Safe Abortion: why is it still not guaranteed in Italy?

First of all the numbers. In Italy having an abortion is difficult because: it is conscientious objector 36.2 percent of non-medical staff, 44.6 percent of anesthetists and 64.6 percent of gynecologists, with peaks of 84.5 percent in the autonomous province of Bolzano, 83.8 percent in Abruzzo and 82.8 percent in Molise. These are the data published in the new report Pharmacological abortion in Italy: between delays, opposition and international guidelines of the international network Doctors of the Worldon the occasion of «International Day for Safe Abortion», which occurs on September 28th all over the world. Furthermore, in some health facilities there are only objecting doctors. As can be read in the research «Mai Dati», by the Luca Coscioni association and carried out by Chiara Lalli and Sabina Montegiove, in 22 Italian hospitals (and four consultants), the the percentage of conscientious objectors among healthcare personnel is 100 percentwhile in 72 it is between 80 and 100 percent.

But how is it possible that even today, 45 years after the entry into force of law 194 of 1978, which guarantees the right to voluntary termination of pregnancy, it is so difficult for women in Italy to have an abortion? Succeed first of all and secondly succeed without having to face an obstacle course made up of: insistent questions from the operators, volunteers from the Pro-Life network who wait for you in front of the clinics saying that they will help you raise your child and even priests, who as has happened over the years in the Marche region, they are waiting for you in front of the hospital with bloody scrubs.

To tell all this, the countryside “The Impossible Pill”which, with the ironic contribution of Laura Formenticrosses our country from Sicily to Mont Blanc to demonstrate and denounce how Italy is culpably distant from the directives of the World Health Organization. If we take a step back we arrive at the summer of 2020, when, during the pandemic, the Minister of Health, Roberto Speranza, modified, to everyone’s great applause, the directives for the administration of the RU486 abortion pill, pharmacological abortion. In particular, he established that it was available in clinics and eliminated the requirement for hospitalization. As has already happened in many countries for more than twenty years, such as in France for example. Here RU486 was introduced as early as 1988, in England in 1990. In these countries, medical abortions account for over 70% of the total, a percentage that exceeds 90 percent in Northern Europe. The then minister expanded the deadline for taking the pill from 7 to 9 weeks of gestation, for clarity: the World Health Organization, which defined medical abortion as a safe and recommended procedure for pregnancy terminations, recommends its use up to 12 weeks.

But have things really changed? The answer is no. In Italy you can count with your hands the regions in which medical abortion it’s really possible. The most relevant cases are: Piedmont (first Italian region for absolute number of pharmacological abortions where, however, in 2020 the Region, led by the centre-right, issued a “circular on pharmacological abortion” which prohibits the administration of RU486 in clinics and activates “information desks” managed by anti-abortion associations in hospitals)Emilia Romagna and Lazio. The latter is the only Italian region to provide the procedure as an outpatient procedure at homeaccording to international guidelines.

In Sicily, out of 57 obstetrics and gynecology departments only 31 perform IVG and RU486 is only available in hospitals. There is a lack of staff: 81.6 percent of gynecologists object, with peaks of 100% in 26 facilities. TO Catania Pharmacological IVG is not available in any hospital, while in Messina only the Polyclinic administers RU486 and has only been doing so for a few months. Before then, patients had to travel to Palermo, over 200 kilometers away.

Furthermore, finding data is very complicated. As well as being able to speak on the phone to a consultant. In particular, the data that should be updated by the Ministry are few and scattered. «For Doctors of the World, promoting and defending access to health does not only mean providing care and assistance, but also supporting social change and helping people achieve it, because inequalities in access to care, including abortive care, do nothing more than reflect and amplify social and gender inequalities”, he explains Elisa Visconti, director of Doctors of the World Italy. «As a medical health organization, we recommend that the Ministry of Health monitor and ensure that all Italian Regions receive the guidelines issued in 2020 on the subject of pharmacological abortion, in their entirety: the regulation of abortive procedures cannot follow political logic, but only medical-scientific criteria”.