The right to abortion: “Women need kindness, not deprivation”. Interview with Dr. Alfano

Following the decision of the Supreme Court of the United States and the flash mobs of protests that also took place in Naples to request an update of Law 194, we speak with the Neapolitan psychotherapist about the psychological mechanisms that arise at such a crucial moment and understand how crucial to improve the functions of counseling centers and to strengthen sex education in schools On June 24, the United States Supreme Court overturned the historic Roe v. Wade arguing for the absence of a constitutional right to abortion.

The US Supreme Court has ruled that abortion regulation, as a controversial issue, should be left to individual states and their elected representatives. So far, nine states have banned abortion.

We cannot help but wonder at the implications of this phrase, which also triggers a rain of reflections in us.

Are we in Italy that far from the US? How much can the right to abortion be taken for granted in our country? Questions that may seem absurd, but which come behind a decision that leads to the conclusion that our rights could suddenly be called into question and revoked.

Act 194

The desire to defend rights and to shout no to the controversial decision of the United States Supreme Court has led to protests. Even in Naples, there was no shortage of flash mobs to express solidarity with people who see their rights denied, such as abortion. Activists and campaigners took to the streets not only for what is happening in the United States, after seeing this election as a worrisome wake-up call, but also to put the spotlight back on Act 194.

Law 194 was an achievement in legalizing abortion in Italy, allowing women to decide over their own bodies and lives, but above all making abortion a safe medical practice.
But at the moment 194 is a law applied mainly to hiccups in southern Italy: in our region 88.8% of doctors are conscientious objectors; in Campania, the number of IVG centers and consultants present is insufficient and ineffective. Moreover, those who choose to turn to public health to terminate the pregnancy are faced with a complex and endless practice, aggravated by excessively long waiting lists that necessarily lead to private facilities, because often with the times of public hospitals the limits set by law allows.

In recent weeks, the request to update 194 to prohibit the presence of objectionable doctors in any health facility is back in vogue. Activists took the opportunity to reiterate the need for sex education programs that talk about sexual and reproductive health by explaining what abortion is; the need for investment to strengthen local health facilities and counseling centres.

The psychological aspect

In this climate of protests and struggles to continue asserting rights and ensuring that the conquered are not unexpectedly annihilated, it is inevitable to ask ourselves what role the psychological and emotional aspect plays in women and girls at such a delicate moment.

We talk about it with Dr. Carolina Alfano, psychologist, gestalt and transactional analysis psychotherapist and teacher at the Igat School of Specialization in Psychotherapy in Naples. For years, Dr. Alfano collaborated in schools, not only trained teachers, but worked a lot with children and young people, dealing with sex education and topics such as termination of pregnancy.

Dr. Alfano, a choice like that of the US Supreme Court that has already been passed in nine states that ban abortion, is an invasive act that undermines women’s freedom of choice in the 21st century. Although it is far from us, the perspective that such an essential and symbolic right for women has an impact on the psychological sphere of women?

“When you read the news about the election of the Supreme Court, it is clear that it has a resonance, even though it all happened abroad. It certainly ends up making us question the woman’s ‘choice’. I am not going into the merits of whether abortion is ethical or not, I am focusing on what is and can be the individual’s personal stories that we cannot know and the reasons that can lead to such a choice: abortion. There was this saying, paraphrasing, put yourself in the other person’s shoes and walk in them for a while before you judge, just so we can really understand what drives a person to act that way.”

Since the news arrived in Italy, the spotlight, which in fact never went off, has been focused on Law 194. An achievement for Italian women from the 70s, but which in 2022 still has some gray areas with the presence of insufficient counseling centers and with partial services which appear to offer ineffective interventions and which do not offer the real support required and required by law. What are the failures objectively speaking?

The clinic is a center for ASL that protects and promotes the individual’s psycho-physical and social health. Many people, women, girls, often do not know who to refer to and who to lean on. The clinic should guarantee psychological, medical, social support and, in case of termination of pregnancy, favor a path that allows a more informed choice and supports the person. Often, however, we get lost behind a bureaucracy that ends up prolonging the times and the ailments, and another problem is that the users often far exceed the number of staff available. In addition, I think there is also a lack of confidence in the length of the timing and the lack of timeliness in being able to follow, which means that we turn to the private sector, in the event that we have the financial opportunity.”

A few weeks ago, flash mobs were also organized in Naples, highlighting another controversial side of 194: the waiting time determined by the long process that women turning to public health have to go through to terminate the pregnancy, where more often than not relate to the objecting medical-health personnel who show an inevitably judgmental approach to them. How might this mark the psychological and emotional path?

“The woman who chooses to have an abortion often feels that she can’t do anything else, neither from culture, education, life history, etc. This involves feelings of guilt, internal conflicts, and if we are faced with someone who has a critical attitude rather than helping us make a decision as much as ‘consciously’, it can only worsen the selection process. The woman in question could be persuaded and decide not to have an abortion again, but this could then be the result of an adjustment, because the doctor or psychologist is seen as a judgmental parent. However, it would not be a conscious choice. A doctor, a psychologist, whoever he is, should cultivate an attitude of listening without judgment and respecting the patient’s choice as a result of working with consciousness ”.

It must also be taken into account that many women choose abortion because they are forced by events. The paradox of the freedom to go one way as the only solution is also a decisive element. If it is denied or judged, it has an impact on a woman…

“The non-choice, or the feeling of having no chance, generally creates in the person impotence, conflict, the feeling that nothing else can be done. This implies an attitude that can lead to depression or strong surrender. It is obvious that in the case of lack of choice we can also have actions that become harmful: in the case of a woman who cannot choose freely, she can harm herself, harm the child if she is forced to keep him. It is not new that women who feel helpless, hurt themselves or their children, are often seen as an extension of them. The news is full of such stories”.

Consciousness and consciousness which factors play with the passage of time? Above all, in what state is a woman and a girl of an older age?

“Of course we discriminate: an adult woman’s cognition is certainly different from a girl’s. The first must have (I say should in a normal development) a maturity and some consolidated experiences that create a baggage and also another ability to face difficulties. A young woman may lack experience, underestimate what she has to do, without having a foresight about the psychological consequences that an abortion may have. It is also true that a girl with age can overcome such an experience even more easily : because she has more time ahead, at a young age she is led to metabolize events earlier. In any case, I believe that there is always a need for accompaniment and support to prevent the choice we are about to make is devalued or minimized.”

Awareness linked to the very young. A sensitive subject where an education appears weak. How should it also be taken up in schools?

“I often work with young people in schools. Today, when information, thanks to computerized means, is immediately useful, I was amazed to hear questions like: “but is abortion contraception?!”. I take this example because there is a need to address issues of sexuality with young people, precisely because they can access information, but there is still no critical capacity, which is often borrowed and conveyed by the adults of reference. Young people cannot be prevented from making mistakes, but it is necessary to inform them; we adults: psychologists, teachers, parents, educators have a duty to do that. Knowledge protects.”

It is with girls that the role of counseling centers could be more significant.

“I believe that meeting more people in the area, physically, through information is a good channel to create awareness and not make people feel alone. There are many young women, but also more adults than out of shame, out of ignorance, they don’t know what to do, who to turn to, end up keeping their mouths shut or entering the vortex of depression, anxiety, loneliness, which then pushes them to harm themselves in particular”.

What is your point of view as a woman after hearing the news from the Supreme Court?

“When I heard the news from the Supreme Court, what I heard was a potential risk. In a broader perspective, abortion is not just “I have or I don’t have” this child; there are many abortions that are therapeutic occur because of serious malformations of the child, or because the child has been subjected to abuse within the family, outside the family, etc… There are many cases and situations. I repeat, I do not want to go into the judgment of ethics or unethics, but I think that when a choice is denied, the thing itself is avoided, but by increasing despair, the risk is to be very hurt and trust on someone as long as they do. solve the problem”. Desperate people make desperate gestures. We need kindness, not deprivation, for women who are suffering and will still carry the scars of this election.”

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