Shifts in Abortion Governance in Italy and Spain: Obstetricians-Gynaecologists’ Perspectives on Abortion and Conscientious Objection

The neo-liberal policies embraced across the New Europe and the ‘austerity measures’ adopted after the 2008 crisis have led to dramatic cuts in social services and healthcare, making women’s reproductive choices, either to have children, or to limit births, more difficult. In this context, many Southern and Eastern European countries have undergone a dramatic decrease in fertility rates, which has triggered anti-reproductive rights backlash. The increasing engagement of the Vatican in the debate over sexual/reproductive rights partially explains why in Catholic countries like Italy and Spain a shift has occurred in abortion governance, from women’s to foetal health and rights, and why in recent years conscientious refusal of abortion care has become the object of heated political debate in Europe. The development of pre-natal and foetal medicine has also contributed to fuel the debate on the morality and legality of abortion, by transforming the embryo/foetus into a ‘patient’. In this presentation I explore how, in this context, obstetricians-gynaecologists experience abortion and conscientious refusal of care, based on two studies respectively undertaken in Italy in 2011-2012, and in Spain (Cataluña) in 2013-2015. Short questionnaires and in-depth interviews were conducted with 54 obstetricians-gynaecologists at four hospitals providing abortion care in Rome and Milan, and with 23 obstetricians-gynaecologists at two hospitals and one clinic in Barcelona. A similar medical/moral classification of abortions emerged in the discourse of most obstetricians-gynaecologists working in public hospitals in both countries, regardless of their religiosity. I argue that this is the result of physicians’ ‘stratified expectations about reproduction’ (Beynon-Jones, 2013) in a context of economic crisis and declining fertility rates as well as of the increasing medicalization of contraception and reproduction, which has reinforced the stigmatization of ‘voluntary abortion’ (for unintended pregnancy).