40 years after legalised abortion, Italian women face restrictions on access to abortion

December 30, 2018

On 4 October 2018, a motion to declare Verona a 'pro-life city' was approved by the city council. Motion 434, which was proposed by Alberto Zelger of the Lega Nord party, calls for public funding for pro-life groups and for campaigns to encourage pregnant women to consider adoption over abortion. The vote was met with protest by the women’s group Non Una Di Meno (Not One Woman Less), who wore costumes from the television adaptation of Margaret Atwood’s The Handmaid’s Tale as they protested the city council decision. In Italy, abortion was legalised in the first 12 weeks of pregnancy (and subsequently only when there is a serious risk to the pregnant woman’s life or a severe foetal abnormality) by the introduction of Law 194 in May 1978. The law was seen as one of the biggest advancements in Italian women’s rights. However, while the procedure remains legal across the country, the entitlement of doctors to refuse to perform abortions has made the procedure increasingly difficult to procure, while doctors who do perform abortions have seen their careers affected by the stigma.

 

The Handmaid costume, from Margaret Atwood’s dystopian novel The Handmaid’s Tale, has become a symbol of pro-choice protest. Source: TitiNicola.

 

While four decades have now passed since abortion was legalised in Italy, anti-abortion sentiment remains higher than in other European states. An Ipsos poll found 15% of Italians believed that abortion should never be permitted or should only be permitted if the woman’s life is in danger, compared to just 1% in Sweden, 3% in France, 5% in the UK and 6% in Germany. The Italian minister of families, former vice-mayor of Verona, Lorenzo Fontana, is openly against abortion and told the press after assuming office in June 2018 that he would work to reduce the number of abortions carried out across the country by giving doctors powers to dissuade women from having the procedure. The number of abortions has already been in decline for decades.

 

Italian doctors maintain the right of “conscientious objection”, meaning that they are not legally obliged to perform procedures relating to abortion. Some of Italy’s objectors are motivated by their Catholic faith, but others are simply concerned that association with the practice would damage their credibility in the Italian medical community. Italy is one of very few countries which records figures of objections among doctors: in the last 20 years, there has been a 12.9% increase in doctors who refuse to perform abortion for moral reasons, according to the Italian Ministry of Health. This has seen the percentage of objecting doctors rise from 62.8% in 1997 to 70.9% in 2016. However, this figure varies regionally, with as many as 84% of doctors in Sicily and Campania objecting, leaving a minority of doctors to provide the service for an entire region. Doctors are entitled to refuse to perform abortions in most member states of the European Union, but the right of objection is not legally upheld in Bulgaria, the Czech Republic, Finland and Sweden.

 

The generation of women who campaigned for Law 194 are concerned by the decline in legal abortion provision and fear that younger generations do not see the urgency in protecting this right. Currently, women often have to travel to other cities or regions or go abroad to have an abortion as only 60% of hospitals in Italy perform the procedure at all. In 2017, it was reported that a woman in the north-west of Italy was turned away from 23 hospitals before she was able to obtain an abortion through intervention by the trade union the Italian General Confederation of Labour. For those who have illegal procedures, the penalties are high – up to €10,000 as of 2016 – so women may risk death to avoid going to hospital when they experience complications from illegal procedures. Previously there was just a symbolic fine of €51.

 

Source: Edson Chilundo.

 

Women face challenges in obtaining abortions even when they are faced with serious medical complications to pregnancy. In 2016, a woman died in Cannizzaro hospital in Catania, Sicily, after miscarrying. The family of Valentina Milluzzo allege that the doctor treating her refused to perform a potentially life-saving termination after she suffered complications and went into premature labour at 19 weeks of pregnancy as he was a 'conscientious objector'. The hospital denies this, and the case has been under investigation since.

 

The Council of Europe – responsible for ensuring states uphold the European Convention on Human Rights – ruled that Italy’s weak regulation on conscientious objection has negatively impacted women’s ability to access healthcare services that are guaranteed by Italian law. Furthermore, the Council of Europe charged Italy for discrimination against doctors who do perform abortions, arguing that they face 'direct and indirect labor disadvantages'. In areas where objection is high, non-objecting doctors are burdened with a high workload, while young doctors are not being taught to perform the procedure, making even greater the lack of doctors available to perform an abortion. Non-objecting doctors have reported hostility from colleagues and being passed on for promotion because of their decision to provide abortions.

 

In Lazio, the region including Rome, only seven doctors provide abortion services after 90 days of pregnancy. Silvana Agatone, who is one of these seven, argues that the service is a necessity as she believes that the restrictions on abortion provision will result in women compromising their health because they are too afraid to seek an abortion. Agatone is one of the founders and President of LAIGA, the Free Association of Italian Gynaecologists for Law 194, which provides information on where to find non-objecting doctors for women seeking legal abortion.


You can follow the Non Una Di Meno movement on Twitter @nonunadimeno to see how they are working to protect Law 194.

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