Abortion. The report to Parliament: “In 2020 just over 66 thousand interventions (-9.3% compared to 2019).” Gynecologists object to slight decline but for Hope: “Their number is still high”

Hope: “The number of conscientious objectors remains high for all categories of health professionals, particularly for gynecologists (64.6%). The organization of abortion services must be such that there are a sufficient number of professional figures to ensure that women have access to voluntary termination of pregnancy and this must be guaranteed by the Regions, in order to protect the free exercise of women’s sexual and reproductive rights. and access to abortion services and minimize the impact of conscientious objection in the exercise of this right. “THE REPORT TO PARLIAMENT

JUNE 13

The decline in voluntary abortions in Italy continues, rising to 66,413 in 2020, 9.3% less than in 2019. A decline that the Ministry of Health also explains in its Report to Parliament this year which could be due to “increased use of emergency contraception.”

Higher abortion rates remain among women between the ages of 25 and 34. These are foreign nationals who continue to be a population at higher risk of abortion than Italians: for all age groups, foreigners have abortion rates 2-3 times higher than Italian ones. In 2020, 35.1% of the interventions were performed using the pharmacological method. In terms of conscientious objection, in 2020 the phenomenon affected 64.6% of gynecologists (a decrease compared to 67.0% in 2019), 44.6% of anesthetists and 36.2% of non-medical staff. There are large regional variations for all three categories.

The synthesis
In total, 66,413 IVGs were reported in 2020, which confirms the continuing downward trend in the phenomenon (-9.3% compared to 2019) from 1983 onwards.

The abortion rate (IVG versus 1,000 women aged 15 to 49 living in Italy), which is the most accurate indicator for a correct assessment of the use of IVG, confirms the decreasing trend of the phenomenon: is equivalent to 5.4 per 1,000. in 2020 (with a reduction of 6.7% compared to 2019). The Italian figure remains among the lowest internationally.

In 2020, the number of abortions decreased in all geographical areas.

Abortion use in 2020 decreased in all age groups compared to 2019, especially among the youngest. Higher abortion rates remain among women between the ages of 25 and 34.

Among children, the abortion rate in 2020 was 1.9 per 1,000 women, a value lower than in 2019. As in previous years, the lowest recourse to abortion among women is confirmed. young women in Italy compared to other Western European countries.

Foreign nationals continue to be a population at higher risk of abortion than Italians: for all age groups, foreigners have abortion rates 2-3 times higher than Italian ones. However, there is also a decrease in the abortion rate in this population group (12.0 per 1,000 women in 2020, compared to 17.2 per 1,000 women in 2014).

The percentage of abortions performed by women with a previous experience of abortion has continued to decline since 2009 and was equal to 24.5% in 2020. Analyzing the data by citizenship, it is confirmed that the percentage of women who have undergone Previous IVG is higher among foreign women (32.7). %) compared to Italians (21.2%). Comparison with other countries that detect data on recurrent abortions shows that this indicator for Italy remains the lowest internationally.

The evolution of the percentage of repeated abortions confirms that the tendency to resort to abortion in our country is constantly decreasing, now also among foreign citizens; the phenomenon can presumably be explained by the greater and more effective recourse to methods of conscious procreation, alternatives to abortion, under the auspices of the law.

Also for the year 2020, the use of the family clinic for the issuance of the certification necessary for the application for IVG (43.1%) predominates, with respect to the other services (Doctor: 19 .9%; Obstetrics-Gynecology Service: 33.4%). The clinic not only offers this service but also plays an important role in preventing HIV and supporting women who decide to terminate their pregnancy, even if it is not uniform in the area.

The percentage of interventions performed early, therefore less exposed to complications, continues to increase: 56.0% of the interventions were performed within 8 weeks of gestation (compared to 53.5% in 2019), the 26.5% at 9-10 weeks, 10.9% at 11-12 weeks and 6.5% after the twelfth week.

Waiting times are declining, although there is still a not inconsiderable variability between communities.

The use of pharmacological abortion varies greatly between regions, both in terms of the number of interventions and the number of facilities that offer it. Comparison over time shows a continuous increase in the use of mifepristone and prostaglandins and the widespread use now in all regions. In 2020, 35.1% of the interventions were performed using the pharmacological method.

In terms of conscientious objection, in 2020 the phenomenon affected 64.6% of gynecologists (a decrease compared to 67.0% in 2019), 44.6% of anesthetists and 36.2% of non-medical staff. There are large regional variations for all three categories.

Hope: “The number of conscientious objectors remains high”“In Italy, the use of IVG has been steadily and progressively declining since 1983, our country has one of the lowest abortion rates among Western countries,” he writes. Roberto Speranza in the report’s findings highlighting how “it can be hypothesized that the increase in the use of emergency contraception – Levonorgestrel (Norlevo, pill the next day) and Ulipristal acetate (ellaOne, pill 5 days “It had a positive effect on reducing the number of IVGs. For these drugs, the right information is essential to prevent misuse.”

“Despite the decrease in abortions – continues Speranza – in foreign women, confirms their higher risk of miscarriage compared to Italian women. Therefore, it confirms the need to promote an informed and effective contraception for foreign women who access the National Health Service, in particular through childbirth.

Regarding the waiting times for the intervention “in general they are decreasing, although there is still a not inconsiderable variability between the Communities. There is an increase in IVG in the first 8 weeks of gestation, probably as a result of increased use of the drug (Mifepristone + prostaglandins) in the early gestational period. “

The Minister then highlighted how “mobility between the regions and the autonomous provinces is in line with that of other services offered by the National Health Service” although “the type of intervention and the duration of hospitalization show regional variability that suggests the need for in-depth analysis by regional agencies, also through interregional comparisons, to identify critical issues and standardize therapeutic protocols in the light of good practice, with the aim of ensuring a supply of care and organizational quality. “

Next, Speranza points out that “the evolution of the percentage of repeated abortions confirms that the tendency to resort to abortion in our country is constantly decreasing, now even among foreign nationals; The phenomenon can presumably be explained by the greater and more effective use of methods of conscious procreation, alternative to abortion, under the auspices of the law. “

The Minister noted that the number of conscientious objectors for all categories of health professionals remains high, particularly for gynecologists (64.6%). The organization of abortion services must be such that there are a sufficient number of professional figures to ensure that women have access to voluntary termination of pregnancy, as indicated in Article 9 of the Law. núm. 194/78. This should be guaranteed by the Regions, to protect the free exercise of women’s sexual and reproductive rights and access to abortion services and to minimize the impact of conscientious objection in the exercise of this right. “.

Finally, the Minister emphasized that “the family counseling center represents a reference service for many women and couples, also in terms of the IVG route, as well as under the protection of law no. 194/78. Thanks to the professional team’s multidisciplinary skills and their ability to identify the social and health determinants of the population’s health needs, counseling centers offer support to women throughout the abortion process, promoting elections. aware and facilitating the prevention of unwanted futures. pregnancies “.

June 13, 2022
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