a child by mistake and because I was naïve. The
school accepted my situation, partly because of the support I had received from the Child
Protection Department. I can say that I was fortunate. I remember my classmates asking me to
take them to see the child. They helped me think more seriou sly about the child’s future.

The child’s father did not acknowledge him. He has only my name. I arrived at the maternity
ward by ambulance with only my mother, who helped me most when I was upset and desperate.
Upon admission to the maternity ward, although this was very hard for me, I did not hide the fact
that the boy was conceived as a result of a short- term relationship, and that he would have only
my name.

I had my identity documents with me when I cam e to the maternity ward, and a nurse filled in
the admission chart. When she enquired about my husband, the child’s father, she gave a
condescending look, as if to say “what a stupid girl , with nothing better to do at her age than to
have a baby.”

I did not know what to do and was very confused after the child was born. What was I to do
about him, about school, about my future. I stayed in the maternity ward with the child after the
delivery for about 10 days; a single nurse suggested that it would be better for me not to see the
child anymore, and to leave him there so that I could start my life over again. That same nurse
explained that not seeing the child would help me not to get attached to hi m, as this was not good
for him. I breastfed the baby, in spite of some problems because I did not know how to do this.
My mother and brother visited me du ring my stay in the maternity ward.

One month after I had the baby I met the child’s fa ther and told him everything. He seemed to be
happy and told me he would acknowledge the baby. But this di not happen, he never called me
again, and never kept his promise. I accepted this situation, thought about it for a while, and then
set my priorities. At that time, school was the most important thing for me, so I decided to
suspend my medical leave and return to High School to pass my exams and avoid having to
repeat the grade. I talked to the nurse an d the social worker from the Child Protection
Department about all these things. I did not want to abandon my child, and left the maternity
ward in “justified” circumstances to solve so me problems related to school and the child’s
identity.

Before leaving the maternity ward I made a written request in the presence of the social worker
to the Child Protection Department for my child to be put in a placement center. The child was
transferred from the maternity ward to the pla cement center about one and a half months after I
declared him and I obtained his birth certificate; this all happened while I was busy with my
education.

108
I know what a placement center is, because I stayed in one for a year when my father left us and
my mother could not afford to keep us in school. I heard that children w ith no financial support
can also be cared for by foster parents. I did not want my child to end up in a family because I
was afraid he would get attached to the respectiv e family, and then there would be no way to get
back to my initial decision. I know I can vis it my child anytime in the Placement Center,
according to my school schedule. The Placement Cent er can also arrange for an operation for my
child to help him get rid of th e flaw with which he was born.

Although the child was never acknowledged by his fath er, he is a child that was made with love.
Unfortunately, this love was only mine and his father considered this relationship as just a bit of
fun.

The news that I have an illegitimate child spr eak quickly in my village. When people asked
about this, I denied it. I do not know how to fix this lie, but will think about it.

In future I want justice to be done by me, w ill file a paternity suit, even though I know it will
cost me a lot of money and energy, and will try to raise my child on my own.

6.4. Aspects relating only to mothers who aba ndoned their children in pediatric/recovery
wards.

Mothers who abandoned their children in pediatri c/recovery wards were questioned about the
circumstances in which they abandoned their chil dren. More than 80% of the children came from
home to be admitted in medical institutions.
Figure 36: Where did the child come from at the time of hospital admission? (n=155)

Some 95% of mothers claimed th ey brought the children in because they were sick. Almost 20%
of them also indicated social r easons for the child’s hospitalizing.

Figure 37: What was the situation of the child at the time of hospitalization? (n=145)

82.5%
9.2%
8.3%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Brought
from homeTransferred from maternit y
ward/other hospital/
recovery ward Not brought to hospital
by his mothe r

109
Some 70% of mothers had a writ ten recommendation from a physic ian for the hospitalization of
the child.
Figure 38: Who recommended the child’s hospitalization? (n=145)

Some 17 % of hospitalized children did not have a birth certificate (Figure 39).
18% of mothers did not provide an identity document at the time of hospitalization (Figure 40).

Figure 39: Did the child have a bi rth certificate? (n=145)

95.0% 2.7% 5.5% 10.3%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Sick AbusedNo home No one in whose care
I could leave him
58.6%5.5% 2.7% 29.6%3.6%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Family physician Ambulance physician Ambulatory physician I came in on my
own initiative Othe r

110

13% of mothers no longer lived at the address recorded in their documents (the information is
not presented).
Figure 40: Did you provide an identity document at the time your child was hospitalized?
(n=137)

These mothers were also requested to justify th eir decision to abandon the child in the hospital.
The reasons given lead one to believe that thes e mothers are mainly from the category of women
who have their own family, are raising several children, and are tempted to rely on the hospital
for the child’s social protection in difficult situations.
No
17%
Yes
83%
yes
82%no
18%

111
The types of answers to this quest ion are presented in the box below.

Please justify your decision for abandoning th e child in the hospital/pediatric ward.

– I was 8 months pregnant.
– I had to go back to the other children.
– My family would not allow me to stay, I had other problems.
– I had another three children to care for.
– There was no one I could l eave the other children with.
– I did not have suitable housing to keep him at home.
– I was depressed.
– It was winter and I did not have suita ble conditions, I was pregnant again.

As in the case of mothers from the maternity ward s, the authorities of the medical, social welfare
and community institution authorities attempt to lo cate the mothers in or der to find protection
solutions for the children. The mothers were aske d about the whereabouts of the children at the
time they were contacted by these authorities. Th e authorities had taken a protection measure for
a small number of these children, but most of them were still in pediatric/recovery wards ( Figure
41).
There was impossible to find out from the mother s how long the child had stayed in hospital,
with no medical justification, because very few mothers remembered such information, and
denied having left the child there wi th the intention of abandoning him.

Figure 41: Where was the child? (n=150)

However, some 50% of mothers requested that a protection measure be ta ken for the child, after
the Child Protection Department contacted them (Figure 42). As the open questions revealed,
there were cases in which the child was brought to the mother’s home w ithout prior notification
of the Child Protection Department.
70.6% 12.6
% 3.3
% 2.6% 13.5%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% In the pediatric ward In the recovery ward With a foster parent In a Placement Center Doesn’t remembe r

112

Figure 42: What was your decision regar ding the child? (n=129)

The mothers were again requested to justify thei r decision concerning the child. The statements
of the mothers reflects the ambi guity of their decisions concerni ng the responsibility of raising a
child and of placing him in an improvised protec tion situation, namely the pediatric ward.

65.2%24.3%2.2% 8.3%
0% 20% 40% 60% 80% 100%I took him home I gave my consent
for adoption Cannot remember/
not answe r
Please justify your decision
I took him home
– I want to raise him.
– I wanted to keep him.
– The hospital social worker brought him back to me.
– Because I wanted to.
– My mother wanted me to bring him home.
– I did not intend to abandon him and took him back quickly from the Dystrophic Ward.
– The hospital staff brought her to my mother and she brought her to me.
– I left him there temporarily, I did not in tend to abandon him, but I had some problems
and nobody helped me.
I requested a temporary protection measure
– It is better for the child.
– The lack of income.
I gave my consent for adoption
– It’s in her best interest to go to a family. I requested a temporary
protection measure

113The mothers whose children benefited from a pr otection measure were as ked if they knew what
type of measure was taken. Some 56% of mother s and 68% of fathers di d not know what child
protection measure had been taken.
Figure 43: Do you know what protection measure was taken for the child?
(n=64)

Figure 44: Does the child’s father know the type of protection measure that was taken for
this child? (n=74)

6.5. Family planning – aspects below refer to all categories of mothers
The use of family planning methods constitute the most efficient way of preventing unwanted
pregnancies. The aspects targeted during the interviews referred to the knowledge and usage of
contraceptives. More than 50% of mothers know of at least one modern contraceptive method
Yes
44%No
56%
Yes
68%No
32%

114and 25% know of at least one additional/natur al method. The most widely known methods are
pills, the condom and the IUD. Their usage, ho wever, is extremely limited. The most used
methods were the withdrawal method and the condom (Table 84).

There is a difference between knowledge about and use of contraceptives. Qualitative studies
show that this is justified with arguments that denote insufficient knowledge or lack of trust in
such methods.

Table 84
Methods % Have heard about % Have used
Withdrawal method 25.9 16.0
Calendar method 19.1 9.0
Injectable contraceptives 30.8 9.0
Vasectomy 2.0 –-
Tubal occlusion 20.5 2.0
Diaphragm 3.7 –-
Condom 41.6 14.9
IUD 40.2 5.0
Pills 54.1 12.0
The women were also asked how th ey knew about each method used.
The sources of information indicated for the pill , the IUD, the diaphragm, and tubal occlusion
was the physician and the nurse, for the calendar method and the condom they indicated
knowing from acquaintances, and ab out the withdrawal method they indicated their partner.
“There is a constant battle against rumors that birth control methods are harmful. There is
great resistance to contraceptives because many women are more open to listening to advice
given by their neighbor than by a physician.”
Family Physician
“Another cause for child abandoned is the level of e ducation of mothers. This is evident from
the lack of know-how for using contraceptives and planned births. They come from a culture
in which it is believed that men are suppos ed to know everything about sex, and have the
experience to protect the woman.”
Physician

115
Contraceptives are less well know n by Roma women than by Roma nian ones, with the exception
of injectable contraceptives.

Table 85
Have you heard of:
% Romanian
(n=144) % Roma
(n=199)
Pills 59 50.7
IUD 46.5 35.1
Condoms 50 34.1
Diaphragm 5.5 2.5
Tubal occlusion 20.1 20
Vasectomy 2.1 2.1
Injectable contraceptives 27.7 32.6
Calendar method 26.3 14.1
Withdrawal method 29.1 23.1

In terms of usage, it was noticed that in the case of both ethnic groups the traditional methods are
by far the most widely used. As concerns mode rn methods, Romanian ethnic women are making
use most often of the condom and injectables, while the Roma use condoms and tubal occlusion.
Table 86
Have you used: % Romanian
(n=144) % Roma
(n=199)
Pills 25.5 9.5
IUD 10.2 14.1
Condoms 39.1 24.2
Diaphragm –- –-
Tubal occlusion 6.8 15.3
Vasectomy 30.7 9.5
Injectable contraceptives 38.4 53.3
Calendar method 61.9 60.8

“We have responsibilities regardi ng the prevention of abandonmen t. These are included in
the national health care programme which provides family pl anning and birth control
services to socio-economic ally disadvantaged categor ies of the population, whose
educational level is low, and w ho have child abandonment antecedents. “
Medical Unit Director

116

The use of induced abortion is the most co mmon method of birth c ontrol among educated
mothers, whose socio-economic status is high, and who are aged 25-29 ( Tables 86 – 88 ).

Table 87
Schooling level
No
abortion 1
abortion 2
abortions 3
abortions4
abortions More than
4 abortions
No education 31.6% 2.8% 3.1% 1.1% 1.1% 2.3%
Did not finish
primary school 17.4% 4% 2.3% 0.9% 0.9% 1.7%
Finished primary
school 10.8% 0.9% 0.6% 0.6% 0.6% –-
Grades 9-10 7.4% 1.4% 0.3% –- 0.3% 0.3%
Vocational school 3.4% 0.4% 0.3% –- –- 0.3%
High School 1.7% –- 0.3% –- –- –-
Post-secondary 0.6% –- –- –- –- –- “The Roma have great reluctance; they know little about basic; they refuse any contact; most
of them reject contraceptives. Those who do accept these have had some education. They are
very poor. Their attitude towards fam ily and family life is different.”
Professionists DJPDC
“Contraceptive measures are presented in schoo l, and are a subject as commonly debated as
teeth brushing. Unfortunately, this very info rmation on contraceptives does not reach the
most vulnerable segment of the population that has not had any form of schooling.
This segment of the population still resorts to sep tic abortions, although it is now possible to
request an abortion, in conditions of maximum medical security. The ignorance of this
category of people is profound, and cross-generational. These mothers do nothing for their
own health, do not allocate even the smallest amount of mon ey from the family budget to
purchase any type of birth control or to pay for a legal abortion. They ask for advice from
people who are as ignorant as they are.”
Obstetrical Gynecologist Physician

117non-tertiary
education
Higher education 0.6% –- –- –- –- –-

Table 88
Socio-economic
status
No
abortion 1
abortion2
abortions 3
abortions4
abortions More than
4 abortions
Very low 57.5% 7.1% 6.3% 2.0% 2.6% 2.8%

Low
11.1%
2.6%
0.6%
0.3%
0.3%
1.4%

Medium
2.6%
–-
–-
0.3%
–-
0.3

High
2.3%
–-
–-
–-
–-
–-
Table 89
Mother’s
age
No
abortion 1
abortion 2
abortions 3
abortions4
abortionsMore than
4 abortions
Under 20 23.1% 3.4% 0.8% –– 0.2% –-
20-24 15.9% 1.4% 1.1% 0.8% –- 0.5%
25-29 13.9% 2.8% 1.9% 1.1% 1.4% 1.9%
30-34 9.9% 0.5% 1.4% 0.5% 0.2% 0.2%
35-40 4.2% 1.4% 0.8% –- 0.5% 0.5%
Over 40 1.4% –- 0.2% –- –- 0.2%

Case study

“I don’t know much about abandone d children. I only know what I have seen on TV. I believe
abandoned children are those who are killed by their mothers or left in th e garbage dump or out
in the fields. They are children whom nobody wants, especially their mothers.”

My name is TF, I am 28 years old and was born in a commune located in county A. I have been
married since I was 16 to a boy whom I met in my village. We have a common-law marriage.
The marriage was concluded based on an understanding between our families, as is the tradition
among our people. We get along very well. We do not drink alcohol, as this is the root of all evil.
We did not have a legal marriage because this costs money. I asked around and it would have
cost me some two million (lei). You need money for the blood tests and other documents which
are necessary to be legally married. For us, this is no longer important.

118At the beginning of our marriage, we stayed at the home of my in -laws, then at my parents’
house, because we had no place of our own. After a bout three years of marriage, we managed to
build a very small one-room house, made of cement bricks. We have no sewerage system, raise
no livestock, have no land except for a small vegetable garden.

I do not know how to read or write, I have neve r been to school. That is why I do not even
understand the world I live in.

I gave birth to five children, all of whom we re claimed by their father, but only four have
survived. I delivered my first four children at home, where I was helped by a neighbor who
knows something about mid-wifery. The fifth child, whom we are talking about, was born in the
maternity ward.

The first person I talked to about being pregna nt was my sister-in-law, and later my husband.
When I told him I was pregnant, he was not happy, a nd he advised me to “get rid of it” if it was
not too late. But, unfortunately, I was over four months pregnant.

I was registered with a family physician, I ha d all the blood tests he prescribed. The family
physician told me that, if I were on his list, I could use the ambulance service when my labour
started. He did not tell me I would be unable to take my child out of hospital without a birth
certificate, or else I might have done something about our identity documents in time. I am now
8 months pregnant. Of the children I have given bi rth to only one died. A little girl died, when
she was three and a half years old, because she caught a cold, had convulsions, and they could
not save her. She died in a hosp ital in Bucharest, where we went to have her cared for by the best
doctors. I don’t remember th e name of the hospital.

The fifth child, my youngest, is 10 months old. I gave birth to him in the maternity ward located
in the municipality of P.; he weighed 2,700 grams at birth. I was assisted at birth by a physician,
whose name I can still remember . After telling me the baby’s we ight and gender, they took him
to the newborn ward. I saw him again about 24 hours later, when I was allowed to breastfeed
him. When I was hospitalized I did not provide any identity documents because I did not have
them on me. My husband and I had lost our identity documents during one of our many trips to
Bucharest. Five days after delivery, when I would normally have left the maternity ward with my
child, I was told that it was compulsory, prior to the baby’s discharge, to provide his birth
certificate. My husband tried to obtain this but failed. That is when I decided to leave the
maternity ward without the baby, in order to resolve the situation. I did not run away as other
mothers do, instead I notified on e of the nurses. I promised I would come back as soon as
possible to get my child. I left the maternity ward with my husband. When I arrived home I
immediately started the process of obtaining new identity documents, but this was complicated
and it took a lot of time. In the m ean time, my father pa ssed away, and I had to take care of his
funeral. Shortly afterwards, about one and a half months after ha ving left the maternity ward, the
social worker from the Child Protection Department showed up at my door. He told me that if I
did not discharge the baby from the newborn ward he would be sent to a Placement Center. After
I solved the birth certif icate problem, I took my child home. The child was in the newborn ward
for about 3 months. As a matter of fact, this was better for him because it was winter and I did
not have suitable conditions at home to raise him. I had no in tention of leaving him for good. I

119took him from the maternity ward after the harsh winter passed. When I took my baby from the
maternity ward, I was accompanied by my husba nd. We left by public transportation, by bus.

The child is now at home, he has a birth certifi cate, and my husband and I, and some sisters-in-
law take turns caring for him. We live on the mone y we earn from day work in the households of
various people. We help them to cut their he dges and wood for winter , cleaned yards, and
various other agricultural seasonal work. We do not earn much but can manage. We also have
the children’s allowances. Recently, we filed a pe tition with City Hall to obtain social welfare.
For me, the most important problem is the house. It is too small for so many children. We do not
have much hope of building another room, as pri ces are very high. Come to think of it, I am
living quite a hard life, harder than that of my parents, even though they had eleven children.

My mother used to have a job, as did my father . We are much poorer than my parents. When I
was a child I had a better life. Now it is worse.

Family is very important to me. My husband a nd I support each other, and I also receive some
help from a sister-in-law with whom we share the same yard.

I was raised by both parents, but especially by my mother. My gra ndparents also took care of me
when my parents were at work. In our family, no children were placed in the care of institutions.

My mother taught me to listen to and respect my husband, love my children and be kind to them.
I care very much for my children. The oldest one is enrolled in school because I can see how
important school is today. I can no t help him with his homework, so he has already had to repeat
one grade.

I was taken to the maternity ward by my husba nd, by ambulance. Before leaving home, I took
my slippers, my nightgown and ev erything else I would need.

My husband finished primary school, but he finds it difficult to read. He used to work at the Park
Administration in our city, then the company was restructured, so he was left without a job, and
subsequently received a support allowance. At present he only has occasional jobs.

I am now expecting another baby. I became pregna nt very quickly because I did not breastfeed
my child. The only thing I know is that, wh ile you breastfeed, you do not get pregnant. My
husband never uses any protection, he says it is my duty to know how to avoid getting pregnant.
I would love to stop having children, but do not k now how. I spoke to the doctor in the maternity
ward, but he told me to come talk to him about this problem when I was discharged from the
maternity ward. I put this off every time, and then it was too late. I also k now that I can have an
abortion on request, on condition that the baby has not yet moved.

1206.6. Overview of activities conducted by th e County Departments for Child Rights
Protection in 2003 and 2004
Because it is believed that child abandonment is al so a sign of the inefficient operation of child
protection services, the sources of inquiries and requests (noted requests ) in our working charts
were recorded, as well as the percentage of such sources at the level of each DJPDC included in
the study. The maternity ward comes in first place in both 2003 and 2004, wh ich means that the
establishment of the protection measure was preced ed by periods of child ne glect at an age when
every day of neglect counts. It was noticeable a positive change, in the sens e that the percentage of requests filed by the
parents in 2004 doubled over that in 2003, while re quests filed by medical institutions or other
public institutions decrea sed rather significantly.

Table 90
Requests filed by: 2003
% 2004
%
Parents 11 23
4th degree relatives 5 9
Police 3 3
Maternity ward 34 28
Pediatric/recovery ward 25 22
Public institutions 13 7
Authorized private bodies 2 4
Private persons 7 4
With regard to the type of pr otection measures taken, there is evident a slight improvement in
2004 in the sense that the number definitive measures were double.
Table 91
Type of protection measure 2003
% 2004
%
Emergency placement 38 39
Foster parent 9 9
Placement center 15 13
Placement with persons/families/up to 4th degree relatives 27 23
Entrustment in view of adoption 7 8
Domestic adoption 4 8

Number of requests recorded in 2003: 2,508
Number of requests between 1 January 2003 and 31 March 2003: 747 Number of requests recorded in 2004: 1,873 Number of requests between 1 January 2003 and 31 March 2003: 867

121Number of reported children for whom a prot ection measure has been established and who
subsequently were not visited for at least 6 consecutive months in: 2003: 128; in 2004: 129

122CHAPTER 7 – CONCLUSIONS

1. Characteristics of the phenomenon

Current situation This study shows that u nder-five child abandon ment continues to be a harsh reality for Romania,
which has been insufficiently influenced by refo rms implemented since 1989 in the area of child
protection. The coordinates of child abandonment in 2003 and 2004 were the same as those 10, 20 or 30 years ago. Many reforms put in place since 19 90, followed by the creation of numerous child
protection institutional structures and services evolved parallel with the phenomenon of child
abandonment, as long as maternity wards and pedi atric hospitals continue to serve as “choice
hosts” for such children. As concerns the scope of this phenomenon dur ing the 2003 and 2004 reference years of the
study, it was noted that some 4,000 newborns were abandoned (i n each of these years) in
maternity wards. To this must be a dded the over 5,000 children abandoned (annually) in
pediatric hospitals/wards. The scope of the phenomenon was determined accord ing to the rate of abandment (number of
children abandoned per 100 births/admissions).
The rate of abandonment in maternity wards stood at 1,8% in both 2003 and 2004.
In pediatric hospitals and wards the rate of abandonment constitutes the number of children
abandoned per 100 admissions, 1.5% in 2003 and 1.4% (2.1%) in 2004. Based on the method
used to calculate the rate of abandonment in pediat ric hospitals and wards this rate is in fact an
under-estimate because the number of children abandoned relates to the number of admissions
and not to the number of persons admitted. Evolution of the phenomenon Concerning the evolution in time of this phenomenon, direct and precise comparisons cannot be
made because cases of abandment were not previously recorded. Comparing the rates with data contained in publications, menti oned in the Introduction, there is
noticeable a slight rise in the phenomenon. Comparing the situation in 2003 a nd 2004 with that at th e end of 1989, one can see no less than a
doubling of abandonment cases in maternity wards. Such a statement is based on the following
data: some 10,954 children under the age of th ree were in Romanian “nurseries” in 1989
(Source: Ministry of Health). As the number of under-three children leaving such institutions
was insignificant, it can be estimated that so me 3,651 children children abandoned in maternity
and pediatric wards were admitted to “nurseries” annually. According to the data of certain

123studies, 83% of these came directly from matern ity wards (namely 2,623 children). If related
this figure to the number of births in 1989, 36,954, a 0.7% abandonment rate will be obtained.
However, the figure of 10,954 children does not adequately reflect th e number of children
abandoned in maternity wards in 1989, because many abandoned children remained and grew up
in maternity wards, or were moved to pediatri c or dystrophic wards. In 1989, dystrophic wards
could accommodate 3,500 children. As such, the rate of abandonment in maternity wards could have been higher than 0.7% at that time. On the basis of these es timates the rate could have been
as high as 1%. These supplementary explanatio ns complicate the estimates, but reconfirm the
growth of the phenomenon. These conclusions will tempt comments and comparisons . Therefore, the fact that almost half of
the children abandoned in maternity wards in 2003 and 2004 were there for s hort periods of time
(5-10 days), because they were taken from ther e directly home to their parents without Child
Protection Services bei ng notified, can mean that this category of children unjustifiably
eliminated from this category of abandoned children. The analysis of the routes of all abandoned children shows that a mere 6.5% of those abandoned
in maternity wards and taken straight to their pare nts in fact ended at home (therefore, these do
not reenter the circuit which assumes ther e is a break with the mother/parents).

2. Characteristics of children abandoned in maternity wards, hospitals and emergency
reception centers

a. Health and Rank
The most significant indicator differentiating abandoned children, in terms of health, is
birthweight. The ratio of abandoned children born with low birthweight was four times higher
than that among the normal population (34% as comp ared to 8.5%). Delayed intrauterine growth
is caused by the mother’s rejection of the child, her precarious living conditions, the existence of
risky behaviour, and not least, lack of know ledge about how to use pre-natal services.
These findings involve numerous implications a nd consequences. As c oncerns the child, the
recovery of this delayed growth will be hampered by the absence of the mother and the prolonged stay in a medical institution. The existence of disabilities in 9% of abandoned children constitu tes an even greater risk for
these to end up on a long route before stable and permanent protection solutions are found.
As in the case of children in maternity wards, over 50% of these are rank 1 and 2.

b. Identity, sex and leaving condition
A significant number of abandoned children have no identity. The data generated by this study
indicates that the ratio of such children is 64% at the time of release fr om maternity wards, 30%
from pediatric hospitals and less than 10% from emergency child protection services.
Many maternity wards have a practice of “deliv erying” abandoned children to their mothers
(who ran away from these wards) without notifying the Child Pr otection Services and prior to

124their having had identity documents issued to them . This practice, that goes against regulations
in force, runs counter to the most elementa ry measures to protec t children from serious
negligence and abuse of any kind, without anyone being able to be held responsible (without a
birth certifice you do not exist!).
There is a slight 2% over-repr esentation of boys over girls.
There is an almost equal propor tion of children from the two environments, urban and rural.

c. Conditions of stay in maternit y wards and pediatric hospitals
As concerns several aspects relating to the or ganization and operation of maternity wards that
might encourage the respecting of child rights, it was noted that most maternity and newborn
wards are set up according to the traditional system (without mother/child rooming-in areas) which in fact supports the separati on of the mother from her child. Furthermore, more than half
the institutions are not complying with the cons ecutive regulations stipulated in the Joint
Ordinance of the Ministry of Health and th e National Authority for Child Protection and
Adoption in 2003 on hiring a social worker, notifying/enrolling a new born on the list of a family
physician, and immediate, written notification of specialized public serv ices. Contrary to
regulations stipulated by legal provisions, a mere 20% of pediatric units have hired social
workers, only in 10% of the cases was notifi cation of the Department for Child Protection
recorded on the children’s charts, while 13% al so contained the decisi on/provision of the DPC.
Concerning the organization and operation of pedi atric hospitals and wards, it was noted that
such units are more likely to allow the admission of mothers with under-fi ve children than that
the latter be visited (37.1% of the pediatric hospitals/wards ne ver allow parents to visit their
children).

In connection with the length of stay of abandone d children in maternity wards, as compared to
the initial years of the tradition of abandonment, they now stay here much less time. The
experience of this study has shown that the length of stay in maternity wards is not necessarily
relevant to the respecting of the rights of the chil d and its developmental needs. What is equally
important is where the child goes. In 2003 and 2004 some 30% and 35% of children, respectively, spent less than 10 days in
maternity wards, while a third and fourth in thos e same years stayed for more than one month in
such wards. Those children who spend less than 10 days in maternity wards are usually those
who are taken directly to the mother’s home (s ome 40%), and only in a few cases are the local
protection services notified. Most of the childre n will become part of the protection system
following an intermediate stay in pediatric medical institutions. About one third of abandoned children are transfe rred to pediatric medical institutions, while the
remainder become immediate part of the protect ion system. Some 65% of children abandoned in
pediatric wards are under age two. The tendency to abandon children after that age drops as the
age increases.

125From an analysis of the circumstances of childr en being hospitalized it was noted that pediatric
wards are also used as social protection institu tions. The hospitalizatio n of most children was
justified medically or socially, although this can also take place without a medical diagnosis, and
some 10% of abandoned childre n fall into this category.
To ensure the “protection” of abandoned children, recovery wards were reinstated to host such
children, especially those without identity documents. Children can live “peacefully” in such
places for months or years wit hout their certain psychological breakdown alarming the social
protection services. In some places these wards, with tens or hundreds of beds, have replaced or are those very same
“nurseries” that were abolished recently. Examining the observation charts, investigators noted the lack of information on children in
these files, something that can be attributed to the lack of illnesses that would have justified
observations by physicians caring for sick children. Even so, it is difficult to make a connection
between the information in many observation char ts and the children whose charts these are.
There is an inadmissably large number of observation charts cont aining no indication of where
the children went after being released from hospital, as there was very little information to be able to identify the family or the child’s place of residence. This situat ion is further aggravated
by the fact that some 30% of children without bi rth certificates, and as such “non-persons,” can
be subject to any treatment without anyone being notified.
Furthermore, there are no standard country-wid e observation charts for pediatric wards.
Sometimes the use of charts not sp ecifically designed for children facilitates the omission of vital
information needed to follow up on the child, because such information is not requested in the
fields of the forms.

d. Conditions for placement in emergency reception services
Contrary to the notion itself, the measure fo r emergency placement was created for children
abandoned in health institutions for long periods of time and once steps to establish their identity
have been finalized. There were less than 10% of children lacking identity documents in such
institutions, and this is all the more significant as many children are brought here from the street.
Regulations governing the emergency placement meas ure are not respected. Some two thirds of
children are kept in this situation for periods exceeding the admissible limit (30 days). Most
children remain in emergency pl acement for at least two mont hs but there are also cases
exceeding one year. With the exception of emerge ncy reception services that operate through a
foster parent, these have more recently been organized within the framework of placement
centers. It is likely that such “neighborliness” fosters such ch ildren being “forgotten” in this
situation. The fact that these laws are not respected grav ely affects the chance and right of the child to
benefit from a permanent and stable protection measure.

3. Route of the abandoned child

126
All children identified in maternity wards, pedi atric and recovery hospita ls and wards, and in
emergency reception services were followed up in the documentation of the county protection services. It was an intention to learn about the route these child ren had been on and the type of
protection measure they had been offered. This ro ute is important because it offers information
about the quality and adequacy of protection servi ces to meet the child’s developmental needs.
The route reconstitutes the places the child ha s passed through during the time he has been
without his mother and the temporary or perman ent protection solutions he has benefitted from
until this day. It is to be mentioned that file s and information were found for a mere 694 of 1,935
children. 48 types of routes for the children were identified in the study sample.
Two thirds of the children abandoned in matern ity wards pass through pediatric/recovery wards
at least once before some form of protection measure is taken. Only one third of all children abandoned in 2003 and the first thr ee months of 2004 had
benefitted from a permanent protection solution (w ith their biological family or adopted)., which
shows that children are kept for long periods of time in various temporary forms of protection.
Very few children, about 6.5%, enj oy the “ideal” route, namely th at from maternity ward to
family. Eight of the routes have 3 stops without arrivi ng at a permanent form of protection, another 8
routes have 4 stops before ending in a final protection solution, and one has 5 stops without a
permanent protection form.

An analysis of routes brought to light the fact that the pedi atric hospital/ward is the most
convenient social service substitute accessible to both parents who want to abandon their child
“temporarily” or “permanently” and, paradoxically, to social child protec tion services which use
the pediatric hospital to host the child in di fficulty while searching for and identifying a
protection measure. The study of the type of mortality table (Kapla n – Meier) of the lengt h of route shows that:
– children starting their route in a maternity ward , as compared to those starting elsewhere,
have better chances of ending up in a permanent protection measure;
– children whose parents have given their co nsent for adoption end up more often in a
permanent form of protection, bu t only after at least one year of other temporary protection
measures;
– the shorter the stop in the health institution, th e shorter the interval for reaching a permanent
protection measure (natural or adoptive family).

4. Characteristics of the mothers

An analysis of the characteristics indicates that such mothers are subject to high social risk,
marked by lack of education, extrem e poverty, and reduced social support.

127
As such, 42.2% are illiterate and 27% have not completed Junior High School; some 80% of
mothers have a very low socio-economic level; 85% live off uncertain income; 28% are under 20
years of age at bi rth of the child.
Concerning ethnicity, there is an over-representation of Roma women, voth in terms of
abandonment in maternity wards and (especia lly) in pediatric hosp itals (51% and 66%,
respectively). In some economically developed counties, mother s of abandoned children are almost exclusively
Roma. In poorer counties ab andoned children belong to other ethnic groups. Such cases are
much more evident among those abandoned in pediat ric hopsitals. Such fi ndings indicate that it
is not ethnicity itself but rather the characteristics of the mother’s way of life that predisposes them to abandonment. There are greater and lesser pronounced differen ces between mothers who abandon their children
in these two types of medical institutions.
Concerning the marital status it was found that the ratio of single mothers is double in the case of
those abandoning their children in maternity hosp itals compared to thos e doing so in pediatric
hospitals. Mothers abandoning their children in maternity wards are somewh at more educated and less
poor than those who resort to ab andonment in pediatric hospitals.
However, the rejection of the child is much more severe among mothers who abandon their
children in maternity wards than those who do so in pediatric hospitals, a nd the decision to give
the children up for adoption is similary more determined. Most single mothers who abandon th eir children in maternity ward s belong to that sub-category
of women who resort to abandonment mostly b ecause they are not married and come from a
culture in which such a situation is, in itself, gravely sanctioned (without there being a need for
other obstacles that would not allow the child to be brought up in the family).
Another category of mothers who abandon their ch ildren in maternity wards are those who were
in a relationship for a while, who were abandon ed by their partner either upon finding out they
were pregnant or somewhere along the pre gnancy, or whose conti nued relationship was
conditioned upon the abandonment of the child. Both of these categories of moth ers, either dependent upon their family or their partner, are
unable to assume the responsibilitie s without community service support.
Mothers who have abandoned thei r children in pediatric hospita ls are poorer, less educated,
living in unstable relationships, and are predominantly Rroma.

128They “chose” the hospital to rais e their child, and not necessarily to abandon it. Both parents
believe the child will be better cared for in the hopsital, and that they ar e dispensable. They
often “forget about the child” and come to visit only at the insi stence of the protection services.
They do not accept a foster parent as they are afaid a strong bond might come about and because
they might lose various financial resour ces by accepting measures of protection.
The rejection of the child is much more pronounced in mothers who resort to abandonment in
maternity wards and have made a definite decision to give up the child for adoption, compared to
those mothers that abandon their children in pedi atric hospitals, convinced that the latter are
better alternatives for the raising of these childr en, and that they themselves are dispensable.
More than half of the mothers have heard of at least one m odern method of contraception to
prevent unwanted pregnancies. The pill, the in tra-uterine device (IDU), and injectable methods
are the most widely known (in that order). But these are seldom used. Contraceptives are much
less known to Rroma women. It is gratifying to know that the national fa mily planning promotion programmes, aimed at
socially disfavoured groups, have yielded some resu lts. Here the referen ce is done mostly to the
use of condoms (39% by Romanians and 24% by Rroma) and of injectable methods (30%
Romanian women and 9% Rroma).

129CHAPTER 4 – RECOMMENDATIONS

1. Characterization and monitorization of the phenomenon – indicators

The definition adopted in this study for abandoned child was not conditioned upon the duration
of abandonment. If the systematic and uniform reporting of cases of abandonment is felt to be
necessary and useful then such examples make the acceptance of a uniform term for
abandonment essential. At present there is little possi bility to follow up the various evolutions in the central and local-
level child protection systems. The statistical indicators used by the National Association for
Child Protection and Adoption are insufficiently relevant to follow up progress registered in the
respecting of child rights. The least informati on is recorded about the most serious problems,
such as abandonment, in all its as pects, in maternity wards and pedi atric hospitals. The fact that
such indicators have not been established re flects the level of understanding and importance
afforded to this phenomenon.
¾ In this context, the systematic and unifo rm reporting of cases of abandonment is
considered necessary, as is the un iform acceptance of the terms of
abandonment/abandoned child. The immedi ate and rigorous application of the new
law on the child could lead to the statisti cal reporting of cases in maternity wards.

The law stipulates it is mandatory that the me dical institution notify (by telephone and in
writing) the Child Protection Services within 24 hours of determining that a child has been
abandoned, at the risk of heavy sanctions for n on-conformity. Once recorded, such events can
become part of regular statistical reporting. The respecting and enforcing of legal regulations is sustained by scientific arguments of theories
relating to the development of the child, that can be debated and assimilated within the
framework of continuing education for the personnel.
¾ As such, there is a recommendation for the in itiation and development of professional
and institutional capacities.

The files of the children are incomplete and hard to find. There are fewer social inquiries than established protection measures, which raises numerous questi ons on the manner in which the
protection measures are pe riodically reevaluated.
¾ In this context it is consid ered necessary the elaboration of an operational computerized
system for the administration of the social child protection service cases, according to
which any child can be found with all information up-to-date.

The processing of such information will allow for the evaluation of measures taken, and of
challenges and progress relating to the adoption of various legislative measures in the area
through the prism of the C onvention on Child Rights.

2. Prevention

130
a. Prevention of low birthweight
Keeping the child born with low birthweight in a medical institution for a prolonged period
without his mother cannot be in his best interest. It is unlik ely that such children can grow
normally in medical institutions with out the presence of their mothers.
Low birthweight can be the result of premature birth, intra-uterin e growth retardation, or both.
The incidence of intra-uterine gr owth retardation in Romania is much greater than that of
premature births. Children who have experienced intra-uterine growth retardation are more
likely to suffer from permanent growth deficits, making their hospitalization in this respect even
less beneficial.
¾ As such, it is recommended the initiation and sustaining of a programme for preventing
low birthweight, to decrease th e risk of early separation of the child from its mother,
and implicitly its abandonment.

Such a programme must be sufficiently comprehe nsive for the many tangible factors that impact
on intra-uterine growth and the duration of gest ation: demographic, ps ychosocial, obstetrical,
nutritional and beha vioural factors.
b. Identity of the child
One of the reasons given for a healthy child to be kept in a medical institution was the lack of of
identity documents. The Child Protection Services avoided taking a ny emergency placement measures (in spite of
regulations in effect to allow this), arguing that accounting laws did not permit the allocation of
resources for a child that “does not exist.” Therefore, children without identity documents we re transferred within the medical system, from
one ward to another, until such documents were issued to them.
The new law more clearly provides for the institu tion of protection measures , even if a child is
lacking the constituent elements of its identity, on the basis of a proces verbal. But the admission into the protection system of a child without identity documents necessitates
supplimentary safety measures to prevent his being “lost”.
¾ In this sense, it would be beneficial if there were some enforcement of the child’s
personal numeric code being communicated to the maternity ward in which he is born,
so that this code can be recorded in the child’s observation chart. The observation
chart should be filed only after the child’s identity has been established.

This recommendation is to be insisted on because Law 272/2004 stipul ates nothing in this
respect, and the measure proposed would be to confirm the established identity. This

131recommendation is meant for both the child aba ndoned in the maternity wa rd and that abandoned
in the pediatric hospital/ward.
¾ Concerning the child’s identity, strict regulatio ns must be issued for the enforcement of
the the filling out of all fields in the observat ion charts, and in this case, especially those
relating to the name, address and identity documents of the parents.

A uniform computer programme would be useful in this sense, to preven t that one or another
field be skipped and not filled out (even with a me ntion that “this information is not available”).
c. Improvement of maternity ward and pediatric ho spital services
The manner in which maternity wards and pediatric hospitals are presently organized offers little opportunity for the development of early attachment between moth er and child, an attachment
that is necessary for the basic mental health and normal socio-emotional development of the
child. The standard practice, to be found in more th an half of the maternity wards, involves the
separation of the newborn from his mother immedi ately after birth, and puts them in contact only
according to a strict breastfeeding schedule. Th is model, associated with significant physical
distance between mother and child, and the prac tice of tightly bundling the child, are well-known
elements that promote a break between the mother and child in the risk categories.

¾ In this sense, it is recommended the sust ained promotion of the rooming-in system,
which does not immediately change the deci sion of the mother to abandon her child, a
decision with which she often arrives in th e maternity ward before giving birth. In
addition to the system, it is also recomm ended the promotion of new practices and
attitudes relating to the mother and ch ild, which encourage permanent contact,
breastfeeding, and will help the new twosome find ways to form a bond and support
each other.

Certain “rituals” from the birt hing period and immediately afte rwards could “activate” some
natural, instinctive resource w ithin the mother to help her care for her child. In the study
obstetricians themselves recomm end early physical and visual c ontact with the child: looking at
and holding the child immediately afte r his birth, early breastfeeding, etc.
In most pediatric hospitals and wards mothers can be admitted with their sick children, an
important benefit for preventing the psyc hological trauma of repeated separation.
Concerning the visits of parents to their hospitalized children, ma ny hospitals restri ct or prohibit
the admission of parents to such inst itutions, citing epidemiological rules.

¾ As such, it is recommended the initiating a nd sustaining of contact with the mother and
parents, and more flexibility in relation to outdated practices that are today
scientifically refuted.

132In the case of abandoned children or those who brought to these institutions for social reasons of
social protection, it is essential th at the staff understand that hospi talization is not beneficial to
the child.
¾ Therefore, it is recommended the developmen t of new integrated services to help
mothers look for other protection solutions, and unlearn the reflex that leads them to
believe that the hospital is an emergency shelter for any type of difficulty the child
might be experiencing. The acceptance and p erpetuation of such situations not only
means a breach of the law, but especially an acute lack of understanding of the
developmental needs of the child.

Repeated hospitalization is anot her way of perpetuating child ab andonment. A solution must be
found to ensure that the interest s of medical staff do not go agains t those of the child, not the
case at present, according to indicators of efficiency in medical institutions. On the other hand, these practices have been c onsolidated because of insufficient community
social services, virtually non-ex istent in cities other than county seats or rural areas.

3. Shortening the route

The routes traversed by abandoned children, with few exceptions, incl ude at least on e stop in a
pediatric hospital/ward. What is of concern is the finding that such stops are decided upon and
approved by the Child Protection Services, based on their limited organization and resources, or
the incoherent legislation in this area. A Protection Service is not in a position to justify the demand for hospitalization or reten tion of healthy children in hosp ital on the grounds that there is
no “space” in the system or child ren have no identity documents, as this is a breach of child
rights.
Law 272/2004 contains a series of measures by which these limits will be (and are overcome) on
condition that their application does not run counter to the laws in effect or those that will appear
in other areas.
¾ The institutionalized collaboration between th e medical and child protection systems in
the area of legislation is recommended and usef ul to avoid blockages in the application
of laws regarding children and their rights . Furthermore, a clear, efficient and
transparent methodology for putting laws in to effect is necessary both for proper
collaboration between institutions and that of institutions and moth ers benefitting from
services.
4. Strengthening of primary assistance of comm unity services and increased access to such
services for families

Although regulations and laws were issued in th e past few years to ensure access to primary
health care for marginalized segments of the pop ulation, results have been very poor. Provisions
making it mandatory for maternity ward health care staff to register any ne wborn on the list of a
family physician are not respected. Many physicia ns have blamed non-compliance on the many

133regulations and laws that have been issued ove r a short period of time, while family physicians
justify themselves by invoking the incoherence of the various measures in existence and the
stipulations contained in th e framework of the contract.
Non-compliance is also possible because there are no provisions for prosecution/sanctions for
this. But beyond these shortcomings, disadvantaged families need not only a family physician but also home education from community level medical and social professionals, to be able to benefit
from already existing community services.
¾ Therefore it is recommended the sustaining of community services that can converge
their results to support the maintaining of the child in his fa mily environment.

Educational visits to families that meet the need s of such families would be extremely beneficial
in preventing all types of so cial exclusion, including the pr evention of child neglect and
abandonment.
¾ Furthermore, it is recommended the diversif ication of various services to meet the
needs of children, and provide support for moth ers and families. Existing crèches (non-
existent in rural areas) could develop serv ices for disabled children, to prevent the
separation of such children from their families and the justification for separation on
the basis of a lack of such services in the community. In rural areas, existing
kindergartens (possibly also sc hools), currently under-utilized due to a drop in natality,
could expand their activity by offering se rvices needed to ke ep children in their
families.

¾ And not least, an important means for preven ting abandonment lies in the promotion of
family planning programmes. Such progra mmes must reach populations at greatest
risk, including those with special health n eeds: alcoholism, psychological and mental
problems, and disabilities.

About half of the women have ha rd of (modern) contraceptive m easures, but very few make use
of these. The population in the study can be characterized primar ily by a great lack of education
and extreme poverty. The reference points of thei r way of life are unstable and very unsure.
Written messages cannot reach their mark as these women are illiterate. Their male-dominated culture prevents them from making their own decisions for fear of
“reprisals” by the men. To a greater extent, their lives are a successi on of disappointments and
hopes for the “privilege” of being able to depend on a man, and the fate of the child that appears
is decided directly or indirectly by this. In such a culture, the intercessi on of planning programmes for pr eventing pregnancies that might
end up in abandonment are/might be very inefficient if they do not take such partic ularities into
account.

134To sensitize them after the birt h on such means rarely succeeds, because they leave shortly after
the birth. It is believed that specialized public services could have a special role, insufficiently used, in
promoting family planning, as these come in peri odic contact with most of these mothers.
Professionals that are part of these services can inform and offer counselling through means
specific to each case.
5. Other recommendations for attentioning thos e who develop policies and strategies in
the area of respect ing child rights

¾ Ensuring the right to education
Improve scolastic inclusion and the completion of mandatory education to prevent illiteracy,
marginalization and social exclusion.
¾ Improve professional training
Include information on child development and th e importance of early childhood in socio-human
education programmes. Analysis and “capitalization” of Romania’s ne gative experience to promote another model for
approaching and understanding the child, fr om the perspective of his rights.

¾ Raise the competence of professionals involved in the various decision-making stages, to
shorten the route of abandoned children, to arrive at stable and permanent protection solutions.
Law 272/2004 on the protection and promotion of child rights sets forth th e obligation of local
administration authorities to guarantee and promote the rights of the child.
In the spirit of this law, it is recommended training for the following:
¾ Staff of local level institutions and serv ices through which the importance of early
childhood and of necessary conditions fo r child development can be promoted;
¾ Specialists of Child Protection Commissio ns, through whom the values of childhood
and the value of the child can be transmitted;
¾ For the solidarity of members of the Commi ssion, in the promotion of common values
build on the recognition of the rights of the child; making thes e responsible for the
proposals of protection measures; the applicatio n of the spirit of the law in particular
and specific favour of each child in part, so that the law can be of help to the child in the
optimal meeting of his development needs, in stead of in regulations that short-circuit
his evolution.

The following should comply with the la w functionally and not just formally:
¾ the individual child protection plan, accord ing to which each child is assured of
individualized and personalized care, and
¾ the services plan, to ensure that the child is not separated from his family.

135Decision-makers must be capable of drawing up local policies and making sure that there is
improvement in the situation of the child, including that of abandoned children. Such policies
and strategies must be elaborated in collaborati on with all involved from medical institutions, the
Department of Child Protection, local councils a nd City Halls, based on the existing situation,
proposing efficient measures and carrying out periodic evaluations.