Medication Abortion in Italy: Evolution, Societal, Technological and Organizational Dynamics

Giulia Fornaro, Bocconi University, Milan, Italy
Letizia Mencarini, Bocconi University, Milan, Italy
Paola Profeta, Università Bocconi

Background: The introduction of medication abortion has significantly transformed access to elective abortion in Italy, becoming the most widely used method by 2021, though regional disparities remain. This study explores four key areas: (i) whether the rise of medication abortion reduces the prevalence of conscientious objection, (ii) the relative impact of individual versus contextual factors on access, (iii) the effect on waiting times and out-of-region mobility, and (iv) the impact of Covid-19 lockdown measures on medication abortion use, comparing it to waiting times and mobility. Methods: Using microlevel data on 853,608 elective abortions from 2010-2021, we performed pooled OLS, two-level mixed effect logistic, Poisson models, and regression discontinuity designs. Preliminary results: Diffusion of medication abortion has no consistently significant effect on prevalence of conscientious objection but reduces waiting times. Individual factors outweigh contextual ones in predicting access, while no consistent link is found with out-of-region mobility. The Covid-19 lockdown led to a sharp rise in medication abortion use and a modest reduction in waiting times. Contributions: This study provides critical insights into abortion access in a country traditionally characterized by hurdles in abortion access and contributes to broader debates on reproductive rights in advanced democracies facing challenges in abortion care.

Keywords: Sexual and Reproductive Health and Rights, Multi-level modeling

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