Abstract / Summary
Background: Induced abortion is a major component of reproductive health, with about one in four pregnancies worldwide ending in induced abortion and important implications for maternal morbidity and mortality. Romania’s history of restrictive pronatalist policies, very high post-1989 abortion rates, and subsequent family planning reforms provides an informative case for understanding abortion as a family planning strategy. Objectives: This narrative literature review synthesizes evidence on induced abortion with emphasis on Romania. It describes the evolution of abortion law and policy, summarizes epidemiological and maternal health outcomes, examines sociodemographic and psychosocial determinants of induced abortion, reviews psychological and psycho-sexual consequences, and discusses the role of non-stigmatizing terminology in clinical communication. Methods: This narrative literature review was informed by a structured literature search of PubMed, Scopus, and Web of Science Core Collection conducted on 20 May 2026. Publications from January 1990 to September 2024 were searched using terms related to induced abortion, family planning, Romania, maternal mortality and morbidity, abortion policy, psychosocial determinants, psychological outcomes, and stigma. Predefined eligibility criteria were used to identify relevant peer-reviewed studies and major institutional sources; additional historical and legal documents were considered for contextual framing. Additional recently published studies relevant to the review themes were identified through targeted update searches and reference-list screening up to 20 May 2026. Results: Restrictive policies and contraceptive bans in Romania were associated with extremely high abortion-related maternal mortality, whereas legal liberalization and integrated family planning programs led to marked declines in abortion rates and deaths. Abortion decisions reflect age, partnership, parity, education, employment and legal status. Psychological studies and major reviews report heterogeneous post-abortion experiences. These outcomes appear to be influenced primarily by pre-existing mental-health vulnerability, pregnancy intention and circumstances, social support, stigma, and decisional autonomy, rather than by the procedure alone. Also, terminology and conscientious objection practices can contribute to stigma and access barriers. Conclusions: Ensuring equitable access to contraception, safe abortion services, nonjudgmental counseling and neutral professional language appears essential for reducing preventable maternal morbidity and supporting reproductive autonomy.