There are laws that are enacted to bring about real-life change. There are others that are pushed through simply to give the illusion of progress. The latter seems to be the case in Italy with Law 194/78.
This legislation from 22 May 1978 decriminalises and regulates the procedure for accessing an abortion but, according to a report by the minister of health published in 2019 on the implementation of the law, conscientious objection among gynaecologists reached 68.4% on average with peaks of 100% in certain hospitals.
Conscientious objection is refusing to obey a particular order or rule, or to do a particular type of work, for moral or religious reasons. It’s legal because it is protected by Article 9 of the law.
The minister’s report refers to data collected in 2017, but not much has changed since then with regards to surgical or medical abortions, the latter of which was introduced in 2009.
Central regions Umbria and Le Marche belonged to the pope and his state, now the Vatican, before the unification of Italy in 1861. As such, these are traditionally more conservative regions for religious reasons when it comes to abortion. They have limited womens’ access to medical abortions through the administration of RU486, which is widely known as the abortion pill but referred to medically as mifepristone. It is typically used in combination with misoprostol to end an early pregnancy.
Northern League governor Donatella Tesei approved a resolution in Umbria in June last year that prohibits medical abortions in day hospitals and introduced a mandatory hospitalisation of three days to take the RU486 pill. This while hospitals and operating rooms were clogged with Covid-19 patients.
Protests followed, so the national Ministry of Health updated the abortion law guidelines in August, stating that it is possible to have a medical abortion up to the ninth week of gestation as an outpatient procedure. The Umbria government refused to follow suit until December. Then came the turn of Le Marche, where the newly elected far-right administration in late January rejected a motion asking it to respect the ministry’s guidelines, which allow for the possibility of administering RU486 even at family counselling centres.
“In this moment of great denatality in Western society, supporting this battle [of abortion] with great emphasis, which made sense in the 1960s and 1970s, is out of place” said regional ruling party Brothers of Italy leader Carlo Ciccioli to justify Le Marche’s decision. A doctor who specialised in psychiatry, clinical criminology and neurology, he added, “The battle today is that of the birth rate. There is no [generational] replacement and I cannot agree with the theme of [ethnic] replacement. That is that as our society doesn’t have children, then we can be replaced by the arrival of people who come from other stories, continents and ethnic groups.”
“We expected it, despite the fact that we had claimed victory in August for the new guidelines,” said Eleonora Mizzoni, an activist with Obiezione Respinta (Objection Rejected), a network of people that maps conscientious objection in Italy. “The first big issue is structural. National guidelines are not binding. The choice of applying them is up to the individual regions.”
This structural problem dates back to 2001, when the reform of Title V of the Constitution redefined the relationship between the state and regions in a federalist sense. That reform further deepened the fragmentation and lack of homogeneity in the health services provided in various territories by attributing new powers and autonomy to the regions. Silvio Berlusconi led the Italian government for three non-consecutive terms between 1994 and 2011, and it was approved during his second term as prime minister from 2001 to 2006.
If a decision on who is responsible for legislating on health issues can be taken overnight, the cultural question is the one that needs more attention. And more time to effect change. The high anti-abortion percentage we have seen among gynaecologists is reflected in the national population; the stigma attached to women who have an abortion is still strongly present in Italy. And like all uncomfortable topics, it tends to be relegated to the bottom of the political priority pile.
“It struck me that during the pandemic, there was no talk of abortion,” continued Mizzoni. “In the Telegram channel of the Ministry of Health, created specifically for the Covid-19 emergency, there was talk of the virus in relation to women’s health in general, but nothing was said about the voluntary termination of pregnancy.” In response, Objection Rejected has created its own Telegram channel, called SOS Abortion Covid-19, which offers valuable information at a time when almost all hospitals and health facilities have reshuffled their operations – redeploying personnel and departments usually dedicated to abortion – often without providing information about the changes.
While access to an abortion is a legal right in Italy, the aforementioned limitations often force women to travel to other regions, costing money and lost work days. Additionally, this also forces women who may want to keep their desire to have an abortion secret to account for the trip to friends and family.
The cultural backwardness and disrespect for women who have an abortion is evident in Marta Loi’s story. Seven months after undergoing a therapeutic abortion – the termination of a pregnancy beyond the first three months allowed by Italian law, if the foetus is malformed or the woman is physically or mentally at risk – she discovered that the foetus had been buried in the Flaminio Cemetery in Rome without her consent. What is more, a cross bearing her name had been erected on the grave.
This is not an isolated practice. In the more than 50 cemeteries of foetuses throughout Italy, there are many grave markers for foetuses buried without the consent of the women who aborted them. This happens because often women who terminate a pregnancy aren’t adequately informed of the fate of their foetus, which by law must be buried after the 20th week of intrauterine age.
Here the role of the pro-life Catholic associations comes into play. Some have agreements with hospitals and local health authorities to bury foetuses that are under 20 weeks of gestation if the relatives don’t make a request. And among the obstacles that the regional councils of Umbria and Le Marche still plan to put in place – following anti-abortion Northern League politician Simone Pillon’s 2018 draft law – there is the greater inclusion of these associations in family counselling centres, to dissuade women who go there to ask for information about abortion.
These counselling centres were created in 1975 to support families and individuals. But Mizzoni said that “even if it should be safe places for women, so many girls tell us how it is now seen as a hostile place since you are a teenager”. National guidelines state that the RU486 pill can be administered in these centres, but no region has adapted yet to do so. “The government should invest in these centres, but this would mean hiring staff and purchasing the necessary equipment,” said Mizzoni. “I think it’s one of the main tools to fight against the politically influential Catholic associations and their Centers for Life.”
‘Guidelines don’t apply’
The situation is getting worse instead of improving, but why? “There is a continuity with the past. It wasn’t better before, regardless of the [regional Le Marche] government in power,” said Marte, an activist with Non Una Di Meno Transterritoriale Marche (Not One Less Transterritorial Marche) whose transfeminine national network includes Objection Rejected. “It’s not an economic problem or anything else. The problem is the concept behind it, that is, the will to control women. Where there are conservative-led regions, the national guidelines don’t apply.”
A right-wing conservative government means a solid link with Catholic circles and, therefore, a form of political control over women’s bodies. Their hypocritical interest in the family hides their intent to limit extending to women their fundamental rights as much as possible. Mizzoni identified the World Congress of Families held in Verona in 2019, which then deputy prime minister Matteo Salvini attended, as the first public display of the new bond between far-right parties and the Catholic associations. From then on, there was a strong turn again against abortion.
Men are often the ones who claim the right to decide a woman’s destiny. But “if we have to make an effort to involve men [in abortion rights], there is an underlying problem,” said Marte. “It should be automatic. They have to question the whole toxic narrative of masculinity, and we should actually start by dismantling the concept of gender that cages men in a stereotyped gender since birth.
“We should make men understand that the struggles for rights, and for the exercise of rights, are always common struggles,” said feminist philosopher Lorenzo Gasparrini. “The struggles for women must be supported without protagonism, as when we support other causes without being directly involved. There are fights that men already partake in. The exception is when it comes to women’s struggles. On those there is the prejudice that they are women’s problems, as if men lived in another society, on another planet.”
The result is still a law empty of meaning 43 years after its approval.