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In Italy, abortion has been legal since 1978, but with some conditions: mandatory counseling, a 7-day waiting period, a 12-week gestational limit for voluntary abortions, a “viability” gestational limit for fetal abnormality or life of the mother, and a conscientious objection provision. Conscientious objection allows any medical professional who morally objects to abortions to refuse to perform them. Though many countries have conscientious objection clauses, the use of this clause in Italy stands out and has a strong effect on abortion access.
The most recent data from the Italian Ministry of Health says that 68% of gynecologists are objectors. However, it is widely known in Italy that significantly less than 32% of gynecologists actually perform abortions. Our first goal is to understand this mismatch. Scholars rely on these reports to understand societal trends, and at a glance, Italy can appear to be an ideal case for academic study of abortion because the Ministry’s annual report is quite detailed. But within Italy in both medical and activist circles, it is an open secret that this data is simply not telling the whole story.
Based on a variety of data sources including qualitative interviews with street-level bureaucrats, a close quantitative review of the historical data, and data gathered by activist groups, we bring academic rigor to the question of conscientious objection rates in Italy. We work to triangulate the breakdown in data reporting, and consequently we make recommendations for how the Ministry could present the data more clearly. We explore how the public administration implements the abortion law, and we additionally make recommendations for how the policy could be implemented in a way that enables more accurate data collection.
We demonstrate based on regional case studies that the conscientious objection rate may be significantly higher than reported, which in addition to improving data integrity has societal relevance. The rates of objection reported by the Ministry are already high, but if the true rate is even higher, this has implications for abortion access in Italy. While scholars are naturally concerned about the correctness of the data for scientific purposes, citizens rely on government reports to monitor the government’s work and hold it democratically accountable. By bringing together the sources we encountered in our field work, we provide a holistic academic overview of conscientious objection to abortion in Italy.