Gaps in person-centered abortion care in Italy: a cross-sectional study of women's experiences

Induced abortion (IA) is a key aspect of healthcare, yet women often face barriers related to access and quality of care. This study explored the care needs and perceptions of women who underwent non-therapeutic medical or surgical IA within 12 + 6 weeks of gestation in Italy.

We conducted an observational, cross-sectional, descriptive study using an anonymous online questionnaire, available in Italian, German, and English. The survey, developed specifically for this study, was distributed between July and September 2024 and explored three phases of the abortion care pathway. Participants were voluntarily recruited via social media and institutional networks.

Among the 352 participants, 50.8% were over 35 years old, and 47.6% underwent surgical IA. Overall satisfaction with care was moderate (median = 7, IQR: 5-8), with considerable variation. While 33.9% reported that their needs were only partially met, 17.4% felt their needs were not met at all. The most commonly unmet needs were emotional support (27.9%) and access to information (13.4%). Notably, 44.2% did not receive information about available psychological support, despite expressing a need for it. Furthermore, 60.1% considered the continuous presence of a dedicated healthcare professional to be highly beneficial.

The findings highlight systemic shortcomings in abortion care in Italy, particularly regarding communication, emotional support, and continuity of care. To improve experiences and promote equity, the adoption of person-centered care models and the integration of a dedicated midwife as a consistent point of contact are recommended. Further research should examine factors influencing these gaps.