Increasing number of pro-life doctors, lack of facilities and abortion pill unavailable. The state of maternity service in Italy
Autore: Il Fatto Quotidiano
In the past 5 years, gynecologists who declare themselves ‘conscientious objectors’ (thus antiabortionists/pro-life) rose from 58% to 69.3% in Italy, reaching peaks of 80-85% in the Southern regions. Public family counseling services lack in the North-West. Central regions are almost without health facilities providing medical abortion to women who request it. These are only some of the elements that emerge from the yearly report on the ‘Law 194/78’ released in October 2012 by the Italian Ministry of Health. Services distribution and availability in Italy are different between the North and the South and from region to region.
Ilfattoquotidiano.it focused on three major issues to evaluate the state of maternity services in the twenty regions of Italy. First, we analysed the percentage of antiabortist doctors. Second, the availability of medical (non-surgical) abortion through the use of the mifepristone (RU489). Third, the distribution of family planning clinics over Italy. Even though the control over the availibility of maternity services belong to the regions, our analysis shows a piecemeal situation with visible differences among the North, the Center and the South of Italy.
- Conscientous objectors — The first map shows that the regions with the highest rate of objectors are located in Southern Italy. Peaks are found in Basilicata (85,2%), Campania (83,9%), Molise (85,7%) and Sicilia (80,6%). In the North, particularly high percentages can be found in Bolzano (81,3%) and Veneto (76,7%). However, in the whole country the percentage never goes under 50% – except in the case of northwestern Valle d’Aosta (16,7%). Similar are the percentages amongst anesthesiologists and other non-medical personnel, with Sicilia, Molise and Calabria showing rates between 70–80%.
In 2005-2010 the number of ginecologists who refused to provide abortions rose from 58.7% to 69.3%. A similar increase is observed amongst anesthesiologists (from 45.7% to 50.8%) and other non-medical personnel (from 38.6% to 44.7%).
- Abortion pill — Despite the fact that women who decide to abort in Italy more and more often choose the pill instead of the surgical procedure (from 857 cases in 2009 to about 7000 in 2011), the chances to get a pill vary visibly in the North, the Center and the South. The regions showing less availability are Marche, Campania, Lazio, Abruzzo, Sardegna and Sicilia – with less than 0.03 health facilities providing pills per 10,000 women aged 15–49 years. It is worth noting the case of the Marche region, where no health facility can provide abortion pills. Northern regions, such as Liguria, Emilia-Romagna and Valle d’Aosta, offer higher availability.
By looking at the data of 2010 and the first six months of 2011, the regions that counted the higher number of medical abortions are Emilia-Romagna (2271), Piemonte (1356) and Toscana (760). On the other side, the ones that counted the lower are Marche (2), Calabria (9), Sardegna (9) and Alto Adige (13). The head of the abortion services at ‘Sant’Anna’ hospital in Turin professor Silvio Viale underlined how often in Italy the adoption of the pill seems to be ‘merely symbolic’ and made difficult by bureaucratic directives that ‘invite to keep the women for three days in hospital after the medical abortion, even if it is not necessary’.
- Public family counseling services — In Italy the ‘consultori pubblici’ are centers where citizens should look for counseling services and – perhaps most importantly – obtain the prescription for the morning-after pill, which is not available in pharmacies without prescription. However, the distributions of such centers in Italy seems not to be uniform. In Lombardia, Trentino Alto-Adige and Friuli there is less than one public center per 10,000 women aged 15-49. Same scenario in Molise. Interestingly enough, in the South almost all the counseling services are public, while in the North private structures are widespread (in Lombardia and Friuli 25% are private, 100% in Alto-Adige).
For whom who may be interested, we release the data on which our analysis is based. Differently from the Ministry of Health, which release his data in PDF format, we publish the data in open format (csv):
- table on conscientous objectors
- table on medical structures that provide the abortion pill (RU486)
- table on public and private counseling services
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