Reproductive Health: A Study of Abortion and Contraceptive Knowledge and Attitudes Among Romanian Undergraduate Health-Profession Students

Despite increasing global attention to reproductive health, significant knowledge gaps and misconceptions about abortion and contraception persist among young adults, including medical students. Understanding their knowledge and attitudes is crucial for developing effective educational strategies. This study aimed to assess the knowledge and attitudes regarding abortion and contraceptive methods among undergraduate Romanian health-professions students. A cross-sectional study was conducted between April and December 2024, using a validated, self-administered questionnaire distributed online. The final sample included 510 students from various medical fields. Data were analyzed using descriptive statistics and chi-square tests, with a p-value < 0.05 considered statistically significant. Most participants were female (77.45%), reflecting the feminization trend in medical education. Overall, 95.88% of respondents declared awareness of abortion, yet significant knowledge gaps remained, particularly regarding legal gestational limits for medical abortion. Notably, 66.47% identified infertility as a potential complication of abortion, though this did not differ significantly by gender. Regarding attitudes, students generally supported abortion in cases involving maternal health risks (74.12%) or sexual assault (79.22%), while acceptance decreased in socio-economic or personal contexts, especially among male students. Contraceptive knowledge was high for condoms (99.22%) and oral contraceptives (95.88%), with no significant gender differences for individual methods after correction for multiple comparisons. Importantly, 64.35% of male students believed that condoms reduce sexual pleasure, and 87.85% of female students expressed concern about the side effects of oral contraceptives. Furthermore, 60.59% of participants believed that access to abortion services in Romania is insufficient, and nearly 80% advocated for legal measures to improve accessibility. Male students were significantly more likely than female students to report not knowing what surgical abortion on demand is (16.52% vs. 2.53%; OR = 0.13, female vs. male, 95% CI 0.06–0.29, p < 0.0001), a gender gap that remained significant after correction for multiple comparisons. In multivariable linear regression, year of study was the strongest independent predictor of objective knowledge (β = 0.31, 95% CI 0.14–0.47, p < 0.001), and students enrolled in Dentistry/Pharmacy programs scored significantly lower than those in General Medicine (β = −0.83, 95% CI −1.32 to −0.34, p = 0.001), whereas gender and age were not independently associated with knowledge after adjustment (p = 0.581 and p = 0.519–0.794, respectively). The findings reveal substantial gaps in knowledge and persistent misconceptions about abortion and contraception among future healthcare providers, particularly regarding legal gestational limits. Gender differences were significant for attitudes toward abortion in non-medical contexts, but were not robust for most individual knowledge items once corrected for multiple comparisons. Targeted educational interventions are urgently needed to address misinformation, promote reproductive autonomy, and prepare future healthcare professionals to provide comprehensive, unbiased reproductive healthcare.