The difficulties of getting an abortion in Italy

NNEWSPAPERS USED to set the agenda in election campaigns. Today, social-media influencers can also. On August 23rd Chiara Ferragni, a social-media entrepreneur whose Instagram account has almost 28m followers, shared a photograph of an operating theater. The post claimed that in Le Marche, a region in north-central Italy with a government led by the hard right Brothers of Italy (FdI) party, it was “practically impossible” to get an abortion. The FdI’s abortion policy has ever since been an issue in the campaign for Italy’s general election on September 25th. The Brothers are expected to come first and lead a new, radically conservative national government.

Ms. Ferragni’s claim was exaggerated. In the first seven months of this year, 543 abortions were carried out in Le Marche—90% of them within three weeks of a request being submitted. But her post nonetheless drew attention to the serious difficulties many Italian women encounter when they attempt to end a pregnancy, and on the prospect that the FdI may seek to make it even more difficult. They have already done so in Le Marche by limiting the availability of pharmacological abortion.

Under Italy’s abortion law, introduced in 1978, women can terminate a pregnancy within the first 90 days (and subsequently in exceptional cases). But the law also gives doctors a right to “conscientious objection”. It was intended to respect the beliefs of devout Roman Catholics. But the loophole offers a way out for doctors whose real motives have nothing to do with religion. A study published in 2015 found that they included perceptions of abortion as ‘dirty’ and unrewarding financially and professionally. Another reason given by objecting doctors was a fear of incurring the disapproval of colleagues—or, worse, superiors who could influence their career prospects. The percentage of doctors that object to performing abortions has actually increased in recent years despite Italian society becoming more secular.

The result is that women often need to go far afield to have an abortion. And if they have limited financial resources, or work or family commitments, that can be a serious obstacle. Using updated figures from a paper in 2016 by Francesco Mattioli and colleagues, The Economist created a map showing the proportion of residents who want an abortion who had to go to another region to terminate their pregnancy. In some cases, this can be put down to the fact that not all Italians live in the region in which they are resident. That is particularly true of students and people on training courses. But what the figures show is that the share of “abortion exiles” is significantly higher in the poorer south of the country, where there is also a powerful link between Catholicism and social respectability. In the whole of Molise on the Adriatic coast, a region with a population of around 300,000, there is only one gynecologist willing to carry out the procedure.

In Le Marche, the share of abortion-seekers who went outside the region in 2020 was 10.9%, compared with 4.7% across the country. In a third of the region’s 12 abortion clinics, the objection rates among gynecologists is more than 80%. In the town of Jesi it is 100%.

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