Useful Italian Words For Essays On Abortion
But that does not mean that finding a doctor to perform one is easy. Seventy percent of gynecologists — up to 83 percent in some conservative southern regions — are conscientious objectors to the law, and do not perform abortions for religious or personal reasons in a country that remains, culturally at least, overwhelmingly Catholic.
It is a circumstance that has alarmed some women’s health experts, who say that the challenges will grow only more severe in the years ahead.
“Most of the non-objectors like me are about to retire, so we will soon have troubles helping these women,” said Silvana Agatone, a 62-year-old gynecologist at a hospital in Rome and the founder of a website that provides information on how and where to get an abortion.
Dr. Agatone has conducted a yearslong phone survey, calling every hospital obstetrician unit she could locate to verify whether or not their doctors were conscientious objectors, and found that only 1,200 gynecologists out of well over 10,000 in Italy performed abortions.
According to a recent report, about 60 percent of Italian hospitals perform abortions, a declining but “more than satisfactory” number, the minister of health, Beatrice Lorenzin, wrote in a statement.
Experts agree that reproductive education has contributed to an overall decline in abortions in Europe. Abortion within the first trimester is legal in most European countries, even if with some restrictions.
The main difference in Italy, experts agree, is a shortage of doctors and centers willing to terminate a pregnancy. Moreover, the Roman Catholic Church’s opposition to the practice has created a stronger stigma here than in many other countries, they say.
In Italy, even at hospitals that ostensibly perform abortions, more individual doctors are opting out.
“I am Catholic and work for a Catholic hospital, so of course I don’t morally or practically endorse abortions,” said Marco Bonito, director of the obstetrics unit at the Catholic San Pietro Fatebenefratelli Hospital in Rome. “And I must say that, at least in the past, non-objectors were ghettoized in some cases, so we can’t rule out that that may have played a role in the low numbers” of doctors willing to perform abortions.
The issue is not as openly divisive in Italy as it is in the United States. Some Catholic anti-abortion movements hold rallies in city squares every once in a while, and local governments, on paper, do not obstruct abortion.
But in practice, some women face hurdles trying to gain access to abortion facilities in their regions, which the European Committee of Social Rights has deemed “detrimental” to their health.
“Women who are denied access to abortion facilities in their local region may, in effect, be deprived of any effective opportunity to avail of their legal entitlement to such services, as the tight time scale at issue may prevent them from making alternative arrangements,” the committee said.
Like Benedetta, many Italian women can recount similar stories of delayed diagnoses and troubles finding a hospital with a willing physician.
“We have a national law, we have had it since 1978 — it’s as old as my husband — and I have to drive through two regions to have an abortion?” said Silvia Brandimarte, 34, who was told her fetus had a serious genetic disease in her 12th week of pregnancy.
For her, too, the diagnosis set off a desperate hunt through several hospitals in the central Italian regions of Abruzzo and Marche before she finally found a doctor willing to terminate her pregnancy in September.
“Women doctors elsewhere just told me that they don’t offer that service — can you imagine?” she said. “I am not a teenager. I was raised in a Catholic family, one of those where ‘you keep what God gives you,’ but I do believe we have the right to choose.”
Noninvasive abortions can be equally challenging. Authorities in Marche, for example, never translated the national directives for the abortion pill RU486 into local protocols and guidelines. Thus, the pill that Italian women have theoretically been able to use since 2009 is still not available here.
The shortage of options for many women in the region has prompted the Italian Association for Demographic Education, or A.I.E.D., which performs outpatient services for a number of women’s health issues, to provide its own remedy. Once a week, it sends doctors who will perform abortions to Ascoli Piceno, in east-central Italy, from as far away as Milan and Rome. The city hospital did not have any gynecologists who terminated pregnancies.
Benedetta visited several centers before finding the A.I.E.D. doctors in Ascoli Piceno. After being turned down by two hospitals in the Marche region, a 39-year-old woman, who already had an 18-year-old daughter and was not in a position to have a baby, went to an A.I.E.D. doctor.
“I cried all through the procedure and after,” she said, asking that her name not be used to preserve her privacy. “And I still feel like a good Catholic.”
In a predominantly Catholic country, the sense of guilt for women who get abortions is still very strong, doctors and social workers in Ascoli Piceno said.
“It’s even made worse by wrong policies,” said Laura Olimpi, a pediatrician and the A.I.E.D chairwoman in Ascoli Piceno. “There is no intention to govern a decreasing phenomenon in the name of women’s health.”
Pope Francis has announced that all Roman Catholic priests have the power to offer absolution for the “sin of abortion” during the church’s Holy Year of Mercy, which began in December. Without changing the church’s orientation on the issue, Francis described “the scar of this agonizing and painful decision” in the hearts of many women he said he had met.
For some women, his words were a source of consolation in the emotional and therapeutic labyrinth they had to navigate.
“The first thing I thought when I heard it was, ‘Well, at least now he will absolve me,’ ” said a 38-year-old mother of two adopted children who decided, without her husband’s knowledge, to have an abortion for personal and economic reasons. She traveled more than 50 kilometers, or 31 miles, to have the procedure.
“It was not the right moment, and I knew it,” she said of having a baby. “Who are they all to judge me?”Continue reading the main story
Abortion in Italy became legal in May 1978, when Italian women were allowed to terminate a pregnancy on request during the first 90 days. A proposal to repeal the law was considered in a 1981 national referendum, but was rejected by nearly 68% of voters; another referendum aimed at eliminating the restrictions was rejected by 88.4%.
Italian women are eligible to request an abortion for health, economic or social reasons, including the circumstances under which conception occurred. Abortions are performed free-of-charge in public hospitals or in private structures authorized by the regional health authorities. The law also allows termination in the second trimester of the pregnancy only when the life of the woman would be at risk if the pregnancy is carried to term or the fetus carries genetic or other serious malformations which would put the mother at risk of serious psychological or physical consequences.
The law states that, unless a state of emergency requires immediate intervention, a period of seven days, not compulsory, has to occur between the medical authorization and the effective date of the termination. Although the law only permits pregnancy termination to women at least eighteen years old, it also includes provisions for women younger than eighteen, who can request the intervention of a judge when the legal tutor refuses the intervention, or there are reasons to exclude the legal tutor from the process. The judge has to make a decision within five days of the request. Women younger of eighteen don't need parental consensus in case of urgent situation or after 90 days.
Legal induced abortions
Since 1980, the Laboratory of Epidemiology and Biostatistics at the High Institute of Health (Istituto Superiore di Sanità, ISS) in Rome has maintained a surveillance system for legal induced abortions. This system is based on quarterly reporting by the regional health authorities. A standardized form is compiled that contains aggregate data on major social-demographic characteristics of the woman (age, residency status, marital status, reproductive history) as well as details about the procedure (weeks of gestation, whether the procedure is elective or performed on an emergency basis, where certification was issued, type of procedure and location where it was performed, duration of stay, and immediate complications. This information is then sent to the ISS, which examines data quality and performs data analysis of trends, geographic distribution, and characteristics of women undergoing abortion. These analyses are performed annually by the ISS and the Ministry of Health (MH) and presented by the Minister of Health to the Parliament; results are also published in ISTISAN reports, an official publication of the ISS. Italy is considered to have one of the most accurate and timely abortion surveillance systems in the world.
Abortion per 1,000 live births
In 1993, the abortion ratio in Italy was 9.8 per 1,000 live births, less than 1% (Table 2). However, this measure also varies regionally. The central and northern regions (in particular Emilia-Romagna, Liguria and Tuscany) are characterized by relatively low TFRs (one lifetime birth per woman), high abortion rates and elevated abortion ratios. While low levels of fertility can also be found in some of the northwestern regions, abortion rates are moderate in these regions (9-12 abortions per 1,000); therefore, abortion ratios in a few of these areas are closer to the national level.
Subsequent to the legalization of abortion in Italy in 1978, abortion rates among Italian women first rose and then declined steadily, from a peak of 16.9 abortions per 1,000 women of reproductive age in 1983 to 9.8 per 1,000 in 1993. Abortion rates vary considerably by geographic region, with rates typically highest in the more secular regions and lowest in regions where traditional values predominate. Data from 1981 and 1991 indicate that age-specific abortion rates decreased during the 1980s for all age-groups, with the largest declines occurring in regions with the highest levels of abortion. Moreover, a shift in the age distribution of abortion rates occurred during the 1980s, with women aged 30–34 registering the highest abortion rate in 1991, whereas in 1981 the highest level of abortion occurred among those aged 25–29. The abortion rate among adolescent women was low at both times (7.6 per 1,000 in 1981 and 4.6 per 1,000 in 1991). These data are based only on reported legal abortions; the number of clandestine abortions remains unknown.
A phenomenon to emerge in recent years has been an increase in the number of abortions requested by immigrant women. Among the 138,357 abortions performed in 1993, 13,826 (10%) involved foreign residents, an increase from 9,850 in 1996. This increase is most likely due to the rising number of immigrant women in Italy; the resident permits, for example, according to the data of the National Statistics Institute (ISTAT), have increased from 678,000 in 1995 to 1,100,000 in 1999. Based on estimates of the population of immigrant women 18–49 years of age, Istat has calculated that the AR for immigrant women was 28.7/1000 in 1998, approximately three times higher than that observed in Italian citizens. Indeed, the increase in the numbers of immigrant women may be the main cause of the leveling-off of the abortion rate in Italy. If the analysis of trends is limited to 1996-1998, years for which information is most complete on residency status, the number of abortions in Italian women declined from 127,700 in 1996 to 123,728 in 1998
In 1993, approximately 140,000 induced abortions were performed in Italy. In comparison, the average annual number during the period 1982-1984 was more than 230,000. Similar patterns can also be seen in abortion rates. After legalization, abortion rates rose modestly, increasing from 13.7 abortions per 1,000 women aged 15–44 in 1979 to a peak of 16.9 per 1,000 in 1982 and 1983. During the period 1982-1984, Italian abortion rates stabilized, and this period was followed by a steady decline: By 1986, the rate had dropped to 14.0 abortions per 1,000 women, and by 1990 it had reached 11.1 per 1,000; by 1993, the abortion rate had decreased to 9.8 per 1,000.
As of 2010[update], the abortion rate was 10.0 abortions per 1000 women aged 15–44 years.