In the United States, there is a wide range of federal and state laws that exempt healthcare providers from offering reproductive care — everything from contraception to sterilization — based on the provider’s religious beliefs.
The reason for these laws, ostensibly, is to protect the conscience of the provider. And women need not worry since they can just find other providers, right? Of course, as we’re already seeing, that’s becoming more and more difficult as more restrictions are applied to reproductive care. Like in Mississippi, where abortion is so heavily restricted that only a single clinic remains open in the state, and even that one has had to fight to keep its doors open
Restricting women’s health care is the method-of-choice in certain parts of our country, but that’s not the only way to prevent women from accessing those services. In Italy, a country that allows first trimester abortions, it can still be very hard to obtain one. Why? The New York Times explains:
Seventy percent of gynecologists — up to 83 percent in some conservative southern regions — are conscientious objectors to the law, and do not perform abortions for religious or personal reasons in a country that remains, culturally at least, overwhelmingly Catholic.
It is a circumstance that has alarmed some women’s health experts, who say that the challenges will grow only more severe in the years ahead.
“Most of the non-objectors like me are about to retire, so we will soon have troubles helping these women,” said Silvana Agatone, a 62-year-old gynecologist at a hospital in Rome and the founder of a website that provides information on how and where to get an abortion.
Dr. Agatone has conducted a yearslong phone survey, calling every hospital obstetrician unit she could locate to verify whether or not their doctors were conscientious objectors, and found that only 1,200 gynecologists out of well over 10,000 in Italy performed abortions.
The contrast between abortion access “on paper” and in reality is even more interesting when considering that even if a hospital says it offers abortions, that’s no guarantee that a patient will be able to obtain one:
According to a recent report, about 60 percent of Italian hospitals perform abortions, a declining but “more than satisfactory” number, the minister of health, Beatrice Lorenzin, wrote in a statement.
In Italy, even at hospitals that ostensibly perform abortions, more individual doctors are opting out.
“I am Catholic and work for a Catholic hospital, so of course I don’t morally or practically endorse abortions,” said Marco Bonito, director of the obstetrics unit at the Catholic San Pietro Fatebenefratelli Hospital in Rome. “And I must say that, at least in the past, non-objectors were ghettoized in some cases, so we can’t rule out that that may have played a role in the low numbers” of doctors willing to perform abortions.
Despite the legal availability of abortion, the reality for Italian women is that the procedure can simply be out of reach. In conjunction with the ninety-day access window, the lack of providers can serve as a de facto prohibition.
But in practice, some women face hurdles trying to gain access to abortion facilities in their regions, which the European Committee of Social Rights has deemed “detrimental” to their health.
“Women who are denied access to abortion facilities in their local region may, in effect, be deprived of any effective opportunity to avail of their legal entitlement to such services, as the tight time scale at issue may prevent them from making alternative arrangements,” the committee said.
The religious sensibilities of healthcare providers should not outweigh the healthcare needs of patients, because, as the state of abortion access in Italy demonstrates, at some point it becomes impossible to just “go elsewhere.” That doesn’t mean that every provider has to offer the service, but it does mean that the law, hospitals, and clinics cannot turn a blind eye to the problems resulting from a lack of access. Women have a right to health care — in reality, not just on paper.
And when the physician’s religious beliefs are prized more highly than the patient’s, when his opinions are afforded more legal protection that the patient’s right to care, we’ve lost sight of the purpose of both healthcare and religious freedom.