The Bucharest Early Intervention Project (BEIP), the first-ever randomized trial of foster care for young children with a history of institutionalization, began in 2000. This was about ten years after the fall of Nicolae Ceaușescu, general secretary of the Romanian communist party. During his tenure, Ceaușescu had been convinced that the way to build a powerful economy was to increase the number of available workers for production. To that end, he instituted a number of pronatalist policies designed to increase the population of the country. These included banning abortion, outlawing contraception, and imposing a tax on families with fewer than five children.
As a result of these policies, there was a dramatic increase in the birth rate. But many poor families were forced to have more children than they could afford. As an alternative to raising children in families, the government encouraged families to place children they could not afford to care for in large, state-run institutions. Faced with widespread poverty and limited economic opportunities, many families abandoned their children at birth or soon thereafter. As a result, over the course of several decades, abandonment became an acceptable choice for tens of thousands of families, creating one of the largest per capita systems of child-rearing institutions in history. By December of 1989, when Ceaușescu was overthrown and executed, there were more than 170,000 children living in various state-run institutions in Romania.
For more than ten years after the Romanian Revolution, the rate of child abandonment remained as high as it was during the Ceaușescu era. As a result, large state-run institutions continued to operate until early in the twenty-first century, when pressure from the European Union, combined with the release of initial findings from the BEIP, led to two major changes. The first was legislation that forbade the institutionalization of children under two years of age (unless they were severely handicapped) and the second was systematic efforts to close many of these institutions in favor of either family reunification, government
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