Council of Europe warns on backlash to abortion access

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Council of Europe warns on backlash to abortion access

By Caterina Tani
BRUSSELS, Dec 6, 2017

A backlash against access to abortion in some EU member states in the past few years is "deeply troubling", the Council of Europe warned on Tuesday (5 December).

In the majority of EU countries abortions are legal, but in some states a wave of "retrogressive restrictions" are threatening women's health and well-being, the European human rights organisation's report said.

Continued at source: https://euobserver.com/health/140158

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Abortion in Italy, a Right Wronged

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Abortion in Italy, a Right Wronged

By ILARIA MARIA SALA
NOV. 13, 2017

Late last month, Cosimo Borraccino, a left-wing member of the regional council for Apulia, in southern Italy, proposed passing a local law to require the enforcement of national legislation granting women access to abortion. His opponents on the council, mostly from center-right parties, said the bill was unnecessary and that Mr. Borraccino was “slamming into a wall of self-evidence.”

Yet when it comes to reproductive rights in Italy, respect of the law is anything but self-evident. In fact, 9 out of 10 gynecologists in Apulia refuse to perform abortions, even though the right to obtain one has been legal since 1978. Nationwide statistics are only slightly less staggering: Seven out of 10 gynecologists in Italy won’t terminate a pregnancy.

Continued at source: https://www.nytimes.com/2017/11/13/opinion/abortion-italy-conscientious-objectors.html

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Lessons for Ireland from the Pro-Choice movement in Italy

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Lessons for Ireland from the Pro-Choice movement in Italy
Date: Mon, 2017-09-25

I moved to Ireland from Italy shortly after the Strike4Repeal of the 8th of March, a mass mobilisation on the streets of Dublin in protest of Ireland’s archaic abortion laws, which I followed closely on social media. While still in Italy, I had been involved in organising a successful feminist demonstration in the city where I lived, on that same date (International Women’s Day), and I felt deep sympathy and admiration for the Irish pro-choice activists and the amazing work they were carrying out. At first glance it was unbelievable to me that in a western-European country people still had to take the streets to demand access to abortion. While the Irish situation initially felt like something I could not relate to, I soon remembered where I was from and I had to think twice: despite abortion being legal in my home country, safe and effective access to abortion service is currently utopia.

Continued at source: Worker's Solidarity Movement: https://www.wsm.ie/c/lessons-ireland-pro-choice-italy

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Abortion in Italy Is Legal but Sometimes Difficult to Obtain

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Abortion in Italy Is Legal but Sometimes Difficult to Obtain
We visited the country to find out why.
Lucia Benavides
Sep 12, 2017

Valentina Milluzzo was five months pregnant when she died in a Sicilian hospital in October after her family claimed her doctor refused to perform an abortion that could have potentially saved her life.

Milluzzo, 32, was carrying twins and was first hospitalized in Catania after complications with her pregnancy. According to The Guardian, she gave birth to a stillborn baby and then became ill. Her family claims her doctor refused to remove the other fetus because he objected to abortions and the second fetus still had a "viable heartbeat." Milluzzo died soon after of septic shock. (The hospital has disputed the family's account, saying that though all of the doctors at the hospital were "conscientious objectors" to abortion, "other specialists could technically have been called in if required," according to The Guardian.) Her case is one of many highlighting the struggle to access abortion in Italy.

Continued at source: Teen Vogue: http://www.teenvogue.com/story/abortion-in-italy-is-legal-but-sometimes-difficult-to-obtain

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Refusal to Treat Patients Does Not Work in Any Country—Even If Misleadingly Labelled “Conscientious Objection”

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Letter to the Editor: Refusal to Treat Patients Does Not Work in Any Country—Even If Misleadingly Labelled “Conscientious Objection”

On September 6, 2017 · In Perspectives
Christian Fiala and Joyce H. Arthur

We would like to point out some serious problems and contradictions in the study “Regulation of Conscientious Objection to Abortion: An International Comparative Multiple-Case Study,” by Wendy Chavkin, Laurel Swerdlow, and Jocelyn Fifield (Health and Human Rights Journal, vol. 19, no. 1, 2017).

The study purports to show that it is possible to accommodate health care providers’ “conscientious objection” (CO) to legal abortion while assuring that women with an unwanted pregnancy have access to health care services. The researchers examined four countries—England, Italy, Portugal, and Norway—all Western democracies with laws that allow CO for abortion. They conclude that England, Norway, and Portugal are able to permit CO by law and still provide and fund abortion care. Italy is the major exception, where access to legal abortion is seriously compromised due to a very high number of objectors.

Continued at source: Health & Human Rights Journal: https://www.hhrjournal.org/2017/09/letter-to-the-editor-refusal-to-treat-patients-does-not-work-in-any-country-even-if-misleadingly-labelled-conscientious-objection/

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Italy’s legal loophole saw woman denied abortion by 23 different hospitals

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Italy’s legal loophole saw woman denied abortion by 23 different hospitals
5 Mar, 2017

An Italian woman has revealed she was turned away from 23 hospitals in north-west Italy when she was seeking abortion services, highlighting the disconnect between the country’s abortion laws and its Catholic influence.

The anonymous 41-year-old mother of two came forward to share her story in Il Gazzettino after she became pregnant when her contraceptive failed. She was refused an abortion by her gynecologist and her local hospital, and then began contacting other hospitals which also refused to carry out the procedure.

The hospitals said they didn’t have an opening within the 12-week timeframe, or that they didn’t have doctors who were willing to do the procedure.

Continued at source: Russia Today: https://www.rt.com/viral/379526-italy-abortion-23-hospitals/

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Italy: Valentina, who had no choice but to die from a miscarriage

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by Safe Abortion, Nov 2, 2016

The story of the death of Valentina Milluzzo, a young woman from Catania, Sicily, in the 19th week of a pregnancy with twins

by Elisabetta Canitano, Gynaecologist and Chair of the Association “Vita di Donna” (Women’s Lives) of Rome

“The child’s heart is still beating.” Throughout Italy in religiously-affiliated maternity wards, and birth centres where religion is predominant, that phrase is used to put women at risk.

Still. “Still”, referring to a pregnancy that is fatally compromised but the fetal heart continues to beat. For women between the 16th and 22nd week of pregnancy, with fetuses that are incompatible with survival, this phrase carries the risk of a death sentence every day. Because women might not get an immediate abortion to save their lives, as recommended by international medical guidelines.

Most of these women at risk have a ruptured gestational sac. We don’t know for sure if that happened in Valentina’s case, but apparently her cervix had prematurely dilated, creating a threat of miscarriage, and it’s known that she had a high fever at least 12 hours before she delivered the first stillborn twin – already dead for some time. Bacteria must have found an open path into her uterus many hours before. When the uterine cavity is in direct contact with the outside environment, it creates the risk of a dangerous infection called septicaemia, nowadays called sepsis. And sepsis happens frequently if the pregnancy is not terminated without delay. In rare cases, the heartbeat stops or contractions begin unaided, and the woman’s body is able to empty itself without further incident. But, for each hour the unviable fetus is left inside by those saying “we can’t intervene, there’s a heartbeat”, the risk of fatal sepsis increases.

What to do then? Where doctors apply the 194/78 law, they explain to women that their wanted child cannot be born and, in fact, threatens to kill them. A therapeutic abortion is recommended and done without delay to save the woman’s life.

At some religious hospitals, the doctors will call a public hospital to arrange a transfer of the woman for an abortion elsewhere. But they avoid their responsibility of care by means of a dubious document, telling the woman: “Sign this to confirm that you leave on your own authority to get help at this other hospital.” The doctors’ essential obligation to protect the women’s life has been dishonourably put on the shoulders of the public hospital.

In public hospitals, things proceed normally without much bureaucracy. Doctors tell the woman “inducing abortion is the best thing as there’s no further hope for the fetus, and waiting will risk your life”, just as when urgent caesareans are performed on women at any week of gestation with acute eclampsia (convulsions from gestational toxicosis).

And then someone pushes the envelope further. Valentina has an intermittent maternal fever, an ominous sign of sepsis, but it doesn’t matter. (In the morning, did the nurse call the doctor to tell him? Who decided to give Tylenol (a simple painkiller, the nurse alone?). The patient’s temperature is 34 degrees, blood pressure is 50/70, alarmingly low, but no matter.

An examination – the one that head physician Doctor Scollo is so proud of as a modern scientific success – is performed and shows the infection is spreading. But it doesn’t matter.

There are atrocious pains, screaming, shivering. To the point that she doesn’t want to leave the bed and go to the delivery room. Valentina’s mother slaps her to revive her, she’s already fainted three times that morning.

None of these signs, terrifyingly clear signs of life-threatening sepsis since that morning, enter the conscious perception of the “conscientious objector” doctor.

Locked in his phrase, “There’s still a heartbeat”, he’s practically a robot. He says nonsense like “there’s a renal colic,” “these are just labour pains,” to deny to himself that he’s putting her life at risk, something that would obligate him to help her. This lack of recognition of basic facts is what always puts women at risk.

He could call the doctor who performs abortions in that hospital as a consultant and have that doctor assist her. But to take this step, he would have to recognize the harm he’s doing, the risk that he inflicts upon women every day in the name of a mantra devoid of any clinical sense.

So the hours pass by, destroying Valentina’s life. With sepsis, even twenty minutes can make a difference between life and death. One must call the anaesthetist immediately and undertake urgent life-saving treatment, otherwise the infection will begin to destroy the liver, the kidneys, the brain, the immune system, the circulatory system.

Valentina feels these terrible pains caused by the destruction of her organs, and shouts them at those who have no ears to hear nor heart to pity her.

There are twins and the doctor says: “Even if only one fetal heart is beating, I can do nothing.” And meanwhile, Valentina is dying. She has been left to die in agony since morning.

At the end, she asks her mother for sedation, she feels what’s happening. She asks, at least, not to suffer any more. Everything is denied to her, including the treatment of pain.

From 9 in the morning, when her fever first rose, she expels the first fetus at 11pm, after her body had literally been eaten by the sepsis. After the expulsion of the second fetus, also dead, there is nothing left for her but to die.

And for us, there is nothing left but the sorrow, the rage, and the promise that this must never happen again to other women.

ORIGINAL TEXT: Il Manifesto, by Elisabetta Canitano (in Italian), updated

Translation into English by Giovanni Lombardo Radice and Martina Zanetti, edited by Joyce Arthur 

PHOTO: Hospital where Valentina died

FURTHER INFORMATION: Preliminary report from the Board of Health, 24 October 2016, appears to exonerate everyone involved in the hospital. This report has already been called into question by three Italian medical professionals in informal comments below the report.

EDITOR’S NOTE: Valentina was in the hospital miscarrying an unviable pregnancy from 29 September until her death on 16 October. This is unconscionable. It isn’t just what happened in the last 12 hours of her life that killed her, but what happened the whole time. Early intervention would have prevented what happened in the last 12 hours. Whether it was clinical incompetence or negligence, or lack of understanding or experience of why this was an emergency obstetric case the minute she entered the hospital, or whether it involved individuals’ refusal to carry out a termination on grounds of conscience or on grounds of an unspoken or unacknowledged hospital policy to adhere to Catholic health policy – or a combination of one or more of these – she died unnecessarily. Without an independent investigation, we cannot know which of these was actually operative, and without that information the risk of this happening to more women in Italy is increased. It would appear from this article that this risk is already present and known.

For information about Catholic health policy on abortion and other cases in which women’s lives  were at risk as a result of it, see Termination of pregnancy as emergency obstetric care: the interpretation of Catholic health policy and the consequences for pregnant women: An analysis of the death of Savita Halappanavar in Ireland and similar cases. Reproductive Health Matters, 2013. Marge Berer

On 4 November, Italian women’s groups will be holding a meeting to talk about taking action, which we hope to report on at a later date.

Source: International Campaign for Women's Right to Safe Abortion

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Italy: Police launch inquiry into death of woman ‘refused’ an abortion by Sicilian doctors

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Family of 32-year-old who died after pregnancy claim she was denied procedure on ‘moral’ grounds

Stephanie Kirchgaessner

Sunday 23 October 2016 00.05 BST, The Guardian

Italian police are investigating a dozen doctors at a Sicilian hospital after the family of a 32-year-old woman who died after a miscarriage claimed she was not given adequate medical attention. The family says that her doctor had professed moral objections to abortion.

The death of Valentina Milluzzo, who was five months pregnant with twins when she miscarried and fell ill, has reignited a debate across Italy about the high number of gynaecologists and obstetricians who refuse to provide abortions. As a result, women may not get the medical attention they require in emergency situations.

The investigation into the Cannizzaro obstetrics and gynaecology hospital in Catania on the east coast of Sicily was opened after the family of Milluzzo, who became pregnant through in-vitro fertilisation, said a doctor refused to intervene even though her life was at risk.

[continued at link]
Source: The Guardian

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Driving Women around the Bend: What’s Really Going on with Abortion Access in Italy?

Ceiling above the spiral staircase at the Vatican Museums, Rome, Italy. © BAILEY-COOPER PHOTOGRAPHY / ALAMY STOCK PHOTO

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Conscience Magazine, 2016 Issue 2

by Rosie Scammel
Posted Aug 22, 2016

In Italy, it has been nearly 40 years since abortion was legalized—confirmed in a referendum by the Catholic-majority populace—but the system for providing abortions has been deemed so severely flawed that both women and doctors are suffering.

“We have a problem in talking about abortion as a right,” says Elisabetta Canitano, president of Vita di Donna, a gynecologists’ organization for women’s health.

After nearly four decades of practice one would expect the rules to be implemented with few hitches, but the Council of Europe recently identified a string of problems. Nationwide, there has been a decrease in the number of healthcare facilities where abortion is available, while women face excessive waiting times. Overall, there is a shortage of doctors who do not object to abortion provision.
Conscientious Objection: Regulation and Rights

In April, the Council of Europe ruled the situation was so dire that women’s right to health was being violated in Italy. Responding to a claim brought by the country’s biggest trade union, CGIL (Confederazione Generale Italiana del Lavoro), the council’s committee of social rights also ruled that the government was violating doctors’ right to dignity at work.

The decision was a further blow to Italy, coming two years after the same committee at the Council of Europe backed International Planned Parenthood Federation’s claim that poor regulation of conscientious objectors within the healthcare system amounted to a violation of women’s rights.

[continued at link]
Source: Conscience Magazine

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FEATURE: Complaints regarding Discrimination in Abortion Provision in Italy Upheld

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Resolution by the Committee of Ministers, Council of Europe, on abortion-related discrimination

The Committee of Ministers is the decision-making body of the Council of Europe. It is comprised of the Foreign Ministers of the 47 member states. Several years ago, two complaints were tabled with the Committee of Ministers under the European Social Charter, which provides a basis for making "collective complaints". The complaints were about discrimination against women in Italy seeking legal abortions and discrimination against medical practitioners in Italy who are providing abortions. One was tabled by the International Planned Parenthood Federation Europe Region and the other by the Confederazione Generale Italiana del Lavoro (CGIL, General Confederation of Workers of Italy).

On 6 July 2016, following a hearing in May, the Committee of Ministers adopted several resolutions relating to these complaints. The Committee found that:

a) the shortcomings which exist in the provision of abortion services in Italy remain unremedied and women seeking access to abortion services continue to face substantial difficulties in obtaining access to such services in practice, notwithstanding the provisions of the relevant legislation;

b) health care establishments have still not adopted the necessary measures in order to compensate for the deficiencies in service provision caused by health personnel who decide to invoke their right of conscientious objection, or the measures adopted are inadequate;

Furthermore, women wishing to seek an abortion may still be forced to attend other health facilities, in Italy or abroad, or to terminate their pregnancies without the support or control of the competent health authorities, or may be deterred from accessing abortion services which they have a legal entitlement to receive in line with the provisions of Act No.194/1978, which legalised abortion under certain conditions. This is contrary to the right to the protection of health as guaranteed by Article 11 of the European Social Charter.

The Committee also finds that the public authorities in Italy are failing to ensure an efficient organisation of the services providing access to abortion, taking into account the right to conscientious objection. As a result, many women are deprived of effective access to abortion services. Pregnant women seeking to access abortion services are treated differently depending on the area in which they live. In addition, the differential treatment on this basis may, by extension, have an adverse impact on women in lower income groups, who may be less able to travel to other parts of Italy or abroad in order to access abortion services.

The resolution states that there is no public health or public policy justification for this difference in treatment. It arises solely due to the inadequate implementation of Act No. 194/1978. Therefore the difference in treatment amounts to discrimination and constitutes a violation of Article E in conjunction with Article 11 of the European Social Charter.

The Committee also finds that there is a violation of Article 1 § 2 of the Charter on the grounds of the difference in treatment with regard to protection at work between medical practitioners claiming conscientious objection to doing abortions and those who do not object. The Committee says that the CGIL has provided a wide range of evidence demonstrating that non-objecting medical practitioners face several types of cumulative disadvantages at work, both direct and indirect, in terms of workload, distribution of tasks, career development opportunities, and more.

The government was asked “to take steps to establish a technical monitoring board so as to verify that Act No. 194/1978 is being fully and correctly implemented, with the aim of preventing any form of discrimination between objecting and non-objecting health care staff, also through modified management and mobility of staff guaranteeing the existence of an adequate services network in each region.

They note the numerous direct testimonies that had been provided by the CGIL, which demonstrate a lack of career opportunities, including promotion, for non-objecting medical practitioners, excessive workload and aggravated working conditions. The Italian government, the Committee says, has provided virtually no evidence contradicting that evidence. Nor has the government demonstrated that discrimination is not widespread.

The differences in treatment and the disadvantages suffered by non-objecting personnel arises, the Committee says, simply on the basis that certain medical practitioners provide abortion services in accordance with the law. There is no reasonable or objective reason for this difference in treatment, which amounts to discrimination in violation of Article 1 § 2 of the Charter.

Complaints about differentials in average working time and effects on health between health professionals objecting to doing abortions and those who do not object were not upheld due to lack of sufficient evidence.

However, the Committee notes examples provided of the moral harassment of non-objecting medical practitioners, including direct testimonies, such as intense verbal pressure to stop providing abortion services. The Committee says that the government does not refute the allegations of moral harassment in any way. The statements by non-objecting medical practitioners alleging moral harassment are insufficient in themselves to ground a violation of the Charter, because they are largely anecdotal.

However, the Committee said that the Charter imposes positive obligations on States Parties to take preventive action to ensure moral harassment does not occur, in particular in situations where harassment is likely. The failure of the government to take any preventive action, training or awareness-raising measures to ensure the protection of non-objecting medical practitioners, it says, amounts to a violation of Article 26 § 2 of the Charter.
Source: International Campaign for Women's Right to Safe Abortion
FULL TEXT (English): https://search.coe.int/cm/Pages/result_details.aspx?ObjectId=0900001680687bdc
FULL TEXT (Français): https://search.coe.int/cm/Pages/result_details.aspx?ObjectId=0900001680687bdd

Information about the Council of Ministers + Photo

 

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