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.

Milluzzo had been admitted to the hospital two weeks earlier, after going into premature labour. After the death of one of the foetuses, Milluzzo reportedly became very ill and her blood pressure dropped rapidly. Her family asked for the other foetus to be aborted but say her doctor refused. Milluzzo died within hours on 16 October of septic shock.

Milluzzo’s partner, Francesco Castro, told reporters that his wife was “screaming in pain for nearly 12 hours” when he asked the doctor to intervene. Milluzzo had already given birth to one foetus, which was stillborn, but Castro said the doctor told him he could “not intervene” because he objected to abortion and the other foetus still had a viable heartbeat.

Milluzzo’s parents have backed her husband’s recollection of events but the hospital has disputed the account, saying that an abortion would not have been necessary in Milluzzo’s case because she was already miscarrying.

Paolo Scolio, a doctor at the Cannizzaro, admitted that all of the doctors in the hospital were conscientious objectors to abortion but that other specialists could technically have been called in if required.

Catania’s prosecutor is now investigating a dozen doctors, which could lead to charges of manslaughter, according to Italian press reports.

Beatrice Lorenzin, the Italian health minister, said doctors were permitted to conscientiously object to performing voluntary abortions on patients, but that doctors were not allowed by law to withhold medical treatment when women’s lives were at risk. This point was reiterated by a national association of Catholic doctors, who said they had to do whatever was necessary to save a woman’s life it if was in danger.

Abortion has been legal in Italy since 1978, but the rules surrounding the medical procedure are stringent. Under Italian law, doctors can perform an abortion during the first 90 days of pregnancy. But after that a woman must either be physically or mentally at risk because of the pregnancy or have evidence of a serious problem with the foetus.

The most recent government figures show that about seven in 10 Italian gynaecologists refuse to carry out abortions on the grounds of conscientious objection. The proportion of doctors who object has risen from about 59% in 2005 to 70% in 2013.

The health ministry had previously denied that the increasing number of doctors in Italy who were refusing to perform abortions posed any risk to women, because the number of abortions was decreasing.

When the health ministry was asked earlier this year whether Italy could ensure that women had access to safe abortions given the high rate of objectors, the ministry said that the workload of doctors who did perform abortions was sustainable.

The number of doctors who object differs from region to region, but Sicily is among the areas with the highest number of doctors who will not carry out abortions, with a rate of about 87.6% of gynaecologists in the region refusing to perform the procedure.

The International Planned Parenthood Federation, a global group that supports abortion rights, said the case had eerie echoes of the death in 2012 in Ireland of 31-year-old Savita Halappanavar, who was admitted to Galway University clinic with severe abdominal pain and high fever but was denied an abortion. She died of septicaemia.

“Italy is not Ireland and abortion has been legal in Italy for 40 years,” the group said. “The tragic death of Valentina highlights the brutality of a system that permits objecting health care providers to disrespect the law.

“Far too many doctors and medical staff put their personal conscience before a woman’s conscience, life and dignity.”