“Many couples have a superficial attitude: they swim as soon as they see and accept what arrives”

In Italy, with empty cribs, almost half of the pregnancies that begin each year are accidental. Every second woman who discovers that she is pregnant did not plan it, she did not intend to have children or have children at that time. This is a discouraging fact, which follows from the Report on the state of the world population in 2022, published by the United Nations Population Fund and presented in our country by the Italian Association of Women for Development.

What the numbers say

“We know that in our country, for every thousand women of reproductive age, about 35 children are born a year, about 7 pregnancies are terminated voluntarily, and we believe that another 2 are terminated secretly, illegally. According to our estimates, spontaneous abortions, including very early ones, are about 15. Summing up these numbers, we calculate that for every thousand women of reproductive age there are 59 pregnancies per year,” explains Angela Spinelli, former director of the Center for Disease Prevention and Health. promotion of the Higher Institute of Health. Of those 59, the United Nations Population Fund estimates that 28 are random.

Ignorance and fatalism

So here is the picture of the situation: there are few children in Italy and at the same time half of the pregnancies that occur are the result of chance. “These are two sides of the same coin: our country does not help women and couples fulfill their reproductive programs,” says Chiara Saraceno, a former professor of family sociology at the University of Turin and author of numerous essays. on this topic. “He doesn’t offer them the tools to bring into the world and raise all the children they want, that is, free and high-quality public institutions that take care of children while their parents work, parental leave that promotes men’s commitment to childcare, labor policies to help women find work and keep it after having a baby. At the same time, knowledge about fertility and contraception in our country is still scarce, relying on oral reports. There are practically no sex education programs in schools, there are very few counseling centers, and many young people are not even aware of their existence. Under these conditions, it is obvious that many couples do not have the courage to have children. They give it up or put it off until it’s too late. On the other hand, they have a superficial or fatalistic attitude towards sexuality and its possible consequences on the reproductive level. They navigate on the spot, deciding after the fact what to do.”

Contraceptives, unknown and expensive

Each year, the European Parliamentary Forum for Sexual and Reproductive Rights publishes the European Contraception Atlas, a kind of report card that assigns a vote from 0 to 100 on the availability of contraceptives, information and services needed for family planning. Italy in 2022 received a poor result: 59.3. One of the reasons is that in our country no contraceptives, hormonal or mechanical, are compensated by the National Health Service, they are all paid and on average expensive. In addition, there is no institutional web page that offers the public correct, understandable and complete information about contraception.

“A study conducted a few years ago by the Istituto Superiore di Sanità among young people and adolescents showed that 10 percent of them, although not striving to conceive, have sexual intercourse without any protection, and 25 percent resort to coitus interruptus which is in no way acceptable. stands for effective pregnancy prevention practice. Even among the general population, young and old, 20 percent use this method,” adds Spinelli. “Few take hormonal contraceptives, and even more so choose the IUD, both methods are also effective and safe. Instead, there is a constant consumption of emergency contraceptives, the so-called “morning after” and “five days after” pills, which means that many couples do not think about it the day before.

If the doctor does not know

Ignorance and prejudice about contraception in Italy is also rooted in the fact that doctors themselves are poorly trained in this issue. “The subject is almost non-existent in their university curriculum,” says gynecologist Marina Toschi, board member of the European Society for Contraception and Reproductive Health. “That’s why it can happen that a woman asks for a pill, and the family doctor prescribes a lot of useless tests or does not recommend it, saying that it causes cancer when the opposite is true, which protects against certain types of cancer. During the years of specialization in gynecology, they talk about contraception, but not much. Most specialists leave school without seeing a spiral insert. Another reason why few gynecologists are willing to insert coils is that this service requires the doctor to take out special insurance, as it is considered a surgical procedure. But often those who refuse IUDs to their clients do not explain the true reason for the refusal, but accuse them of making unfounded excuses about the dangers of intrauterine devices, which instead are considered by WHO to be one of the safest and most effective contraceptives.

One could see that accidental pregnancies are welcome if they help fill empty cradles… “Ignorance is never the solution to a problem. Reproductive self-determination is a fundamental right that must be guaranteed, firstly, because it is correct, answers Saraceno, and secondly, because it is the key to the economic and social development of the country. Information, access to contraceptives and work-family reconciliation help create conditions for the growth and well-being of all.”