SOCIAL EXCLUSION AT THE CROSSROADS
OF GENDER, ETHNICITY AND CLASS.
A VIEW THROUGH ROMA WOMEN'S REPRODUCTIVE HEALTH
TABLE OF CONTENTS
Paper and research overview
1. Conceptual framework
1.A. Approaching reproduction and reproductive health
1.B. Understanding social exclusion at the crossroads of gender, ethnicity and class
2. Methodological concerns
2.A. The ethnographic research and the policy analysis
2.B. Research topics<>
3. Research results: parallel worlds and mechanisms of multiple exclusions
3.A. The socio-economic conditions of Roma communities
3.B. Romani women's conceptions, feelings and practices related to reproduction
3.C. Health care providers' attitudes towards Romani women
3.D. Roma policies. From gender-blindness to pro-natalist concerns
3.E. Reproductive health policies. From ethnic-blindness to racism
3.F. Roma women's organizing<>
4. Final remarks
PAPER AND RESEARCH OVERVIEW
My research paper addresses the access of Roma women to reproductive health in today's Romania as a problem through which one may have an understanding of the broader issue of social exclusion as it functions under the circumstances of post-socialist transformations. As such, it aims to have a contribution to theorizing on how exclusion works at the crossroads of ethnicity, gender and class while (re)producing inequalities, and on how does Roma women's multiple discriminations function turning them into the most underserved social categories of our society In theoretical terms I would also like to take part in the debates about the ways in which structural factors, cultural conceptions and agency are working through each other while shaping women's everyday desires, claims and practices related to reproduction and reproductive health.
This paper is based on an empirical research
carried out by
the means of an ethnographic fieldwork and of the analysis of existing
(its methodological concerns are discussed in Chapter 2). The former
in two Romani communities from the city of
The research paper is the descriptive part of the whole analysis, being completed by my policy paper (presented separately), which – on the base of the empirical data presented here and of ideas regarding the need of ensuring equality through difference as a necessary feature of a fair society – is formulating recommendations for policy action using a human rights language and a more-or-less normative discourse. The policy paper focuses on the issue of reproductive health as an issue of human rights considering that reproductive rights of women include the right to have access to reproductive health care information and services, the right to sexual education and bodily integrity, the right to decide on the number of children and the time-spacing of births, and the right to decide on the contraceptive method most appropriate for their medical and social condition, but also the right to the enjoyment of sexuality as part of sexual health. Its recommendations are referring to the need of mainstreaming ethnicity into the public health policy and of mainstreaming gender into Roma policy in order to overcome the effects of ethnic and gender discrimination in relation to reproductive rights and access to healthcare of Roma women, while recognizing that ethnicity and gender are not naturally given internal essences, but subject positions constructed socially and culturally.
The resulting video-film, which has two parts (the first presenting the two visited Romani communities, and the second dealing with Roma women's specific issues, including reproductive health) is going to be used as a tool for advocating for the recognition of the need to make a change in the structural factors and cultural conceptions that produce and maintain Roma women's multiple discrimination.
1. CONCEPTUAL FRAMEWORK
1.A. Approaching reproduction and reproductive health
The conceptual framework that I am relying on in this research paper is one developed by the anthropological and feminist literature on reproduction. Among others this is revealing that biological reproduction (and implicitly women’s body) always and everywhere stays at the core of the societal, political and economic life, is one of the domains through which one may understand why the personal is political, and vice versa. Its control – together with the control of production –, structures the position (including roles, chances and life trajectories) of women of different ethnicity and class both in the private and public spheres. Moreover, the ways in which the state and the medical system (through its legislation, policies, ideologies and actual practices) are dealing with (the control of) reproduction, are also talking about the formation and maintenance of the ethnicized and gendered social inequalities.
Within cultural (and in particular medical) anthropology there were developed many approaches towards reproduction. Symbolic anthropology was dealing mainly with fertility rituals and different cults for curing reproductive problems without considering the broader social and economic forces. The political economy of health linked a historically informed approach with an ethnographically grounded study, so it placed for example the analysis of the social mediation of the shared cultural beliefs about the body in the context of political and economic changes. There are investigations that besides the ethnographic details and the broader focus use a comparative perspective between, for example, Western and non-Western practices related to infertility. The issue of social personhood and agency is addressed widely by these works and opens up challenging questions about how cultural ideologies of personhood and the socially interdependent self are interpreted differently by different persons (women and men) while trying to act as autonomous agents. In order to understand why it is possible for an individual to be at once a social person and an agency, some anthropologists propose to conceive for example bodies as not belonging to persons but being composed of the relations of which a person is constituted while not precluding women's sense of bodily autonomy or self-control. Especially Marxist approaches treat reproductive issues as embedded into the context of explicit and variable material conditions… and broader economic relations, class divisions, the nature of health care and access to it, and the types of birth control that are available. Alongside, the notion of stratified reproduction highlights the unequal social ordering of reproductive health, fecundity and birth experiences. And the concept of reproductive entitlement is focusing attention to women's moral claims in the area of reproduction, which are articulated in relation to social expectations referring to fertility, sexuality and motherhood. Moreover, for example in the context of anthropology on Eastern Europe, reproduction was also treated in terms of its politics and/or as an issue through which one may understand, for example the re-construction of post-socialist politics in Hungary or the functioning of the socialist regime in Romania in terms of people's duplicity and complicity with the state regulations.
1.B. Understanding social exclusion at the crossroads of gender, ethnicity and class
The identities of women and men of different ethnicity are constituted at the crossroads of the subject positions prescribed for them by ideologies, policies and institutions, and of their subjectivities (everyday experiences and meanings through which they perceive themselves within their significant social relations). So I am not treating ethnicity and gender as naturally given internal essences that shape one's destiny, but as socially and culturally constructed subject positions that are constituted by cultural representations and social locations where people are situated also due to the ways in which society builds up hierarchies according to the social expectations and cultural prejudices regarding ethnic and gender differences.
The ethnicized and gendered construction of the order within which people's life is embedded is a cultural and social process. Through this – on the one hand – women and men are defined and classified on the base of some characteristics supposedly determined by their ethnicity and sex as if these were their natural and inborn essences. On the other hand – through this mechanism – women and men are located in certain social and economic positions (and consequently are having access to or are excluded from specific material and symbolic resources) according to the hegemonic representations of their ethnic and sexual belongings. These processes might be observed inside different institutions and in the context of their complex relationships, including different sites of everyday life.
This paper is an attempt to describe and understand the construction of the social order at the crossroads of several systems of classification (ethnicity, gender and class) as performed by concrete people in their everyday life and lived through their personal experiences. More precisely views this process as mediated by access to reproductive health. Eventually it deals with the relationship between ethnicity, gender and class, understood as systems of classification and as social organizations of cultural differences. This relation – among other mechanisms not addressed here – structures the social order in a particular spatio-temporal location, and – as such – defines and positions women and men within private and public hierarchies, at their turn being under the impact of broader economic and political changes. But this regime could not function if it would not be sustained from below. People not only adjust their expectations and performances to its norms, they do not automatically take up certain roles, but also interpret, negotiate and act out them within their personal relations with the “significant others”.
the base of
the above described conceptual framework I address the formation of the
post-socialist order (in
2. METHODOLOGICAL CONCERNS
2.A. The ethnographic research and the policy analysis
This research paper is based on the recognition of the fact that Roma women's (reproductive) health is determined socially, economically and culturally, and is shaped by mechanisms of social exclusion that function in our society. Due to the latter this issue is also talking about the lack of reproductive rights or about the lack of opportunities to make use of these rights, embedded within the social conditions, institutional arrangements, policies and cultural conceptions regarding Romani communities. That is why my analysis is shaped by a social, cultural and critical approach. Otherwise is based on a primary empirical research done in the summer of 2004 (in cooperation with the Society for Sexual and Contraceptive Education from Cluj), and between June 2005 and March 2006 (with the support of the International Policy Fellowship Program).
As health in general, the state of reproductive
shaped by the social and economic conditions of Roma women’s life, but
the cultural conceptions/prejudices about Roma women existing within
groups and within the broader society and in particular within the
health care providers. I managed to reveal these aspects of the problem
means of an ethnographic research conducted within local Roma groups
local community of health care providers (family doctors,
medical assistants) in the city of
As the access to reproductive health depends
also on how
politics and policies treat this issue, in order to investigate
reflecting the reproductive health policy and Roma policy from
2.B. Research topics
This research paper addresses Roma women's reproductive health as a socially, economically and culturally, but also politically determined phenomenon and considers that through its analysis one may have a look on how mechanisms of social exclusion are functioning at the crossroads of gender, ethnicity and class.
In addition, my policy paper presented
entitled "Roma Women’s Reproductive Health as a Human Rights Issue in
The main aim of this research paper is the description of the socio-economic conditions, institutional arrangements, policies and cultural conceptions that shape Roma women's (lack of) access to reproductive health, but also of their personal ways of dealing with the related problems. It is important to mention that my policy paper also recognizes the fact that it is not enough to claim reproductive health in terms of rights, but there is a need to understand why economic, cultural and social processes do make impossible of the de facto use of the formally recognized rights. Here it is also the place to stress: the creation of circumstances under which these rights might be de facto used by any women, regardless of their ethnicity, age, sexual orientation and class would be of great importance for assuring everybody's reproductive health. Even if economic inequalities continue to persist due to the structural processes of market capitalism, equity in the health system should be a key concern for governments, and health service delivery should be culturally sensitive and responsive especially in the case of states (among them Romania) who officially expressed their will to respect the principle of cultural diversity.
I am subscribing to the definition according to which "reproductive health is a state of complete physical, mental and social well-being…in all matters relating to the reproductive system". In terms of physical well-being its mostly used indicators are: fertility rate, infant mortality rate, and maternal mortality rate, the proportion of births attended by skilled health personnel, contraceptive prevalence, and occurrence of abortions, cervical cancer and breath cancer. In my ethnographic research I was especially focusing on the ways in which the use of contraceptives and abortion was shaped by Roma women’s life conditions, by the cultural conceptions dominant within the investigated communities and by the nature and functioning of the local health care system, but, on another level, also by the existing public health and Roma policies.
3. RESEARCH RESULTS.
PARALLEL WORLDS AND MECHANISMS OF MULTIPLE EXCLUSIONS
3.A. The socio-economic conditions of Roma communities
During my fieldwork I spent more time within the non-traditional băieşi Roma community from Digului district than within the Romanes-speaking corturari from the nearby hill called Bemilor. However, I made interviews and was filming there, too but during my stay I could approach basically only two families whom invited me in their houses. Nevertheless, in this paper I am also referring to them, because in the local context it is important to understand how the two communities are referring to each other while identifying whom and how they are.
The Roma community from Dealul Bemilor is a traditional group whose members descended themselves from traveler ancestors and spoke Romanes. They settled down here at the end of the 1960s and are called by local Romanians and other Roma groups as “corturari”. The 40 persons, out of whom 10 are children below the age of 14, are living in 20 households and their houses without utilities (10 houses are having electricity) are situated on the hill near the rubbish heap at the periphery of the city. Half of them do "own" the houses where they live (but they do not have house contracts with the city hall!), while others live together with their relatives. Nobody is employed, none of the children are enrolled into school, only 5% of the adults graduated primary school, and only 7 families are receiving social allowance for which they do community work. Some of them are occasionally working abroad, others are collecting plants during summer, and many do collect scrap-iron. 25% of people above the age of 14 do not possess identity card, and 10% of the total inhabitants do not have birth certificate. Up to other causes, the lack of identity cards is due to the fact that even if their houses were built by them or were inherited from their parents they are not having house contracts with the local administration and until when they are not paying taxes on these houses, identity cards are not going to be issued for those living there, who – moreover – as people without identity cards will not be eligible for receiving social allowance. The houses are connected to the city's electric line, but the community does not have its own source of clean water, people have to go down on the hill and even further for bringing water for their daily supplies.
Due to the fact that they wear traditional Roma costumes and speak Romanes everywhere are easily identified as “Gypsies” and are exposed to discrimination and negative prejudices.
of the “corturar”
families which became wealthy due to their occasional migration for
Formally this community is ruled by a buljubasa, but today he happens to be a man who does not practice the traditional duties of such a leader, so the community is practically not represented by anyone and does not have access to the resources that are supposed to serve the Roma communities’ needs. It is a well-known fact throughout the whole city that this community did not benefit from any of the projects that were supposed to improve Roma’s life condition.
community investigated by me in the city of
total of 125 houses from
The whole community has only one source of clean water – put into function somehow illegally –, 80% of the houses do not have toilets of any kind, and the slop water is thrown out in the mound from the middle of the “street” or into the river together with the garbage (being a permanent source of infections and a cause of several illnesses). 90% of the houses are having electricity, and the big majority of the families (even the poorest ones) do invest in providing a television, while some also do have CD-, video, and DVD-players. Besides their practical utility, these objects are also part of people's symbolic status and prestige within the community. Obviously those who are working abroad are doing better in these terms.
within this community are structured by several factors, among them by
differences. Poor people (defining themselves as desperate ones, “necăjiţii”)
are taking loans from the wealthier families (named “cămătarii”)
have to pay back the double of the credited amount. Those who are doing
– the families of the very few employed, of the retired people with
of workers abroad – are proud of being Gypsies, of having a relatively
acceptable life despite the fact of being Gypsies and of proving for
a Gypsy is a good worker and a honorable man. They try to isolate
from the rest of community and do sustain at their turn the belief in
system of meritocracy within which, as they say, those who are lazy and
want to work deserve to live in misery, “like a Gypsy”. Moreover, they
recognize the fact that one of the main obstacles of their inclusion
Romanian society is rooted in the prejudices that treat them as members
stigmatized community, and not as individuals who are different than
“stereotypical Roma”. They are critical towards Romanians for this
among whom, – as they say – one may also find criminals and thefts and
living in misery. One man was telling me that he is Gypsy for twice:
he is of Gypsy origin and second because he was born in
One may observe that the meaning of Gypsyness is shifting from a proudly assumed identity to a stigma, so it functions as a category of classification even within one Roma community and also in the relationship between two different Roma groups. These multiple meanings of Gypsyness probable result from the parallel existence of the desire of self-respect and of the internalized stigmatization, from the ambivalence of identifying with a community and taking a distance from it at the same time, and from the latent will to find always an Other relative to whom one may feel "properly". This explains why someone self-identifying as a Gypsy, at the same time blames Gypsies for being dangerous, or dirty, or lazy or so on and so forth. While being there, we were warned from different directions about the “dangerousness” of the Other: this was stressed by “corturari” about “băieşi”, and vice-versa, and within the “băieşi” community by “necăjiţi” about “cămătari”, and vice-versa.
community do report acts of discrimination experienced whenever they
jobs and are declaring their address from
Nonetheless, this community has an informal representative and in the recent past did benefit from some supportive projects assuring different community services. Their representative was a candidate at the last local elections, but unfortunately did not receive enough votes. Moreover – even if he is recognized both by the community and by the local administration as a Roma expert, and even if according to the governmental strategy for the improvement of Roma’s situation a Roma expert should be hired by the local government – he is only used by the later as an informant about the community and as a mediator in several cases, but is not hired on a paid position and is not involved into decision-making. His wife is hired as a school mediator and the two of them together are committed to make a change in the situation of their community, and would like to get more support in terms of information and empowerment from Roma organizations distributing resources. They are convinced that Roma identity should be assumed proudly, that is why he is teaching the youngsters Romanes language, culture and history, collects money from selling scrape-iron for making them traditional costumes and takes Roma kids to several festivals where they are appreciated due to their dancing and singing abilities. Both of them consider that integration of Roma into the Romanian society should start with their inclusion, and that is why they cannot agree with any phenomenon of segregation wherever it occurs (schooling, housing, etc.). However, they consider that special programs and even affirmative action should be directed towards improving Roma’s life conditions and empowering them by strengthening their self-esteem and cultural pride.
Learning about how identification processes are going on and how the category of Gypsyness is structuring social relations I realized again that one of the main obstacles of constructing a positive Roma identity is the ethnicization/racialization of negative social phenomenon (like poverty, criminality, lying, stealing, dirtiness, laziness and so on and so forth) and the internalization by Roma of the practices that are blaming the victim and are naturalizing/legitimizing acts of discrimination against them. In the case of Roma men and women the processes of social exclusion are not only functioning through class differentiation and social stratification, but also due to their culturally devalued ethnicity marked by a darker skin color on the base of which they are discriminated and excluded from vital resources (like education and employment) that are crucial for living in dignity and providing a self-respect needed for making future plans.
When I am referring to ethnicization I am referring to the mechanisms by which everything what is bad and deviant is labeled as being Gypsy-related, and accordingly is excluded from "normality". But I am also thinking about the fact that – due to the described structural discrimination – Roma people are much more exposed to the risk of impoverishment on the base of being defined as "Roma" (a category referring to, as mentioned above, all the negative features one may have including the "dark skin"), and – on the extreme – to the "choice" of assuring their survival by illegal means, which, at its turn, re-enforces their social exclusion and cultural devaluation.
3.B. Roma women's conceptions, feelings and practices related to reproduction
During my fieldwork I could observe that besides the social and economic conditions and the cultural devaluation of Romani people described above, Roma women's reproductive health (and choice to have a control on this) was also shaped by the (gendered) cultural conceptions dominant within their own communities. As it always happens, in this case too, the "structural factors, including the distribution of economic, political and institutional resources" do not only act in themselves, but are "both experienced directly by individuals and interpreted and made meaningful through cultural processes." These include views on gender relations, on women's role in family and in public life, on their role in sexual relations and their body, on the proper number of children, girls and boys, but also religious beliefs that might criminalize not only abortion, but the use of any contraceptive method and sexuality altogether.
Moreover, views and conceptions do not function alone while shaping women's choices regarding reproduction. Feelings do have their own role in decision-making, because – especially regarding issues that belong so much to intimacy and privacy – women cannot make abstraction of their emotional ties, which link them to their children, spouses and other kin whom they consider as significant others of their life. Furthermore, the economic conditions in which they live, or more properly said, the ways in which they think that they might cope with poverty do shape Roma women's decision-making regarding reproduction, its control, and implicitly, their reproductive health. One may conclude that eventually "social, emotional and economic issues are linked in women's desires, claims and practices related to reproduction", so Roma women do not conceptualize their thoughts regarding reproduction in terms of rights, but mostly in the terms of their material conditions, social relations and feelings.
As I was told, in the community from Digului district girls usually marry early and give birth at an early age, abandoning school at the age of 13-15: there is no girl in our district who graduated high school, and at the best they had ten grades during Ceausescu, but after revolution is good if they graduate eight grads, usually dropping out after the fourth or even never enroll.
They do not marry officially (nevertheless this is a recent development), giving many reasons for this, among them the following: I do not like to change my name; we do not have our own home, he stays with his parents and I am staying together with my children at my mother's house; if we do not marry, I may receive the social allowance and make the community work, while he might find all kinds of works on a daily basis without being blamed for also taking the social allowance; this is how is happening here; he can abandon me anyway if he wants.
However, women refer to their partner as my husband, or even more often as my man (bărbatul meu). As a rule, the family and the community consider them married (due to what they name legămînt) after having slept with their partner in one of the parent's house. Before "marriage" they meet and are together during the nights on the dark corners of the streets, so one may observe many young couples near each other kissing or even making love.
Girls feel free of choosing their husband, however there are more rules regarding a women's sexual behavior than a men's: she needs to be a virgin; it is a shame to leave your husband and to look for another and having children of two kinds; women who change their husbands are blamed by their community together with their whole family. It happens more often that a man leaves her woman for another one, and in this case the first "wife" moves back to her parent's house and the "new wife" moves in the men's or the men's parent's house. But it also happens that a woman tries to run away (usually due to the frequent acts of domestic violence), but her attempt is much more difficult to fulfill: she might be accepted back by her mother but risking to be labeled negatively by the community; or might try to leave from the district and even from the city, but each time being afraid of being followed, founded and returned back by the angry man who cannot accept to be abandoned.
Usually in a year after marriage – even if at an early age – girls give birth to their first child. And after that moment, children continue "to come" yearly: the year and the child, they say. Breastfeeding creates a huge dependency between the mother and her child. It goes on for many years, even up to three or four. Even if this means that the mother always have to carry her child after herself, this is part of her proudness: I am giving breast (ţîţă) wherever I am going, whenever it is needed, when my child is hungry, or nervous, or cannot fall asleep, on the street, on the bus or in the shop, it's no shame about this.
Being a mother, altogether, is a prestigious role in the community, and it is actually the way by which a girl starts to be recognized as an adult person. Up to this, if she gets her own home or at least her own bad that has not to be shared with her little brothers or sisters but with her husband she may experience the increase of her status. Having many children is considered a sign of the powerfulness of the Roma family and masculinity of a man is judged according to the number of the children he made in a lifetime. Women who have to take care of their family and household, but also of the relationship between family and public institutions (being in charge with taking children to school, to doctor, or to make the necessary arrangements at the mayor’s office) might have other opinions about the “proper” number of children. But in the cases of communities where tradition is strongly shaping people’s life and choices, their voice is hardly heard. They might have power to decide (and they do it secretly), but this power lacks authority and is considered an illegitimate one.
The responsibility of having children is assumed actually for the whole life: anything would happen to me I need to take care of my children; I just feel wonderful when I am together with all of mine six children in the bed; I need to give him first to eat and see him well; if my daughter wants to come back in my house, she is always welcomed, but I told her that it is wrong to leave her husband till the children are small; you have to stay near your man and suffer if you need to, even if he beats you when he is drunk, for the sake of your children… anyway, where would you think you could go together with them; children gave me the strength of going further on and survive; I take them to the doctor whenever they are sick, but I am not really going there for myself. Responsibility is expressed also in the terms of not desiring to have more children: I wanted to have these four kids, especially during Ceausescu when we had where to work and we had a stable income, but now I cannot afford to make more, I cannot dare to watch them being hungry.
Almost every woman whom I met from this community was having information about the modern contraceptive methods, but – due to many other reasons – they made several abortions during their life-time. The sources of information were the family doctors, the gynecologists, or women friends and neighbors.
There was no open and public talk about contraceptives, abortion or, generally, about reproduction and sexuality, nor even among women themselves: I'm ashamed to discuss about this; if I suddenly get fat or to the contrary become thinner the community starts to whisper that this was due to the pills; if they would find out that I am using condoms would blame me of being a prostitute (traseistă); they say that I give myself airs (mă dau mare) if they hear that I am doing this. The "public opinion" which was mostly whispered and not openly expressed, but still, as such, was having the function of a community control was having a huge importance in shaping the opinion about the “proper” contraceptive method: my friend got fat from using the pills; when I took those pills I lost weight; there was someone who died after the injection; my neighbor made cancer after she used the intrauterine device (sterilet). All these rumor-type information were having some kind of truth on their base: some got fat, others lost weight, a woman who made injections died (but for other reasons) and the cervical cancer was there, but caused by other medical factors.
The mixture of all of these knowledge – under the conditions of which woman do not dare to talk about these problems openly and doctors for many times do not listen to them or do not answer to their doubts – turns the whole issue of contraceptives into a mystical topic, a problem that one needs to face if she wishes to avoid having more children or abortions, but also one which – due to the related stress – she wants to forget altogether.
The connected frustration is even bigger because of the contradictory "messages" a woman receives from different authorities and of the experiences she lives out regarding reproduction: the community would expect women to give birth to as many children as they can; it is said that you are more powerful if you have more children; if God wants you to remain pregnant, you have to give birth to the child; it is said that you, as a woman, have to respect your parents and your man, so, if for example he wants to have many children, you have to make them; how can I make more children in this booth?; it is unbearable for a mother to watch their children freezing or hungry; once you have children you have to labor and to worry all the time, you seen I have to carry all my four children after me all the time; it is a sin to make abortion and use contraception so even now, in my forties I would give birth to a child if he would come.
Under the conditions of this limited and quite complicated access to contraceptive methods (having all kinds of uncontrollable side effects) abortion remained for very many Roma women “the best”, or at least the “most practical” solution for unwanted pregnancy. The majority of women whom I talked stressed that making an abortion is a practical decision: I could not have raise more children; if you don't want him, because you don't have the material conditions, it is better not to give birth, it is more acceptable to make an abortion, because it would be far worse to torture him afterwards. Almost everybody considered it a sin: you kill a soul, and this will affect you all along; God will not give you to eat after you die; you feel like a murderer. Nevertheless, abortion was requested as a last resort: it is like a war inside your body, it is difficult to decide, but finally you opt for it if there is no other way.
Otherwise, the "option" for this intervention harmonizes with the dominant strategy of going to doctors. As going to doctor (and especially for reasons related to reproductive organs) is an unpleasant event linked to several taboos regarding body and sexuality, and thinking and acting preventively is not really part of the dominant health culture generally in our society (and not only within Roma communities) abortion (as a concrete intervention in the case of an emergency) is more “favored” than the use of contraceptive methods (which impose, among others, a regular control and supervision, involve more costs, and, as I discussed above, are full with several tensions and unknown aspects): as far as now I did only one abortion, I can still make two or three, I'll just go to the doctor, now it is allowed and it is cheep at the state hospital, and make a request for it.
The act of making an abortion sometimes is considered to be the manifestation of women’s power, a moment that is controlled by her, which might be done secretly: I do not tell him about this, this is my problem, and I have to deal with it. Paradoxically, this kind of power is "achieved" by a woman after her man failed to take care, as he was supposed to do. It is a kind of ironically taking back the control from the hands of a man who proved to be unsuccessful, or who let her woman pregnant without her will. Under the conditions of a shortage micro-economy within which they live, or of a bad social relation that threatens even their bodily safety and does not offer emotional pleasures making an abortion is about escaping from further troubles. If this is the case, its side effects are less or not at all considered, are a luxury topic that is far behind the elementary survival. This again proves that – due to several factors – Roma women do not take care of their bodies and do not consider reproductive health a crucial issue of their life till they do not really get sick.
The case of women who together with their family join some sort of neo-protestant church (and this is a phenomenon that becomes more and more usual within the Roma communities and implies a very strict community control) is totally different in these terms. From their point of view not only abortion, but also the use of any contraceptive method is a sin and – due to cultural reasons – contraception for them is not an available tool for controlling reproduction.
What is happening with Romani women living under the conditions of severe poverty in terms of reproductive health looks to be a vicious circle from which one may not easily escape. On the base of their material conditions they do not want to have many children. But men are not really preoccupied with not letting their wives pregnant (they do not accept to use condoms) and women – if they rely on their partners – do need to make abortions in the case of any unwanted pregnancy. Not being married officially and hardly having their own home (sometimes on the one hand men and on the other hand women with their children stay separately in their parent's houses) women cannot rely on their "husband's" help in raising children. Nevertheless, women do know about contraceptives, but their information are not necessarily medically based and – due to the existing taboos – they hardly talk about this openly nor even among each other, not to talk about in the presence of strangers. Doctors are more than willing (we are going to talk about this in the next chapter) to administer to Roma women for free the contraceptives that are at their disposal (mostly injectables, whose secondary effects are only very vaguely known). Under these conditions women "choose" to use the contraceptives that are for free because they do not afford buying others (which might be more proper for their health) and they better take something/anything that is available for free (despite its negative consequences) than making more children under their given material conditions (that they do not even imagine to change).
Romani women take decisions regarding reproduction according to their views, feelings but also to the social expectations that they wish to fulfill as wives and mothers. This is why it might look odd to discuss in their context about reproductive health as a human rights issue. Nevertheless, one may make – as I did in my policy paper – recommendations by using the language of human rights. The reasons for this are multiple: this is a discourse that is legitimate in the realm of policy-makers and, as such, should be used as an advocacy tool for making them aware about Roma women's needs and about the social, economic, cultural and political processes that turn them into one of the most underserved categories; this is a language, which emphasizes Roma women's rights as humans regardless of their gender, ethnicity and class, while being conscious about the fact that gender, ethnicity and class as systems of power and socially constructed identities do shape their destinies by excluding them, as individuals and groups from the de facto access to resources (example to reproductive health); eventually this a discourse that claims the right of Roma women to be entitled to decide (among others on reproduction) on the base of their material conditions and emotional ties regardless of the pro-natalist or fertility control policies that try to subordinate them to "higher instances", like those of family, community, nation or God.
The majority of the women whom I have met within the Romani communities expressed a powerful desire towards taking their destiny in their hands (or acting as agency), nevertheless having very limited choices for doing this. On the base of what they considered to be a right decision under the given material conditions and within the social relations in the context of which they were living they felt (and were) morally entitled to decide, for example, on the number of children, on making abortion or using contraceptives. Their desire might have been to act as powerful individuals and they did make moral claims on the base of which they took their decisions regarding reproduction, but this decision-making was strongly limited by structural factors, social expectations and cultural conceptions witch they could not control. In this way their choice was not totally theirs among others due to the fact that they were excluded on the base of their gender, ethnicity and class from the resources that could ensure their reproductive health (an aspect which is going to be discussed in the terms of medical services in the following chapter). But also because it was always important for them to be accepted and respected individuals within their group and their autonomy was limited by very strict community expectations regarding womanness and motherhood.
3.C. Health care providers' attitudes towards Roma women
As part of my research I conducted individual and group interviews, but I was also having informal discussions with those local health care providers who had to deal with women’s reproductive health: family doctors, gynecologists, their medical assistants, but also staff of the County Health Directorate, including the community medical assistants.
is to be
mentioned that in the city of
the thirteen family doctors of the city of
Among the family doctors I could encounter attitudes that were having some sort of racist implications (I am having too many Roma patients, and this happened because I was a newcomer in this city, so I had to take what it was left by my colleagues; they do come very often to my cabinet and are always claiming something; it is very hard to work with them because they do not listen to you; they do make to many children). But there were also opinions that recognized: Roma women do take care well of their children, they bring them in for shots; Roma children are healthier because their mother breastfeed them for such a long period of time.
The three gynecologists of the city were working both at the public hospital, and at their own private clinics. Their prestige within the former location was quite reduced both materially and symbolically. Their private enterprises went pretty well, but obviously Roma women – due to their financial conditions – could not benefit from the services of a better quality offered by this sector. At the public hospital the gynecology section was downsized to a compartment (the number of beds was drastically reduced due to the reduced number of births after 1990) and its material infrastructure was very old: here we are the looser of the transformations process, totally devalued and mistreated, even if, theoretically, for example the Ministry of Health talks about the need to take care of maternities.
Due to the marketization of the public health care gynecologists were paid according to a strictly defined norm, which did not include, for example, family planning consultation, the administration of intrauterine devices and the abortion on the patient’s request as if these would not have been medical services. All these were done on voluntary base, and there was a lot of work in these terms during the 1990s. As Roma women wanted to benefit from abortion services at the state clinic (because these were more expensive in the private sector) among these physicians one could encounter even an anti-Roma attitude based on cultural prejudices about their "dirtiness", "excessive fertility" and "stupidity": they cannot do anything but children, they do not have the will and the intelligence and the education for using properly the pills. These were the reasons why a decision was taken in 2004 about the re-localization of the abortion-on-request-service, whose site was moved from the hospital to the policlinics and practically entered into the responsibility of one of the gynecologists out of the three. The price of this intervention went higher and the free access to abortion in the case of women having four children or in the case of minor girls was eliminated. The moving took three moths and meanwhile no abortions were made on women's request, those who could afford approached the private cabinets, others probably gave birth to the unwanted child.
In the attitudes of doctors towards Romani women I could discover a double talk. Their gestures, the words used for characterizing Roma women (as those quoted above) and their informal confessions (about the "fact" that mainly Roma women are requesting abortion at the state clinics, or about the "need" to segregate them in order "to protect our Romanian patients", or about the "immorality of abortions") revealed the existence of mechanisms which aimed to exclude Roma women on the base of their ethnicity from particular locations, but also from certain rights like the right to make a request for abortion at a state clinic under safe conditions. Complains about the "fact" that "mainly Roma women do give birth our-days" were maintained even if they ran counter to the figures used with the aim to sustain this opinion: last year 17% of the births were given by Roma women, and this year is even more, around 26%.
One of the conclusions I could make regarding what was happening in the relationship between Roma patients and medical doctors was the phenomenon of ethnicization of particular services. Obviously, there were not only Roma women, but also impoverished majority women who were looking for abortion services in the public hospital. But as usually poverty and all the related and assumed characteristics ended up being considered as a sign of Gypsyness, in this case abortion on request, the problems with the use of pills on a daily basis and the phenomenon of to-many-births was Romanized as well, Roma women started to symbolize these issues and moreover these problems tended to be defined as "Romani issues".
All the mentioned characteristics of the local medical system were obstacles in the real access of Romani women to a health care of a good quality and, as a result, to the opportunities of de facto using their legally assured reproductive rights. They constituted the factors of structural discrimination of women on the base of their sex. In the case of Roma this discrimination became a triple one, produced at the crossroads of their ethnicity, gender and social position. In a broader context, the downsizing of the gynecology section at the state hospital and its under-developed infrastructure illustrated the mechanisms of devaluing women's concerns, in particular reproductive health. Even if theoretically the society and the state recognize the role of women in biological reproduction, they do not invest much money into and do not confer much symbolic prestige to this domain of health care. As discussed in Chapter 3.7., foreign investment and assistance were crucial for raising awareness about women's reproductive health, but – by mainly focusing on the provision of contraceptives – they reduced the public consciousness about reproductive health to the issue of fertility control. One should recognize that all this was happening under the post-ceausist conditions of the abolishment of the anti-abortion law and of – willingly-or-not – celebrating abortion "as a gift of democracy". Under these circumstances there was indeed a need to relocate the emphasis from women's right to abortion to their right of controlling reproduction by the means of modern contraceptives. But it would be always important to stress: the aim of this change is the increase of women's access to reproductive health and not fertility control of any kind.
3.D. Roma policies. From gender-blindness to pro-natalist concerns
the 1992 census 409.723 people out of a total population of
million identified themselves as Roma, and in the 2002 census the
those self-identifying as Roma increased to 535.140, but unofficial
of the actual figure of Roma in Romania range between 1.8-2.5 million.
the large Romani population in
current situation of
Romani communities should be viewed in the context of the socialist and
pre-socialist legacy, too. Roma people were enslaved for a long period
records of their enslavement in the provinces of
many reports on the situation of Roma present, after the collapse of
Ceauşescu regime in December 1989, anti-Romani sentiment broke out in a
collective violence against Roma. Under the pressure of international
organizations and internal Roma activism the “Strategy of the
Romania for Improving the Condition of the Roma” was published on
Ethnic Roma Inclusion” (an initiative of eight Governments in Central
Southeast Europe started as a joint initiative of the World Bank and
Society Institute) was launched in
on Roma Health organized in December 2005 in Bucharest – on which I
participated due to my International Policy Fellowship grant – proved
central Roma agencies consider that they should not overemphasize the
women’s reproductive health as international agencies do mostly due to
forced sterilization cases in Slovakia. I realized again that,
reproductive rights are a highly sensitive issue within the Roma
and movement. However, this is not only because they might be
for the sake of actions against Roma reproduction and, misused, might
transformed into an alibi for fertility control. But this is also due
fact that some Roma leaders interpret them in the terms of an attack
Roma traditions regarding the “proper” number of children or to women’s
and sexuality, or, moreover, as an assault against the unity of the
The fears regarding the assimilation of reproductive rights with
control are completed by the suspicions around the risk of treating
planning (alongside with sexual disease) as a Roma issue and around
the negative prejudices about Roma. In this context it was affirmed: it
not acceptable that if Roma families are having four children, the
considered to be unwanted ones. We should not forget that infantile
within Roma communities is of 16% and the Roma minority could maintain
due to the fact that we dared to make five or six children, or more.
Suspicions regarding the need of statistics disaggregated on the
ethnicity (not to talk about gender) were formulated in the same
the side of the international organizations the following perspective
formulated: The reaction to the so-called “overemphasis” of women’s
reproductive health was probably due to the fact that in the first part
day the participants discussed this issue. It is not that reproductive
would not be important, because, for example maternal mortality in the
Roma women is of 28 %. The problem is that this is discussed in wrong
due to which reproductive health is associated with family planning,
forced sterilization and fertility control. We should define
rights more broadly and consider them alongside the right to work, the
non-discrimination, and the right to have decent living conditions.
– as discussed in Chapter 3.F. – there are Roma women’s initiatives in
- woman is the one who maintains contacts with the gadje world (mayor’s office, school, doctors), she takes the children to doctors and send her husband as well, even if she is not taking care so much of herself, and when she would think about buying contraceptives, she would better think about using that money for the sake of her children
- in terms of health issues one may enter most successfully into the community through women, because they take care of their families; due to the fact that health mediators are supposed to inform the community about their rights and their access to medical information and services it is good if they are women, because in this way they may contact women easier
- through health mediators it is possible to identify women’s needs, and also to promote women in public roles, while recognizing their role in the family, in the community and in the broader Roma movement.
Within this context the debate about Roma health mediators is important because it is linked to a series of other issues, like: women’s role in Roma communities, women’s presence in the Romani movement, advantages and disadvantages of affirmative action, negotiations between and within governmental agencies and Roma non-governmental organizations, the governmental involvement into solving the problems of Roma communities. That is why it should be within the focus of policies regarding Roma women’s reproductive rights.
Neither the Strategy, or other documents reflecting the basic orientation of Roma policy in Romania were taking seriously the issue of gender relations and of the unequal power relations between women and men within the Romani communities, and do not reflect on the types of discrimination experienced by Roma women in the Romanian society. That is why the need for a gender aware Roma policy should be strongly emphasized. This should address the Roma-woman-specific types of discriminations, both those coming from the outside of Roma communities, and those generated within them. For sure, issues like those related to childbearing, mothering, abortion, use of contraception and reproductive health are ones through which the hardships of Roma women are lived out as particular experiences which are required to be addressed explicitly. The recent orientation towards mainstreaming mentioned above could be used within the Roma movement to argue for the need of another mainstreaming, that of gender into Roma policies. But I would say that this does not replace altogether the policy of targeting Roma women’s special needs with affirmative action measures, mainly because the implementation of mainstreaming policy would take a very long time and because women militating for women’s rights are hardly involved into policy making.
The discourses that characterize the above presented policies and views about Roma women reveal the fact that they are driven in the best case by a gender-blindness, which refuses to recognize the importance of Roma women's issues, and, in the worth case, by pro-natalist concerns, which, at their turn, reproduce the subordinated position of Roma women from which it is very difficult to act as autonomous subjects trying to de facto use their reproductive rights. One may try to understand that in the case of a vulnerable community which, on the top, aims to construct its identity on the base of culturally valued traditions, pro-natalist concerns may have their functions in this attempt. They might be used as an instrument of defense in the front of the racist prejudices and practices directed against the community. This is why the issue of reproduction control is sensitive in the case of Roma groups (but in fact it is sensitive in the case of any social group during times when it wants to prove its strength through demographic indicators). Moreover, this is why it is important to stress that my policy paper considers reproductive rights as women’s rights and makes recommendations for the improvement of women’s access to contraceptive methods that assure their health. At the same time it emphasizes that this issue might not be treated separately from the general problem of women’s status within Roma communities and should be linked to the empowerment of Roma women within the mainstream Roma movement.
3.E. Reproductive health policies. From ethnic-blindness to racism
the Ceausist anti-abortion law (a law that conferred, among others, the
was true that
through this change women gained the formal right of controlling their
reproduction. The fact that women really used this right is reflected
following figures. In 1990 the number of registered abortions increased
992.300 (from 193.100 in 1989), but the number of maternal death
abortion decreased to 181 (from 545 in 1989). But it was also true that
through it – the new power achieved high popularity and for many years
had not improving the medical system in a way in which this could have
increased the access of women to modern contraceptive methods that
assured their reproductive health. In 1993, when the first Reproductive
Survey was made in
A real concern with women’s interest would not have turned the respect of women’s right to control their body into the celebration of abortion as the gift of democracy. Instead it should have mean the development of a whole health care and educational system within which women – as responsible and accountable individuals – could decide on the most proper contraceptive method that might assure their own wellbeing. So, the very first change on this domain (which wanted to be recuperative) was actually a sign of excluding women as reproducers from those priorities of the new regime which were considered to be solved in a way that was concerned with the real interests of the involved individuals. Viewed from this point of view (too), the social order of the post-socialist Romanian “transition” was showing signs of exclusionary practices on the base of gender, which moreover were observable from other perspectives as well (like their presence on the labor market and politics, fro example).
international pressure (like the loan agreement between World Bank and
government in 1991, the financial support coming from the United
Population Fund in 1997, and the need to harmonize the national
with the European on), and the local civic initiatives structured
forced the Romanian national governments to introduce on their agenda
of reproductive health. As a result, some formal structures were
across the health care system and (but only in 1999!) family planning
integrated into the basic package of services provided to the
Strategy of the Ministry of Health on the domain of reproduction and
(developed with the technical assistance of the World Health
supported by the United Nations Fund for Population) was launched in
2003, as a
result of which courses on family planning for family doctors and the
distribution of free contraceptives started. The Strategy provided the
framework within which the related legislation could have been
important role in this process was and still is played by the Society
Sexual and Contraceptive Education (SECS), a nongovernmental
a centre in
SECS was involved in 1996 in the creation of the Coalition for Reproductive Health that – as part of its POLICY project – published a booklet entitled “Sănătatea Femii – sănătatea naţiunii” (The Health of Woman – the Health of the Nation), a title which suggests that a public talk in today’s Romania on women’s (reproductive) health is not treated explicitly in the (feminist) terms of women’s rights but in the context of the well-established national discourse. The latest booklet published by SECS entitled “Fiecare mamă şi copil contează” (Each Mother and Child Counts) is aiming to make available information about contraceptive methods for a large segment of population, but – at least according to its title – is not addressing (and empowering) women as autonomous subjects located in particular social conditions, but as human bodies centering on their reproductive function.
Ultimately, in 2004 the Law regarding reproductive health and the medically assisted human reproduction was elaborated in Romania, which defines the issue of reproductive health and health of sexuality as a priority of the public health system, and discusses about these issues in terms of rights, but its discourse is mostly couple (family) than women-centered. As stated, these new regulations aim to reduce the number of unwanted pregnancies, of illegal abortions, of maternal mortality and abandoned children. By now, each woman who decides to make an abortion has to be informed appropriately in order to take a decision, doctors have to prove that they did this informing and women have to express their decision in a written form, and free provision of post-abortion contraception should be provided. Moreover, women should have yearly free access to one Papanicolau test.
liberalization of abortion, the establishment of the family planning
the provision of free contraceptives through the family doctor’s
above mentioned Strategy and Law, and the Law on violence against
reflects the progresses achieved since 1990 in
problem of access of Roma to healthcare was addressed in a way in
Scholars and activists addressing the access to healthcare of Roma  – besides the high rates of illness, lower life expectancy, and higher infant mortality – are also emphasizing that Roma women begin childbearing at a young age, and are having less access to preventive sexual and reproductive health information and care (including gynecological care, family planning and natal care). Among others, they stress the following reasons for this situation: Roma women tend to postpone attention to personal well-being in the interest of attending family care and the home (so obtaining contraception for themselves is among the last on their list of medical priorities); they are dominated by a feeling of shame when seeking help, especially if this requires a break in social codes of modesty; there are Roma customs that prevent women to seek care during or after pregnancy; under the circumstances of unequal gender relations women feel little power to choose when, with whom and with what form of protection, if any, to have sex; women are having fear of seeking medical care because they fear violence, abandonment or ostracism from their partner, family and community; and last, but not least, the stereotypical view that Roma women do not think of future, and other gender and ethnic stereotypes might cause health care workers not to offer family planning information and services, or provide information only on certain type of contraception. Recognizing that the effects of discriminatory healthcare are felt disproportionately by women (because it’s women who typically bear principal responsibility for family health care and maintain the contact between Romani communities and public health services) it is urgently needed to include Roma women’s perspectives and experiences into policies devised on the behalf of Roma, and – I would add – into policies devised on the behalf of women.
The ethnic-blind reproduction policies maintain Roma women's underserved status, because do not consider the differences between the socio-economic condition of Roma and non-Roma women and do not care about the lack of equal opportunities in de facto using the formally assured reproductive rights. This means, among others, that – also due to this – Roma women continue to be disposed "to choose" abortion as a method for the control of reproduction, and if they decide to use modern contraceptives they are obliged "to choose" the ones that are available for free and not the ones, which might be indicated according to their medical condition. Still, one may say that reproduction policies are in the best case ethnic-blind, for it might happen that they might be "ethnically aware", although not in a positive but in a negative sense. More precisely, reproduction policies might not be like that in themselves, but they might be used for racist purposes, following the aim to control the unwanted Roma "overpopulation".
The following story reveals the possibility of this development. During my fieldwork, while trying to solve some issues for a Roma family at the city hall in Orastie, in the labyrinth of local administration one day I could meet – among others – the (female) director of the Public Service for Social Work. She got very excited when learned about the fact that my research was linked to the issue of reproduction and use of contraception. She exposed very quickly her ideas about the need of making a “campaign of fertility control” among Roma women (campanie de injectare) using the injectable contraceptives, being convinced that the main causes of Roma poverty (and of the troubles that the mayor’s office and she personally has to face day-by-day) were rooted in the Roma “over-population”. Her discourse and attitude made me aware again of the fact that reproduction policy needs to delimitate very clear the issue of women’s reproductive rights from the issue of fertility control, and has to have mechanisms that prevent the transformation of the policy for reproductive rights into a racist policy of controlling population growth (or of excluding some from the right to procreate). At the same time, this experience convinced me once again about the need to address the issue of women’s (reproductive) rights in the context of the general Roma policy in a way, which reflects a clear standpoint on the relationship between reproduction and Roma’s harsh life condition and makes explicit the fact that the latter could not be improved through restricting the growth of population because it has other causes than this.
3.F. Roma women's organizing
Besides the aspects discussed in the previous chapters the analysis of Roma women’s access to reproductive rights needs also to reflect on the extent to and way in which this issue is present in the country’s Roma movement. The state of affairs in reproductive rights is reflecting on the one hand the status of Romani women within their communities, and, on the other hand, is strongly shaped by the attention which is accorded generally to women’s rights within the movement and within the broader social environment. That is why my policy paper has to refer to this dimension, too.
Roma discourse started to explore the gender dimension of racial
and Roma women’s situation quite recently. All this begun when the
Group on Roma/Gypsies decided at its 7th meeting in
(29-30 March 1999) to request a consultant to prepare an introductory
this issue, but it was preceded by Roma women’s organizational efforts
levels. The report was made by Nicoleta Biţu.
then she worked at the Roma Centre for Social Intervention and Studies
Anyway, it is important to observe that organizing at international level was and remains crucial in terms of fighting for women’s rights, and in particular for reproductive rights. This is so because the former is having the potential to empower those local women who might not have enough legitimacy and authority within their own societies, respectively male-dominated Roma movements. And if this is true in general terms, it might be even more so in the case of reproductive rights, because this is a domain that affects very closely women’s condition within their communities, where sexual taboos, virginity cult, arranged and early marriages, and domestic violence shape their position and opportunities.
Altogether, for example, the Roma Women’s Forum organized by the Open Society Institute’s Network Women’s Program and the Roma Women’s Initiative in 2003 in Budapest (preceding the conference “Roma in an Expanding Europe: Challenges for the Future”, which concluded endorsing the “Decade of Roma Inclusion”) had a huge importance in giving Roma women a place at the policy paper. The out coming paper expresses very clearly the agenda of Roma women activists: “[they] do not want to create a separate movement of Romani women but rather seek to mainstream Roma women’s issues into all levels and structures for both women and Roma”. The recommendations of my policy paper are also formulated in this spirit.
RWAR organized the international conference "Public Policies and
Women in Central and East European Countries" with the support of
Open Society Institute. This brought together in
of Gypsy Women for our Children was funded in 1997 in
far as her
local activism is considered, the Association leaded by her aims “to
the Roma people in
– Roma Center for Social Intervention and Studies was established
the present executive director of Romani Criss was convinced about the
that changes within Roma communities are going on slowly, and non-Roma,
also modernized Roma should not enforce so rigidly the agenda for
change in the
traditional communities. According to her opinion there is no Roma
Daniel Rădulescu, in charge with the health department of Romani Criss emphasized that the health problems of Roma women did not differ so much from the health problem of non-Roma women, so they did not need special measures. He considered that the positive discrimination measures were not effective, because they reinforced the existing prejudices. By this he wanted to say that there were no specific Roma illnesses, and the Roma population was not more vulnerable in front of illnesses than the non-Roma one due to its „origins”. However, he recognized that Roma did not have a proper level of health education, and this was a specific problem, which needed to be explained by considering many factors, including racism and discrimination. Radulescu also considered that the issue of reproductive health was a delicate and difficult one. They had a project on this in 2003, but it was difficult to implement it, because in the community of traditional male leaders this was a taboo subject. They realized that women do talk about this among them in secret, but without the acceptance of the community one could not just enter and open up the discussion, so everybody should be careful about not enforcing these projects on communities that are not ready to accept them. He considered that the biggest problem was that if a Roma woman went to the family doctor he or she would not have been informing her about her choices, but would have make her an injection, while nobody knew about its consequences and about its risks of leading to sterility.
for the Emancipation of Roma Women was constituted in Cluj in 2000
by young women enrolled into higher education. As its current
Neagu mentioned, they encountered all kinds of attitudes among their
fellows, some of them even ridiculazed the effort of establishing a
organization. They knew about the existence of other Roma women’s
They had a campaign on family planning in several communities from the whole county and their strategy was that of presenting the use of modern contraceptives as an alternative to abortion, and aimed to make women understand that they were free to choose on the base of their information. As she said, women recognized the fact that they did not have the financial resources and the personal energies to sustain a big family, but they usually did this after becoming pregnant, so have recoursed to abortion. On the base of her experiences, Ioana Neagu was reluctant in defining the main cause that made Roma women not using contraceptive methods. Was that tradition, or religious belief? In any case, she observed that even in communities where women used contraceptives before, after the influence of neo-protestant churches became stronger, they gave this up. Most importantly she stressed that one might not make general affirmations about the use of modern contraceptive methods by Roma women, but might observe that they might have problems in using them correctly, respectively in having the chance of using the most proper ones.
She considered that there would be a need for making an education campaign within the community of health care providers who have Roma patients, in order to make them aware about the conceptions Roma have about the female body, in particular about the fact that they associate its bottom part with dirtiness, or about male virility, or about the value of numerous children who make a family stronger. More information campaigns should be done within the Roma communities as well, involving both women and men. She strongly affirmed that Roma do not need special laws, but a mentality change, which would eliminate discrimination and internalized prejudices.
My research recognized the potential empowering ability of international organizations towards local women’s organizing. However, it should be mentioned that there is a gap between the discourse and practices of international organizations, and those of the local ones, so the latter are still having huge difficulties in implementing these ideas within their national movements, and also within the communities where they work. The lack of financial resources, the lack of primary researches on which policy-making from below should be based, the reduced number of projects dealing with women-related issues, the resistance of central Roma organizations towards deconstructing traditions that subordinate women, the lack of cooperation between Roma and non-Roma women’s organizations, and many other factors are responsible for the marginalization of Roma women’s organizations. At its turn, at the level of NGOs, this phenomenon is reproducing women’s discrimination on the base of their sex and ethnicity within their community and the broader society.
4. FINAL REMARKS
the end of
this research paper I need to answer the question related to the
reasons why my
analysis of reproductive health was focused on the prevalence of
use of contraceptives neglecting its other aspects? I am aware of the
it is dangerous to reduce reproductive health to these issues, because
willingly-or-not – might favor the assimilation of the former with
control that I would like to avoid. Especially because during my
encountered both on the side of Roma organizations and on the side of
care providers this tendency due to which one claimed pro-natalist, and
other racist fertility control aims forgetting about the main issue
supposed to be served by reproductive health policies, i.e. about
health. Still, under the conditions of post-socialist
This paper showed that Romani women were situated at the crossroads of several contradictory subject positions. These were prescribed for them by different discourses and institutions (like state policies, Roma policies, their own communities, health care providers), so they might have been quite confused in their effort of identifying with one or another position while also following their own interests and desires as autonomous human beings. How did they feel, think and act under these circumstances? My research paper discussed this aspect of women's reproductive health in the context of their lived experiences (as revealed by the interviews) observing their paradoxical situation created due to the fact that they belonged to different communities, and, as such, were subordinated to different regulations.
As Romanian citizens, since December 1989, formally they were entitled to make use of their reproductive rights, but – as culturally devalued and socially excluded Roma individuals –, they were subjected to racial discrimination which makes them unable to really use their reproductive rights (transforming them into underserved categories, or even exposing them to racist fertility control as Chapters 3.C. and 3.E. of this paper were revealing). On the other hand, Roma women were viewed by the mainstream Roma movement (that expressed and legitimated patriarchal community values) as life-givers and caretakers who were obliged to carry the burden of the biological and cultural reproduction of Roma communities (see Chapter 3.D.). This position prescribed to them might also has became an obstacle (at this time constructed from within) of their de facto access to reproductive health as far as it culturally imposes to them to marry and give birth at an early age, and give birth to as many children as they could in order to ensure the survival of the community.
Roma women's status is a newcomer one on the agenda of the Romani
 One should include into the history of this approach the contributions of the radical and of the Marxist feminism. The former announced a whole range of arguments for treating the personal as political and for both theoretically and socially recognizing the importance of the sexuality-related issues. And the latter emphasized the ways in which women’s productive and reproductive, visible and invisible work was needed for the reproduction of capital.
reflected, for example in Devisch Rene: Weaving the Threads of
Life: The Khita
Gynecological Healing Cult Among Yaka, Chicago:
Illustrated among others by Morsy Soheir: Gender, Sickness, and
for example by Inhorn Marcia: Quest for Conception: Gender,
Egyptian Medical Traditions,
Strathern: Reproducing the Future: Essays on Anthropology, Kinship
New Reproductive Technologies,
discussed in Faye Ginsburg and Rayna Rapp (eds.): Conceiving the
Order: the Global Politics of Reproduction, Berkeley:
Rayna Rapp: "Gender, Body, Biomedicine: How Some Feminist Concerns
Reproduction to the
 Maya Unnithan-Kumar: "Reproduction, health, rights. Connections and Disconnections," in Human Rights in Global Perspective. Anthropological studies of rights, claims and entitlements, edited by Richard Ashby Wilson and Jon P. Mitchell, Routledge, 183-209.
Gal: "Gender in the Post-Socialist Transition: The Abortion Debate in
 Gail Kligman: The
Politics of Duplicity. Controlling Reproduction in Ceauşescu’s
 I am relying on the conception about
Stuart Hall as expressed in "The Question of Cultural Identity", in
S. Hall, D. Held and T. McGrew (eds.): Modernity
and its Futures, Cambridge: Polity Press, 1992: 273-327; of
discussed in Feminism and Anthropology,
Cambridge: Polity Press, 2000 (1988) and in A
Passion for Difference. Essays in Anthropology and Gender.
In the understanding of identities as social processes of
involve mechanisms of naming, positioning and recognition, I am
ideas of Barth (Ethnic Groups and
Boundaries. The Social Organization
of Culture Difference, Little, Brown and Co.,
 The social organization of cultural differences (a term used after Barth, see above) is about the attachment of different meanings and values to different individuals and groups, and about the establishment of their hierarchy. But it also includes processes by which those in power use symbolic and material mechanisms in order to build up and maintain the boundaries between them, as privileged (superior), and the “others” as disadvantaged (inferior).
 Here I would like to express my thanks to my master and doctoral students, who by time to time assisted me on the field and made several valuable interviews. My gratitude goes especially to Iulia Hossu, Plainer Zsuzsa and Viorela Ducu-Foamete, but also to Petruta Mindrut and Gelu Teampau. It is to be mentioned that Iulia was also working very hard on shooting in Orastie, being the camera-woman without whom the film we made could not have been produced.
 My policy paper considered that reproductive rights included women’s right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence; the right to the highest standard of reproductive health, the right to have access to reproductive health care information and services, the right to sexuality education and bodily integrity, the right to decide on the number of children and the time-spacing of births, women’s right to decide on the contraceptive method most appropriate for her medical and social condition.
The agreement on this definition was achieved at the
International Conference on Population and Development (ICPD) held in
 Addressing the population and reproductive health issues and trends in Central and Eastern Europe and Central Asia, UNFPA emphasizes the following, but without offering ethnically disaggregated data: the rapid rise in rates of HIV/AIDS and sexually transmitted infections — the rate of increase during 2002 was among the fastest ever experienced anywhere — especially among young people, and in the eastern parts of the region; inadequate access to quality services for counseling, diagnosis and treatment of STIs is increasingly recognized as a constraint on the whole region; the need to address the reproductive health needs of young people, ensuring access to information and services to help them adopt healthy behaviors; the continuing incidence of recourse to abortion; the large discrepancy between the life expectancy of males and females in numerous countries; negative population growth rates in many countries; the ageing of the population throughout the region; the rise in trafficking of women and girls; high maternal mortality rates. See in Country Profiles for Population and Reproductive Health (2003).
 C. H. Bowner: "Situating Women's Reproductive Activities", in American Anthropologist, December 2000, Volume 102, Issue 4
 Maya Unnithan-Kumar: Reproduction, health, rights. Connections and disconnection, in Human Rights in Global Perspective. Anthropological studies of rights, claims and entitlements, ed. by Richard Ashby Wilson and Jon P. Mitchell, Routledge, 2003, 183-209, p. 184
 Materials of the Strategy and its evaluation
read in: Strategy of the Government of
http://www.riga.lv/minelres/NationalLegislation/Romania/Romania_antidiscrim_English.htm; O necesară schimbare de strategie. Raport privind stadiul de aplicare a Strategiei guvernamentale de îmbunătăţire a situaţiei romilor din Romậnia (A necessary change of strategy. Report regarding the application of the Strategy of the Government of Romania for Improving the Condition of the Roma, by the Resource Centre for Etnocultural Diversity, 2004, at www.edrc-ro; Monitorizarea implementării la nivel local a Strategiei pentru Îmbunătăţirea Situaţiei Romilor din Romậnia (Monitoring the implementation at local level of the Strategy of the Government of Romania for Improving the Condition of the Roma), by the Resource Centre for Etnocultural Diversity, the Open Society Institute Budapest and EUMAP, 2004, at www.edrc-ro, http://www.romacenter.ro/noutati/index.php?page=8; Report on the Implementation of the Strategy for the Improvement of the Situation of Roma Community from Romania, 2002, http://www.eumap.org/reports/2002/content/07.
The results of a recent policy research coordinated by Marta Schaaf
were just published
under the title Mediating Romani Health. Policy and Program
Open Society Institute, Network Public Health Program,
 Indicators on this are provided among others in the Summary Report made in 2005 on the Reproductive Health Survey made in Romania in 2004 as an outcome of the cooperation between the Romanian Ministry of Health, the United Nations Population Fund, the United Nations Children's Fund, the United States Agency for International Development, the JSI Research and Training Institute, the Swiss Agency for Development and Coopeartion, the World Health Organization and the Institute for Mother and Child Care 'Alfred Rusescu'.
The outcomes of this research was published under the title Breaking
Barriers – Report on Romani women and access to public health care,
OSCE, The European Monitoring Centre on Racism and Xenophobia, and
Europe, 2003. The project was administered
Council of Europe and overseen by an advisory group consisting of
of the Council of Europe, OSCE HCNM, OSCE Office for Democratic
and Human Rights, the European Union’s European Monitoring Centre on
Xenophobia (EUMC), and the World Health Organization Regional Office
 Corinne Packer wrote largely on this issue. See, for example: The Health Status of Roma: Priorities for Improvements, in Human Rights Tribune, Volume 11, Nº 1; or: Roma Women and Public Health Care, in Sexual and Reproductive Health in a Multicultural Europe. The European Magazine for Sexual and Reproductive Health, No. 55/2003, at http://eumap.org/journal/features/2002/sep02/romwomenprior
 She wrote many reports and policy papers related to Romani women, the most recent ones were: Romani women in the European Union: Realities and Challenges (November 2005); National Action Plans and Equality for Roma Women. A Report to the International Steering Committee of the Decade of Roma Inclusion (January, 2005). In the latter she observes that “we asked for the mainstreaming of Romani women’s issues, not for separation, but instead of gender awareness within all sectors of the action plans, we see nothing but superficial and token mention of women’s issues. Our recommendations … were ignored”. Biţu called the attention of the Steering Committee to work with the Roma Women’s Initiative to figure out how to address issues of women and gender before the Decade launch
The report entitled The Situation of Roma/Gypsy Women in Europe, 1999
stresses that their life is often characterized by a conflict
traditional culture and modern developments, but one always has to
particular Roma group to which women belong to. It gives an overview of
international activities related to Romani/Gypsy women issues and of
policies in favor of them, and she concludes that
 See for example the analysis of Isabela Mihalache Romani Women’s Participation in Public Life, 2003, at www.errc.org/rr_nr4_2003/womens2.shtml., who talks about “the process of the emergence of a ‘consciousness’ among Romani women about the realities of a patriarchal culture”, but also about the fact that “it is extremely difficult for Romani women activists … to embark on a road full of risks and insecurities – the road of activism against oppression from within the community.” Her personal position is very clearly put (“I refuse to accept traditions that imprison people and do not allow them their freedom”), but it is one that is not easy to assume exactly because of the repressions coming from the mainstream movement that is having a different interpretation of preserving traditions. Very recently (2006) an important report assisted by Mihalache was published under the auspices of the Roma Participation Program entitled Broadening the Agenda, The Status of Romani Women in Romania, by Laura Surdu and Mihai Surdu, presented as an outcome of a research conducted by Roma about Roma.
The out coming report was entitled “A Place at the Policy Paper”
on the Roma Women’s Forum,