Maghweb’s Fight for Abortion Access in Italy

Italy was among the first European countries to legalize abortion in 1978, following decades of feminist struggle to affirm the right of women and people to make decisions about their own bodies. Yet more than forty years later, access to safe abortion remains uneven, caught between legal recognition and practical barriers — from high rates of “conscientious objection” among doctors, to the lack of psychological support and the persistence of judgment and stigma within healthcare facilities. In this interview, we spoke with the team at Maghweb, a transfeminist organization based in Palermo, to learn how they are working to redefine abortion access in Italy and to build a system of care that is fair, humane, and dignified for all

• ⁠⁠What made you join Magwheb and focus on abortion rights in Italy?

Maghweb began working on access to abortion following a disinformation campaign released by Pro Vita e Famiglia with the following slogan: “Would you ever take poison? Stop the RU-486 abortion pill: it endangers the health and life of women and kills the child in the womb.” Our counter-campaign arose from the political need to reshape the spaces we move through every day, making them safe for women and other people living in the city. In this case, we occupied the public space by displaying posters with a clear counter-message: “The RU-486 pill guarantees a safe abortion—It is not poison. The real poison is disinformation.” Two key needs shaped our action: the need for clear and scientific information in the field of sexual and reproductive health (which no one is taught, given the complete absence of structured sex education in schools) and the need to challenge and call out (wealthy) anti-choice movements in their continuous oppression of women and people’s decisions about their bodies and negative manipulation of the public space into one of hostility and misinformation. Such needs drove us to create a nationwide network that helped rights defenders, activists and people across Italy display the Non è un veleno ( It’s not poison) posters in their own cities.

• How does Italy’s national law on abortion shape access today?

Abortion in Italy is currently regulated by an outdated law. A law which is evidently a product of its time, 1978. The society in which this law was formulated and approved still allowed for so-called “rehabilitating marriage”: a law permitting rapists to avoid criminal proceedings, provided they (behind this plural pronoun there is a stark “he”) had married the person they had assualted. The law stipulates that abortion may be carried out up to the 12th week in public facilities, while at the same time guaranteeing healthcare staff the right to exercise conscientious objection — that is, to refuse “to abstain from the procedures and interventions for the termination of pregnancy.” To this day, there are no limits on conscientious objection, even though the law specifies that “institutional objection” — i.e. 100% of doctors objecting in a single hospital providing termination services — should not be possible. This, of course, generates tension between those who wish to access the service and those responsible for providing it: non-objecting staff are often insufficient when it comes to meeting demands. 

Another major limitation of the law is the so-called “week of reflection”: the person seeking an abortion must declare their intention to a gynaecologist, who performs an ultrasound and issues a document recording the request to terminate the pregnancy and certifying the stage of the pregnancy. From that moment, the person must wait one week before accessing the service — unless the doctor certifies the request as urgent. This element skews the power dynamic in favour of the doctor, who may either facilitate the patient’s access or, by enforcing the waiting period, force them to delay — in some cases even beyond the legal time limit.

• ⁠Are there big differences in abortion services between regions within Italy? 

There are big differences between abortion services across Italy. This is due to the fact that health is managed at a regional level in Italy and that each region has a varying level of structural (infrastructural, religious, cultural, social, conscientious objection) elements that obstruct abortion. Data about the rates of the key obstacle to abortion (conscientious objection) is a key indicator of this variation between regions: while on a national level, the rate of conscientious objection is at around 65%, in Lazio for example it is at around 54%, in Sicily it reaches 80% and in Molise over 90%. The timeframe in which a person has the right to access the pharmacoglogical abortion also varies between regions: while in most regions pharmacological abortion is accessibile up until the 9th week of pregnancy, in the Marche region it is only possible to access this form of abortion up until the 7th week. Information and clarity about obstruction to abortion in different regions is very hard to obtain, with data requests from members of civil society, activists and politicians towards the different hospitals about this issue being rejected or the data being provided being fallimentary and providing only a fragmented picture (see Mai dati by Chiara Lolli and Sonia Montegiove for a national level experience of this denial of data). We are however continuing to struggle to make levels of conscientious objection as transparent and clear as possible: we are currently in dialogue with a local political of the Sicilian region who has accessed data about such levels in each hospital in the region and together with collectives and SRHR defenders from the rest of Italy (e.g Obiezione Respinta) we are often contributing to this grassroots mapping of hospital and pharmacies’ obstruction of the right to abortion (see here). We also map pharmacies due to the frequent denial of the emergency contraception 5 day after pill to users by pharmacists: even though pharmacists have no legal right to deny access to this pill, they often refuse to sell it to people (see here), especially if they are under eighteen (even though by law people under eighteen can buy this contraception pill over the counter, without prescription). 

• ⁠What non-legal barriers, like cost, clinic availability, or wait times, stop people from getting care? 

We can answer this question on the basis of bottom-up, lived experience data that we have gathered from our various testimonies and our various, regular experiences of accompanying people to have an abortion. The availability of doctors is a significant barrier: for example, within the different hospitals that do practice abortion in Palermo there is usually only one doctor on call in the days where the abortion service is running. This means that wait times are extremely long: for example, in one hospital you need to arrive at 7am to be put on the list to then wait your turn. Then, the gynaecologist on call will see all the other patients first, before starting with the abortion patients at around midday. In some cases, the gynaecologist has refused to give patients the certificate if they cannot see the embryo in the ecography, even if the patient has also done blood tests showing that they are pregnant (when the patient is around 5th and 6th). This means that the patient has to wait a whole other week to get the certificate, after which by law they are obliged to carry out a 7 day reflection period – this means that they then lose a whole extra week in the tight time frame of accessing pharmacological abortion and thus further narrows down the period in which this service is available. The judgemental or neglectful attitude of doctors can also stop people from receiving adequate care: for example, gynaecologists who are responsible for giving the certificate to patients sometimes refuse to look at the patient or speak to them in an informative and decent way or make derisive or destabilising comments that express judgement and express stupidity towards the patients about them getting pregnant in the first place, causing them emotional stress and unease. Further, when some people are having an abortion they are not offered painkillers or in some cases when they ask, they are denied painkillers. Other structural situations, such as the proximity of the room in which women and people have abortions to the rooms where new parents are giving birth also obstruct people’s right to adequate and dignified abortion care and this proximity has been reported by patients to cause extremely traumatic experiences in the post abortion period.

• What range of reproductive health services do Magwheb and its partners offer to someone seeking support?
  

Since 2021, Maghweb has run an advice and information desk and community hub to safeguard sexual and reproductive health and rights. This hub, supported by Maghweb’s online awareness-raising channels, promotes access to local SRHR services and, more generally, aims to be a listening space for those who struggle to find opportunities to talk about their sexual wellbeing. The desk also hosts sex education workshops, thanks to the presence of sexual health educators and a sex-therapist consellour. These are held not only at the hub but also in a range of Palermo’s middle and secondary schools. The educational activities implement a psychological, social and biological approach and provide comprehensive learning experiences for young people, parents and teachers, aiming to improve the skills and knowledge of all people who are involved in education about sexuality and relationships. 

Since April 2023, the help-desk and community hub has become mobile thanks to the purchase of a van, ensuring access to information and services on sexual and reproductive health even in Palermo’s suburban areas and across the rural parts of the province (to date, more than 30 outings have taken place across 8 provinces). Alongside the staff — which includes educators and a sex therapist counseller— a midwife also travels, offering free consultations on menstrual health and training on breast self-examination for the prevention of breast cancer.

In 2025, thanks to the network that Maghweb has built with healthcare professionals across Palermo, the community SRHR hub was able to activate the following services:

·       Free therapeutic sessions for the management of sexual disorders with a clinical sex therapist and psychotherapist.

·       Free appointments with two gynaecologists to ensure access to basic services for those facing financial hardship and for AFAB trans people (assigned female at birth) who have changed their gender identity in official documents and have therefore lost access to the free screening services usually available through public clinics for people with a registered female gender identity. 

• ⁠Can you share a story of someone who faced challenges accessing abortion and how Magheb helped? 

One story that particularly struck us and that we always share is that of a young woman of Tunisian origin who wanted to have an abortion. She had visited every SRH counselling centre in eastern Sicily without being able to obtain reliable information — only a certificate. When she went to a hospital in Catania to undergo the procedure, she was told that “it was easier to win the lottery than to have an abortion there.”

When she called us, she was convinced that the only way to access abortion— which is by law a public service offered by the national Italian healthcare system — was to travel to Tunisia. In the end, with immense difficulty, she managed to have the procedure in Palermo: she had to come from her small hometown in the Sicilian hinterland which is poorly connected to the city by an unreliable and infrequent private bus service and due to the “week of reflection” she had to return twice and cover all the costs of transport and accommodation the night before the abortion. 

• What role do local communities and families play in either supporting or blocking access? 

When it comes to supporting access to abortion care in local communities, expanding networks of women and people who want to be more equipped with rights-based information and information about how, where and with what rights abortion can be effectively accessed are becoming more and more important in supporting fellow community members to access this service and reclaim their SRHR. Collectives like Obiezione Respinta and Maghweb/Non è un veleno and Mujeres Liberes are actively trying to equip and strengthen the capacities of the people in these networks (through ad hoc, mutual aid-based crisis management training) so that they can become “supporters” of friends and peers and effective defenders of rights. For example, Maghweb currently has a large Telegram group of women and people who are currently in training and who often ask for instructions and advice to accompany and support friends and peers. Allied SRHR staff (sometimes gynaecologists and especially midwives) with whom Maghweb is in contact are also crucial in guaranteeing services that should exist and facilitating access.  In some cases, partners of people trying to access abortion also play an important role in accompanying service users, but we have found that it is more likely that friends take responsibility for this role. When it comes to families, in general, most people who come and ask us for help do not share information about the fact they are having an abortion with their families and we have heard of various cases in which the person’s fear of their family’s negative reaction has a negative influence on the freedom of their decision. In general, the people we talk to and support—both from the youngest age range and the older—cannot and do not talk openly about their sexual health needs with their families. A local film documentary (“Novanta Giorni” directed by Alice Malingri) also shows how privately funded anti-choice centres, disguised as “Mother and child help centres”  in Palermo actively undermine women and people’s decisions to abort, advising in insistent ways to newly pregnant women and people who call them for advice about the importance of following through with their pregnancy. These kinds of centres tend to be particularly insistent at manipulating and influencing members of migrant communities who find themselves in intensified positions of vulnerability due to intersectional discrimination. 

• How does Maghweb work with other NGOs or public agencies to improve services? 

Our constant presence in the city, our connections and ongoing dialogue with other local, national and regional transfeminist organisations (e.g Arcigay, Obiezione Respinta), with Italy’s national network of non-objecting doctors (LAIGA), with various professionals working in hospitals where abortions are performed and with clinics for STI testing, have enabled us to create a reliable collection of information and collective practices to safeguard and facilitate access to the right to abortion in Italy and particularly in Sicily. Thanks to this network, we manage a continuously updated informative mapping of hospitals that perform abortions in our region. This mapping includes opening hours, locations, types of abortion (medical or surgical), types of treatment, quality of treatment and length of hospitalisation during the service. This mapping is an entirely innovative resource whose information does not exist on hospital websites (the information on these websites is either inaccurate or non-existent). Additionally, our active membership in the above-described network has enabled us to create a completely new and growing abortion support service: through bottom-up training sessions during meetings organised with other organisations in Northern and Central Italy (such as Obiezione Respinta, Mujeres Libres and LAIGA, who are experts in grassroots and medical level abortion care upport) we have managed to create an abortion support network at a local level, training members of the community with the basic information and skills to be able to accompany friends and peers. This network continues to grow through word of mouth and our growing visibility on the territory. 

• What simple policy or funding changes would make a real difference for abortion access in Italy?

There is no definitive solution, as we know that the law is a product of a society that stigmatizes abortion and leaves those who wish to access it alone and exposed to judgement. However, a first step would certainly be to remove the “week of reflection”, which penalises the person seeking an abortion at a time when timing is crucial. A second step would be, if not to eliminate it entirely, at least to curb the phenomenon of conscientious objection by ensuring access to the service in every hospital for at least two days a week. Finally, it would be important to extend the legal limit for abortion, raising it to at least 14 weeks.

• ⁠In five years, what would you like Italy’s abortion care landscape to look like, especially with Maghweb’s involvement? 

In short: present and active, informed, non-judgmental, humane, courteous and dignified. We say this with full knowledge about the facts about the present landscape: the vast majority of feedback we receive about women and people who have abortions is negative and aberrant. Such negative feedback starts in the family planning clinic (the public and free local facility designed to provide information and prescribe the certificate for abortion where in theory conscientious objection should not be legally possible). Here many users complain about being treated with judgement, about being denied correct information about procedures because the health personnel are conscientious objectors. In sum, most remarks show how a free, non-judgmental psychological service within the hospital is totally lacking. As we go forward and keep building this struggle, we would like support within abortion services to be genuine, honest, informative and objective, free from conscientious objectors and subtle but insidious forms of judgement and religious influences that violate women and people’s right to free choice about their SRHR. Furthermore, in order not to overwhelm non-objecting doctors, the state must impose a limit on non-objecting staff within facilities and increase the salaries of non-objecting doctors. We also demand that it provides free psychological assistance to women and people who request it and opens a line of public funding for organisations such as ours, which work to fill the void left by institutions, and safeguard people’s rights to self-determination when it comes to their SRHR and in particular their right to free and safe abortion.