Italian law states that, from the date on which the document certifying a request for a non-urgent IVG is issued, there must be a waiting period of seven days before the termination is carried out. This period is intended to allow the person further time to reflect on their decision.

However, if there are medical, psychological or social circumstances for which waiting would be inadvisable, the clinician may issue a certificate marked “urgent”, thereby removing the mandatory waiting period.

It should be noted that the Italian law of 1978 is outdated in comparison with current recommendations of the World Health Organization (WHO), which advises that all voluntary terminations of pregnancy should be treated as urgent, since the earlier the procedure is performed, the safer, more effective and less impactful it is on the physical and psychological health of the person who has made their decision.

In an ideal situation, therefore, the clinician should always certify the IVG as urgent.

We also recall that, even when holding an urgent IVG certificate, it is still possible to change one’s mind up until the moment the procedure is actually carried out. Furthermore, the National Health Service is rarely able to guarantee a service entirely free of waiting times, mainly due to delays caused by conscientious objection.

The certificate may be issued by any medical practitioner registered with the Italian Medical Council (Ordine dei Medici), including those with a specialisation other than Gynaecology, outside of public family planning clinics, and even if they are not the patient’s registered GP.

Nevertheless, despite the fact that conscientious objection is not protected by law for the issuing of an IVG certificate, in Italy, many clinics and doctors refuse to provide this healthcare service, either explicitly or implicitly. We receive reports from patients of healthcare staff claiming they are not authorised, asking them to come back another day, or referring them elsewhere.

In such cases, the advice is to submit the request via Italian certified email (PEC), in order to obtain written proof of the unlawful refusal and to be able to report the issue with the support of a pro-choice organisation.

Fortunately, IVG certificates can also be issued via telemedicine: any conscientious medical practitioner can fulfil the role of trusted doctor required by law, regardless of their speciality (orthopaedics, andrology, psychiatry, etc.).

Although any doctor registered with the Medical Council (Ordine dei Medici) may issue a certificate, Italian medical universities do not teach how to do this. This is where we provide support.

The consultation

The consultation must be conducted in accordance with the law. Article 5 of Law 194/1978 states that the doctor’s role is, in all cases – and particularly when the request for termination is motivated by the impact of economic, social or family circumstances on the pregnant person’s health – to examine, together with the woman and with the father of the conception (where the woman consents), and with full respect for dignity and confidentiality, the possible solutions to the issues raised; to help remove the causes that might lead to termination; to enable her to assert her rights as a worker and as a mother; and to promote any appropriate intervention to support her, offering all necessary assistance both during pregnancy and after childbirth.

After the consultation, the certificate may be issued.

IVG Certificate (Template)

[On headed paper including the doctor’s Medical Council registration details]

ITALIAN

Documento rilasciato ai sensi di quanto previsto dall’art. 5 della legge n. 194/78.

Data

Si è svolto oggi il colloquio telefonico/in videochiamata/di persona con [Nome e cognome persona richiedente], nat_ a [Città] in provincia di [Provincia] il [Data di nascita], residente a [Città] in via [Indirizzo completo di Cap e provincia], come risulta da documento personale esibito.

La stessa persona riferisce ultima mestruazione in data [data]; epoca di amenorrea: ___ settimane + ____giorni.

Accertamenti eseguiti: (specificare: N test di gravidanza casalinghi positivi, o analisi del sangue con Beta, o ecografia), eseguiti in data [data] eventualmente [presso].

La persona interessata richiede l’interruzione volontaria della gravidanza in base alle circostanze previste dall’art. 4 della legge n. 194/78.

Nel corso del colloquio sono state esaminate con la richiedente le possibili soluzioni, come previsto dall’art. 5 della legge n. 194/78.

Il certificato, in questo caso è

• Normale . (La persona richiedente è invitata a soprassedere per sette giorni, trascorsi i quali potrà presentarsi, con il suddetto documento, ad una delle sedi autorizzate per ottenere l’intervento richiesto).
  
• D’urgenza. (La persona richiedente non è invitata a soprassedere per sette giorni e può presentarsi nelle sedi autorizzate per ottenere l’intervento richiesto).

Doctor’s signature

Applicant’s signature

ENGLISH

Document issued pursuant to Article 5 of Law No. 194/1978.

The date is very important, do not forget it

Today, a consultation was conducted by telephone / video call / in person with [Name and surname of the requesting person], born in [City], Province of [Province], on [Date of birth], resident in [City], [Full address including postcode and province], as verified by the personal identification document provided.

The person reports their last menstrual period as [date]; period of amenorrhoea: ___ weeks + ___ days.

Investigations performed: (specify: number of positive home pregnancy tests, or blood test with beta-hCG, or ultrasound), carried out on [date], if applicable [location].

The person concerned requests voluntary termination of pregnancy under the circumstances provided for in Article 4 of Law No. 194/1978.

During the consultation, the possible options were examined with the applicant, as required by Article 5 of Law No. 194/1978.

This certificate is issued as:

• Standard
  (The applicant is invited to wait for seven days, after which they may present themselves, with this document, at an authorised facility to obtain the requested procedure.)

• Urgent
  (The applicant is not required to observe a seven-day waiting period and may present themselves at an authorised facility to obtain the requested procedure.)

Signatures

In the case of a telemedicine consultation, it is advisable to add the following wording:

La telefonata/videochiamata è stata registrata. [Nome cognome] ha dato il proprio consenso alla registrazione e al trattamento dei dati personali. La videochiamata è equiparata alla visita in presenza come da decreto del Ministero della Salute del 17-12-2020 (atto 215/CSR) e la firma digitale non è ripudiabile.

Doctor’s signature

Applicant’s signature

TRANSLATION: This telephone/video consultation was recorded. [Name and surname] has given consent to the recording and to the processing of personal data. The video consultation is equivalent to an in-person visit pursuant to the Ministry of Health Decree of 17 December 2020 (Act 215/CSR), and the digital signature is non-repudiable.

It is advisable to encourage the person concerned to book the IVG appointment as soon as possible, bearing in mind that the appointment may be cancelled by them even on the same day. This is because in Italy very often you will have to wait your turn for days or weeks.

In the case of a non-urgent certificate (standard), the IVG will be scheduled for the first available date after seven days from the date the certificate was issued. In the case of an urgent certificate, timing will depend solely on the organisation or capacity of the healthcare facility.

In Italy, it is often more efficient for the person to go in person to make the booking, bringing the IVG certificate with them. Before booking, it may be useful to become familiar with the types of abortion available in Italy and to check which techniques are offered at the most convenient facility.