In Italy, abortion is often a right only on paper. The CNN investigation
Rights — di Valentina Neri
Law 194 turns 41, yet today women seeking an abortion still face a path strewn with obstacles. This is the subject of a CNN investigation.
In Italy, abortion is often a right only on paper. The CNN investigation
Law 194 turns 41, yet today women seeking an abortion still face a path strewn with obstacles. This is the subject of a CNN investigation.
"In Italy, abortion is a right. For many women, obtaining one is nearly impossible." This is the title of a lengthy investigation published by CNN. A journey that begins with a story — unfortunately all too common — that of Emma (a fictional name), who, after the 90-day deadline from the start of her pregnancy has passed, is informed of a serious foetal malformation and is forced to travel hundreds of kilometres just to reach a facility (the San Camillo-Forlanini hospital in Rome) that will allow her to undergo a therapeutic abortion. This delicate and painful case is the starting point for understanding what remains of Law 194, which is turning 41 this year.
What Law 194 provides for
Law 194, enacted on 22 May 1978 and confirmed by voters in the abrogative referendum of 17 May 1981, made the voluntary termination of pregnancy legal. Until that point, the penal code punished with imprisonment both the woman and the doctor who had performed the procedure.
Abortion is permitted only within 90 days of the last menstrual period, a limit that can be exceeded (up to the fifth month of pregnancy) only if the foetus shows serious malformations or the woman's health faces serious risks. It may be carried out in any public or accredited facility, by means of a surgical procedure or (from 2009 onwards) the abortion pill RU486, which is less invasive. Those who perform clandestine abortions face up to five years' imprisonment.
Medical and paramedical staff (including anaesthetists, nurses and obstetricians) have the right to conscientious objection: this means that, on personal, ethical or religious grounds, they may refuse to perform abortions. This right lapses only in serious emergency situations in which the abortion is indispensable to save the patient's life.
How many conscientious objectors are there in Italy
It is precisely this last issue that CNN devotes considerable attention to. It is true that conscientious objection is by no means an Italian exclusive, as it is guaranteed by 22 out of 28 European states (figures from the UN's Global Abortion Policies Database). In our country, according to the Ministry of Health report published in January of this year with data updated to 2017, 68.4 per cent of gynaecologists exercise conscientious objection, a higher percentage than that of anaesthetists (45.6 per cent) and non-medical staff (38.9 per cent).
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But the national average — the report also stresses — is only indicative up to a point, because everything depends on the balance between objectors and non-objectors within each individual hospital. And if in a hospital, a city or even an entire region of Italy objectors are the majority, abortion becomes an obstacle course. This is what happens in Molise (where objecting gynaecologists account for 96.4 per cent), Basilicata (88.1 per cent), Sicily (83.2 per cent) and Abruzzo (80.4 per cent). The average workload for each non-objecting gynaecologist, the Ministry explains, ranges from 0.2 terminations of pregnancy per week in Valle d'Aosta to 8.2 in Molise.
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This is also the reason why the San Camillo-Forlanini hospital in Rome held a competitive selection process in 2017 to hire two new doctors, on the condition, however, that they did not declare themselves objectors. A decision that stirred up a hornets' nest of controversy, but which was in fact aimed at preventing the ward in question — dedicated precisely to terminations of pregnancy — from finding itself short-staffed. At present, CNN notes, the facility has earned a reputation as the place to turn to for an abortion, even though objecting gynaecologists remain the large majority (19 out of 25).