Italy

Abortion became legal in Italy in 1978, when Law 194 came into effect. It is a guaranteed free reproductive service to its citizens. Article 4 of the law states that women can have an abortion within the first 90 days of conception due to economic, social, family, and health reasons. There is a seven-day waiting period of “reflection” between the initial consultation where the abortion certificate is given, and when the procedure can be performed. However, if there is need for urgent patient treatment, the seven-day waiting period can be waived. Medical abortion is only possible up to week 7 of the pregnancy, and requires three-day hospitalization. After the 90 days have passed, only therapeutic abortions are allowed when the pregnant woman’s life is endangered if the pregnancy continues. Severe fetal abnormalities can also be grounds for abortion post the initial 90 days.

Even though abortion is a right, having the procedure done is nearly impossible for some women. Article 1 of Law 194 stipulates that “The State… recognizes the social value of maternity and protects human life from its beginning”. This phrasing shows that abortion is a compromise, and the aim of the law is to discourage abortions. Article 9 also gives healthcare workers and abortion providers the option to “conscientiously object” to take part in carrying out abortions due to religious or personal reasons, except if the woman’s life is in danger. It is this clause that is at the root of inconsistent abortion access in Italy. Numbers show that around 70% of Italian gynecologists refrain from performing abortions. The numbers vary per region; the percentage is slightly lower in the north and higher in the south. In reality, this creates a disparity in equal access to abortion care across the country. In some regions of Southern Italy, there is only one doctor who carries out abortions, and if this doctor goes on holiday, is ill or retires, all abortions cease to take place. There can be several reasons as to why the number of conscientious objectors is at an all-time high. The Catholic church heavily influences politics and the attitudes of the healthcare training given to healthcare workers. Moreover, non-objectors can face discrimination in the workplace and a greater workload. Nevertheless, Law 194 specifies that conscientious objection cannot stand in the way for the legal right of terminating a pregnancy. Given that abortions can only take place within 90 days of conception and the number of conscientious objectors, there can be long waiting times in certain regions. This forces women who have the practical and financial means to travel to another city, region or even country to have the pregnancy terminated.

When abortion access is difficult, some will turn to clandestine abortions to deal with the problem of being pregnant. Anna had an illegal abortion performed in 1967. Numbers from 2019 suggest that between 10,000 and 13,000 unsafe abortions take place every year. The number has declined since the 1980s, but although abortion is a legal and guaranteed right, some turn to unsafe abortions when the right to abortion is not upheld.

Abortion was illegal in Italy until 1978 and it was considered a crime. Between the 50s and the 60s, due to many deaths related to clandestine abortions, the topic became increasingly more relevant for the public opinion. The Vatican and the Catholic church had a large influence on public opinion, especially among the older generations in the 50s and 60s.

Then abortion became a political issue during the 1970s, mainly brought forth by socialist politicians and some members of the communist party. During those years the legislation started favoring the secular side of the argument: according to a 1974 survey, 63% of the Italian population thought that the parliament should work out a law on abortion as soon as possible. In 1975 they started campaigning for removing any criminal norm related to abortion. This movement was backed by left-wing working-class movements such as “Lotta Continua” (Continuous Fight) and “Avanguardia Operaia” (Working Class Avant-Garde) and there were repeated sabotage attempts by right wing democratic Christian parties.

In 1975, the constitutional court introduced the notion that “the right to health and life” of who’s already alive differs from “who’s yet to be born”, which created considerable turmoil. However, it was clear that a total decriminalization of abortion was still completely out of the question. It was also clear that a compromise was needed to bring all parties together, and the only viable option was allowing abortion following specific cases and circumstances. They wanted to forbid abortion as an act of “free will” but advised by a medical commission with decisional power: the aim of left-wing representatives was to avoid putting all the blame on women and to sensitize and make the entire society aware and responsible.

In 1977, the Chamber approved a law on the interruption of pregnancy, which can be summarized as follows: the decision was up to the woman, with a distinction in terms of timing – before or after the 90th day – after which a doctor must give advice if the woman’s life is in danger, or the fetus has severe abnormalities.

In 1978, Law 194 stated that the Nation did not support abortion as a “birth control mechanism” and that national and regional social organizations were in place in order to avoid abortion; however, in case the doctor would deem it necessary and urgent, he/she could give the woman a certificate of urgency, with which she could get an abortion in the authorized clinics.

In 1979, Pope Saint John Paul II started campaigning for a pro-life stance and collecting signatures to repeal Law 194. There was quite a clash ahead, enhanced by the fact that neither a demo-Christian nor a socialist/communist framework were suitable anymore for the Italian population in the late 70s, creating a sort of widespread values identity crisis – especially on “newer” themes such as abortion.

In 1981, there was a referendum for two options regarding Law 194:
1.    Pro-life proposition: either universal prohibition of abortion or reduction of the freedom of abortion provided by Law 194
2.    “Radical” proposition: complete liberalization of abortion
Results:
1.    79,6% of people entitled voted
2.    Pro-life proposition: 67,9% against
3.    Radical proposition: 88.5% against
4.    For context, “no” won on themes such as life sentence and gun license.

Since neither option really won, this was perceived as the incapability of the political class to make citizens actively involved in decision making, and the major outcome was the confirmation of “individualism” and of the principle of conscientious choice. People were already uninterested in politics – as such a high abstention rate was something new. The refusal to repeal Law 194 still shows how the secularization process was already well underway and how the influence of the Church was destined to become minoritarian.

Difficulty of accessing adequate abortion care was exacerbated by the onset of the COVID-19 pandemic that hit Italy hard. Abortion services were given lower priority in the hospitals, and gynecologists relocated to COVID-19-care, jeopardizing women’s abortion access within the 90 days of the law. Travel restrictions within regions in Italy and in Europe made it challenging to access abortion services in places where women would normally venture. There is no way to know the number of women who have been affected by COVID-19 restrictions in relation to abortion. Due to the three-day hospitalization that is recommended when an abortion is performed medically, some hospitals suspended the procedure during the pandemic, due to the three follow-up appointments that come with the procedure. The Ministry of Health updated the guidelines, proclaiming that medical abortion up to week 9 should be allowed on ambulatory basis due to COVID-19. Only some regions follow this recommendation.

The division of pro-life versus pro-choice is on full display in Italy, and the groupings are staunch opponents of each other. The anti-abortion movement is gaining ground, threatening Law 194s legal access to abortion. Verona declared itself a “pro-life city” in 2018 and held the World Congress of Families in March 2019, attracting conservative visitors from all over the world. Several prominent political leaders in Italy, including former Deputy Prime Minister Matteo Salvini attended the congress. 40 years after Law 194 legalized abortion, posters including slogans such as “every five minutes a child is killed” where put up in Rome, whereas the feminist movement actively promoted abortion rights in the streets and on social media. There are many feminist initiatives in Italy working towards the goal of helping women access abortion services in all regions of the country, fighting against stigma and for abortion rights.

According to Italian law, feti born after week 20 must be buried, usually in mass graves. There has recently been an outcry after several women who had late-term abortions found out that the feti had been given religious burial without their consent, in a grave marked with the woman’s name. Within this framework of religious stronghold and the legal right to choose, abortion is still a difficult topic that shapes the Italian society.

Written by: Tilla Solli for The Women's Museum of Norway

Information collected by the Women's Museum in Merano, Italy

In addition:
BBC News. (2021, March 30). Abortion in Italy: “I found a grave with my name on it.” Retrieved May 15, 2021, from https://www.bbc.com/news/av/world-europe-56182957

Caruso, E. (2020). Abortion in Italy: Forty Years On. Feminist Legal Studies, 28(1), 87–96. https://doi.org/10.1007/s10691-019-09419-w

Fox, K., & Di Donato, V. (2019). In Italy, abortion is a right. For many women there, getting one is nearly impossible. CNN. Retrieved May 13, 2021, from https://edition.cnn.com/interactive/2019/05/europe/italy-abortion-intl/

Human Rights Watch. (2020, July 30). Italy: Covid-19 Exacerbates Obstacles to Legal Abortion. Retrieved May 14, 2021, from https://www.hrw.org/news/2020/07/30/italy-covid-19-exacerbates-obstacles-legal-abortion

Iacarella, A. Breve ricostruzione storica dell'approvazione della legge n. 194 del 1978. Dall'avvio del dibattito culturale ai referendum del 1981.
https://www.academia.edu/10538787/Breve_ricostruzione_storica_dellapprovazione_della_legge_n_194_del_1978_Dallavvio_del_dibattito_culturale_ai_referendum_del_1981

Margolis, H. (2020, August 11). A Step Forward for Abortion Rights in Italy. Human Rights Watch. Retrieved May 15, 2021, from https://www.hrw.org/news/2020/08/11/step-forward-abortion-rights-italy

Pusiol, M. (2021, March 9). Italy: Where legal abortion does not necessarily mean accessible abortion. The New Federalist. Retrieved May 15, 2021, from https://www.thenewfederalist.eu/italy-where-legal-abortion-does-not-necessarily-mean-accessible-abortion?lang=fr