As coronavirus infections spread throughout northern Italy, Lisa* got pregnant. In her late 40s, with two children, a precarious job and poor health, she said: “Unfortunately I realised I was pregnant unexpectedly, above all at my age”.

She decided to have an abortion, which has been legal for most of Lisa’s life. But these services are hard to access even in ‘normal’ times. Many doctors refuse to provide them, and unlike in other European countries, medical abortions in Italy are only available at hospitals, and only up to seven weeks of pregnancy.

Lisa’s experience in February – described in a detailed letter to LAIGA, an association of Italian gynaecologists that support abortion rights, and shared with openDemocracy – was a sign of what was to come for women nationwide.

She was in the first few weeks of her pregnancy, which could have been terminated with a couple of pills. But her town, Lodi, was surrounded by areas already quarantined before the national lockdown in March. According to women’s rights activists, its hospital had already taken drastic steps: suspending all medical abortions and transforming previously-scheduled medical terminations into surgeries.

Lisa’s options were thus: continue carrying her unwanted pregnancy – or begin an odyssey to try to find another hospital to access these long-legal services. Choosing the latter, she called other hospitals in her region and was again turned away both by those in areas with higher infection rates, because of the emergency, and those in areas with fewer infections, because she came from a higher-risk zone.

It took Lisa days to find a ward that would accept her. Since then, women’s rights activists have reported that more hospitals across Italy have also suspended medical abortions. Other hospitals have been transformed into so-called ‘COVID hospitals’, shutting down all other surgeries, including abortion services.

The Italian ultra-conservative group ProVita & Famiglia has now seized the moment with an online petition to block women’s abortion rights nationwide, declaring: “During the pandemic, abortion is not an essential service”.

“Absurd” rules

Anna Pompili, a gynecologist and co-founder of the AMICA pro-choice group of doctors, told openDemocracy in February that “the current emergency is reducing the possibility of having an abortion especially in the north of the country”.

Since then, gynecologists from other regions have noted similar trends. Speaking to openDemocracy from the Umbria region, Marina Toschi, at another pro-choice organisation called AGITE, said medical abortions have been suspended in numerous places “in order to avoid sending women to hospitals multiple times”.

A key problem, say rights advocates, are Ministry of Health guidelines that require women take medical abortion pills in hospitals. A small minority of hospitals offer these as out-patient services, but women must still attend three in-person visits.

Toschi criticised these rules as “an absurd and made-up protocol” and said the current crisis is amplifying long-standing challenges in accessing medical abortion.