There has been a change of policy on provision of medical abortion pills in the Lazio Region of Italy that has been three years in the making. Two recent articles by long-standing prochoice advocates on these matters describe what has happened. One is by Mirella Parachini, a gynaecologist and advocate for abortion rights, who is also deputy secretary of the Luca Coscioni Association. The other is by Anna Pompili, also a gynaecologist and founder of the Amica-Associazione Medici Italiani Contraccezione e Aborto.
Parachini reports that Lazio Region in Italy has changed their protocols for providing abortion pills in the region. In the past, everything had to happen in the hospital. The Lazio protocol now allows a woman to go to a hospital or a local health centre for a scan and to swallow the mifepristone pill there, and then she can be given the misoprostol for self-administration at home 24 hours later. Both authors note that it is clear the pandemic has facilitated the introduction of the changes approved by the Lazio Region, and that not having to attend a hospital is an improvement since health centres are local for women. So it’s a first step, which has taken ten years since abortion pills were first approved in Italy. The next steps for the region will be to identify the outpatient clinics where women will be able to obtain the pills, and training for providers in offering this service.
Parachini notes that it is significant that no news of this new policy has been published in the mainstream media, where they prefer to report only access difficulties for women seeking abortion services, mainly due to massive conscientious objection – undoubtedly a current problem – but without giving feedback on the organisational and administrative aspects when services are actually provided.
Similarly, Pompili points out that the Lazio Region’s decision is an important affirmation, considering that “even today the pharmacies in many hospitals do not have the pills used for medical abortion, because the moral judgment against abortion is extended to the pills themselves by those who claim conscientious objection”. And she reminds readers that local health centres were previously at the centre of a trial by the Lazio Region, to introduce an outpatient, at-home regime for medical abortion, which was approved in 2017, but was blocked by the then Minister of Health.
Both authors describe Lazio’s new policy as a virtuous example for all Italian regions and as a response to regions such as Umbria, where last year they introduced the obligation of ordinary hospitalisation for medical abortion, a decision that raised numerous controversies and which then had to be withdrawn following guidelines issued by the Minister of Health. However, as Pompili remarks: “Published in August 2020, the circular of the Ministry of Health, which updated the guidelines for provision of medical abortion ten years after the method was introduced, eliminating the obligation of hospitalisation and introducing the possibility of an outpatient regime, has for all practical purposes been a dead letter until now”.
Parachini recalls that in May 2020, the following groups – Luca Coscioni Association for the freedom of scientific research, together with AMICA (Association of Italian Doctors Contraception and Abortion), and FP CGIL doctors and managers of the NHS of Rome and Lazio and FP CGIL Gender Policies Office for Women Coordination – wrote to the President of the Lazio Region, Nicola Zingaretti, and to the Councillor for Health, Alessio D’Amato, to request that they set up a technical roundtable to develop indicators for induced abortion, both medical and surgical, and to facilitate access to contraception. Now it has begun to happen.
“Thanks then to the Lazio region, let’s get to work!” Parachini concludes.
SOURCES: Quotidianosanita.it, by Mirella Parachini, 29 January 2021 (in Italian) ; Left, by Anna Pompili, 5 February 2021 (also in Italian) +VISUAL ; Bollettino Ufficiale della Regione Lazio – N. 8 – Supplemento n. 2 (also in Italian), 26 January 2021.
English translation by Elena Caruso, with thanks!!