Reduced Abortion Rates and Improved Provision of Counseling and Contraception Services: Analysis of a Regional Campaign for Young Women in Italy

Abstract

Through its national health system, Italy provides legal and free abortion through the third month for any reason and through the sixth month for maternal or fetal health problems, but one of the public health goals specified in Italian legislation is to minimize its use. One barrier to achieving this goal is inconsistent access to prescription contraception. Six out of 20 Italian regions offer free contraception programs paid for by the national health system. Tuscany was the most recent region to introduce such a program, in November 2018. The authors studied the impact of this program using regional administrative health data to compare the 3-year period before and the 2-year period after its introduction. They computed rates of abortion, contraception uptake, access to counseling centers, conception, and use of outpatient services for sexually transmitted diseases. Their analysis revealed positive effects on teenage conception and on overall utilization of outpatient services for sexually transmitted diseases and strongly suggests that this program has been effective in reducing abortions by promoting access to counseling and contraception services among young women.In Italy, abortion is a free service guaranteed to all women for any reason during the first trimester and for maternal or fetal health issues during the second trimester, although individual NEJM Catalyst is produced by NEJM Group, a division of the Massachusetts Medical Society.

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