Italy will soon make a long-awaited and important move towards women and girls’ ability to exercise their reproductive rights. Minister of Health Roberto Speranza announced last weekend on social media revisions to outdated national guidance, which will ease restrictions on medical abortion – a safe way to end a pregnancy using medication rather than more invasive surgical methods.
The announcement – as the Covid-19 pandemic exacerbates existing barriers to legal abortion in Italy – comes none too soon for women like “Elisabetta,” who sought a medical abortion after discovering she was pregnant in early April. “I called all the hospitals of Milano province,” she said. “Some said they had suspended the service [because of Covid-19], some said they don’t do it at all.” By the time Elisabetta found a hospital providing abortions in a town about 60 kilometers away, the doctor said she was past the legal time limit for medical abortion.
Until now, medical abortion has been permitted in Italy only until the seventh week of pregnancy – when some people may not even know they are pregnant – and national guidance says it should be administered during a three-day hospitalization. Yet the World Health Organization (WHO) says medical abortion can be safely self-managed by women up to the twelfth week of pregnancy. While surgical abortion can be performed in outpatient hospitals throughout Italy, only 5 of 20 regions have permitted outpatient medical abortion.
Improved medical abortion access will help ensure implementation of Italy’s national law, which permits abortion during the first 90 days of pregnancy for any reason. But burdensome requirements and medical personnel’s extensive use of “conscientious objection” to deny services leave women like Elisabetta scrambling to find care within the legal time frame. Though Italian law requires authorities to ensure that conscientious objection does not prevent legal abortion, this is not upheld or enforced.
These changes to Italy’s national guidance on medical abortion are critical to getting women and girls the health care they need. The government should monitor regional health authorities to ensure they implement these measures and uphold the national law and women’s and girls’ reproductive rights.