Abortion in Italy

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 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.

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.

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.

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