last non-objector doctor at the Cosenza hospital became an objector. The only possibility left for women who want to have an abortion in the province are the hospitals of Castrovillari and Corigliano. Otherwise all that remains is to go outside the province or outside the region.
The gynecologist Francesco Cariati, in service at the Annunziata hospital in Cosenza since 2018 and who practiced the last interruption of pregnancy (IVG) on July 14, 2022, declared that he was forced to make this decision: “The requirements minimum to carry on this service and above all there was a lack of respect for the dignity of the patients, but also of mine, as a professional left to himself. For this reason, exhausted, I made the difficult decision to resign as a non-objector gynecologist. I continue to carry out my profession, no longer dealing with the IGV service. I am very sorry for the women who are deprived of this right, but I had no choice, ”he said in an interview with Repubblica. For years, Cariati was the only doctor to guarantee the IGV to the women of Cosenza.
Law 194 of May 22, 1978 (rules for the social protection of maternity and on the voluntary termination of pregnancy) guarantees, in addition to the right to terminate the pregnancy, also the right to conscientious objection by doctors (article 9). A right that, in fact, denies the other, since there are entire structures in which all doctors are objectors.
In Calabria, according to the report of the Minister of Health on the implementation of Law 194 of 1978 published on 13 June 2022 (data relating to 2020), there are eight health facilities with obstetrics and gynecology wards or only gynecology that carry out voluntary interruptions of pregnancy out of a total of fifteen, or 53.3 per cent. 67.6 percent of gynecologists, 75.9 percent of anesthesiologists and 63.1 percent of non-medical personnel are objectors.
In reality, as Chiara Lalli and Sonia Montegiove denounce in the book Never data, open data (on 194), the numbers relating to the individual structures are not there or are difficult to find throughout Italy. The problem of access to the right to abortion affects the whole country: women often do not know where to turn, structures are few or difficult to reach and non-objecting personnel are in the minority. But in some regions the situation is more serious. Calabria, Campania, Abruzzo and Molise are the regions with the highest percentage of intra-regional mobility: more than 20 percent of women are forced to move to another region to be guaranteed a right enshrined in a national law.
“When we ask for help, we are left alone. I am an outpatient gynecologist, as far as I know I am one of the very few non-targets in the province of Reggio Calabria ”, says A., a doctor who is responsible for initiating and following the IVG process for women who come to her.
“We refer them to the metropolitan hospital of Reggio Calabria, but even there the workload is enormous and the waiting lists are very long. There is a lack of staff, the doctors who are there are getting older and no new ones are hired. In Calabrian healthcare in recent years some real craters have been left ”, continues A. In the clinics where he works there are no ultrasounds and diagnostic tools, there are no obstetricians and up to 18 gynecological examinations are made in a single morning. “The problem of the lack of the right to abortion is closely linked to the lack of counseling centers: if the network worked, everything would be simpler. Instead of the consultors, only the walls remained. A crazy degradation, here the women are desperate ”, says A.
Calabrian hospitals are full of pro-life posters, which stimulate a sense of guilt in women
To denounce the enormous difficulties in guaranteeing the right to abortion in Calabria are the activists of the feminist collective FEM.IN of Cosenza: “Three years ago we had to collect hundreds of signatures to introduce the abortion pill at the Annunziata hospital in Cosenza. A method used for eleven years in the rest of Italy, and which had never arrived here ”, says Vittoria Morrone.
In fact, since 2009 in Italy, the RU-486 abortion pill allows chemical abortion within the first nine weeks of pregnancy. After the resignation of the only non-objecting doctor in Cosenza, the collective made some requests to the region: the hiring of at least two non-objecting gynecologists in the hospital in Cosenza, access to data on the application of law 194, tracking of all objective and non-objective medical figures, the application in Calabria of the guidelines for abortion with the pharmacological method, which introduce RU486 in clinics and hospitals.
“We often help women who want to have an abortion, since finding information to understand how to do it is complicated. There is no clear map of the centers or non-objecting doctors. The nearest hospital for RU-486 is in Lamezia, where, however, it is not possible to abort with the surgical method. In short, an intermittent application of the law, we go blindly ”. As if that weren’t enough, Calabrian hospitals are full of pro-life posters, which stimulate a sense of guilt in women, says Morrone: “They are aberrant”.
Consultors as empty shells
Daniela Diano, a former psychologist at the clinic in Siderno, in the province of Reggio Calabria, speaks of “women humiliated by objecting doctors: doctors who speak of infanticide, women treated as mares, as factories to have children”. Diano witnessed the slow decline of the counseling centers over the years: “From the end of the seventies to today there has been a desertification, an impoverishment of services. But the termination of pregnancy is the real sore point. In the years after the introduction of the law there was sufficient staff in the hospitals and counseling centers, various figures, the women were accompanied throughout the journey, they were never left alone. With the corporateization of healthcare these things were no longer possible. Today, even the lea, the essential levels of assistance, are not guaranteed. The situation is no longer sustainable ”.
Another indicator that highlights the seriousness of the situation is the waiting time to have an abortion: “In 2020, high percentages of waiting times exceeding 3 weeks were found in Valle D’Aosta (19.3 percent), Lombardy (17, 6 percent) and Veneto (20.3 percent). In Calabria, 13.8 percent of IVGs occurred after a waiting period of more than 28 days ”, reads the report by the health minister. “With these waiting times there is a risk of going beyond the maximum times allowed by law”, explains Diano.
The problem of the lack of protection of the right to abortion goes back a long way, explains Rubens Curia, doctor and writer, who has been dealing with the right to health in Calabria for years. “After the approval of law 194, in 1978, there were ad hoc recruitments, but over time they were squandered: the staff hired in the eighties gradually retired, and due to the hiring block they were never replaced “, explains. Curia refers to the region’s health expenditure recovery plan launched in 2009 and the consequent Calabrian health commissioner.
It was necessary to balance the possibility of conscientious objection with competitions aimed at hiring non-objecting doctors, but this was not the case, according to the Curia. Moreover, as A. explains, “in some cases doctors hired by non-objectors changed their minds after a few months, becoming objectors, bringing the situation back to its starting point.
“In Calabria, for example, the clinics, which should have played an important role in territorial medicine, are now empty shells, they exist only on paper. There is no staff, what is there is an objector, there are no tools, sometimes even the internet is missing. There is great neglect, and consequently a right acquired for decades, such as that to abortion, is no longer implemented “, says Curia, underlining how the protection of a right is hindered by more than a decade of economist vision of health Calabrian. “Civil rights have been attacked,” she concludes. They remain so only on paper.