Intended for healthcare professionals

Feature Legislation

The Italian law enabling, and disabling, abortion access

BMJ 2022; 379 doi: (Published 08 November 2022) Cite this as: BMJ 2022;379:o2563
  1. Marta Paterlini, freelance journalist
  1. Stockholm
  1. martapaterlini{at}

Access to abortion is protected by Italian law, but getting an abortion is less than straightforward, reports Marta Paterlini

“We received complaints from women who had to listen to the beating heart of the fetus before being able to proceed with the termination of pregnancy,” says Silvana Agatone, of LAIGA, an association of gynaecologists that supports abortion rights.

In Italy, abortion has been legal since 1978 and is recognised by the Constitutional Court as unalterable and binding in Law 194. The procedure is available for free in the first 90 days of pregnancy, with a seven day waiting period (after the first trimester, abortions are only permitted if the mother’s health is at risk or if the fetus has abnormalities).

But in reality, accessing abortion is increasingly difficult in a majority Catholic country, with high numbers of medical staff refusing to carry out abortions.

According to a 2020 Ministry of Health survey, 64.6% of Italy’s gynaecologists are conscientious objectors to abortion, a figure that soars to over 90% in parts of the south.1 In some regions, such as Molise in southern Italy, this can result in just a handful of doctors who are willing to carry out the procedure.

“Finding doctors to perform [abortion] can be a minefield, since there are no official lists disclosing professionals or hospitals which do or do not offer the interruption of pregnancy, while services vary wildly across the country,” says Silvia de Zordo, of the University of Barcelona and principal investigator of the Europe Abortion Access project, which is backed by the European Research Council.

Many of Italy’s most prestigious medical schools and hospitals are run by the Catholic Church. Those who perform abortions face stigma, and objection is often connected with a healthcare professional’s career prospects. “Quite often doctors feel professionally isolated …

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