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Italy’s women are finding it harder to get abortions as number of pro-choice doctors fall

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2184 (Published 15 April 2016) Cite this as: BMJ 2016;353:i2184

It is not true that in Italy it is “harder to get abortion as number of pro-choice doctors falls”

Neither Michael Day [1] nor the persons he interviewed, nor the Council of Europe took into consideration the data contained in the most recent Report to Parliament [2] on the application of Law 194/78 [3] for the year 2013, submitted to Parliament by the Minister for Health on 26th October 2015. This Report contains both the final figures for the year 2013 and preliminary data for the year 2014, broken down by individual health facilities. Since Law 194 came into effect the total number of voluntary abortions has fallen by approximately 50%: from 233,976 in 1983 to 102,760 in 2013. The number of pro-choice gynaecologists has remained almost the same: 1607 in 1983 and 1490 in 2013. At national level the number of voluntary abortions performed by pro-choice gynaecologists has been halved: in 1983 each of them performed an average of 3.3 abortions/week (for 44 working weeks), while in 2013 each pro-choice doctor performed an average of 1.6/week. Even in local facilities where the workload per pro-choice doctor is well above the average (9.6 abortions/week per pro-choice doctor in a facility in Sicily and 9.4 in one in Lazio), the number of voluntary abortions per pro-choice gynaecologist is lower than 10/week; so that the number of pro-choice doctors is adequate for the number of voluntary abortions performed. The workload required of each pro-choice doctor should neither interfere with his or her ability to perform other duties aside from abortions nor make it difficult to meet the demand for abortions. Any problems encountered in accessing this service are thus attributable to poor organisation at the level of individual local facilities.
Finally, it should be noted that the number of voluntary abortions is equal to approximately 20% of the number of births, while the number of centres performing abortions is equal to 74% of those for births.

References

1. Day M. Italy's women are finding it harder to get abortions as number of pro-choice doctors fall. BMJ 2016;353:i2184 doi: http://dx.doi.org/10.1136/bmj.i2184.
2. Ministero della Salute. Relazione del Ministro della Salute sulla attuazione della legge contenente norme per la tutela sociale della maternità e per l'interruzione volontaria di gravidanza (Legge 194/78). Dati preliminari 2014, dati definitivi 2013. 26 October 2015. www.salute.gov.it/imgs/C_17_pubblicazioni_2428_allegato.pdf.
3. Legge 22 maggio 1978, n. 194. Norme per la tutela sociale della maternità e sull’interruzione volontaria della gravidanza. Gazzetta Ufficiale della Repubblica Italiana 22 maggio 1978, n. 140.

Competing interests: No competing interests

19 April 2016
Carlo Petrini
Head of the Bioethics Unit
Istituto Superiore di Sanità (Italian National Institute of Health)
Via Giano della Bella 34, I-00162 Rome, Italy