Maurizio Orlandella


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    30 years legal abortion in Ascoli Piceno, Italy
    Tiziana Antonucci, social worker, Daniela De Anglis, Sociologist, Adriana Bisonni,
    Consultant, Massimo Cutulli, Gynaecologist, Ennio Painvain Gynaecologist, Maurizio
    Orlandella Gynaecologist 
    AIED was founded on 10th October 1953, and the diffusion of the concept and custom of
    liberal and responsible sexual relationships has represented from, the very beginning, one
    of its principle objectives. The Ascoli Piceno section was created in 1974 and since then its
    practise has assisted approximately 20,000 women, and in particular around 11,000
    requests from patients and certification for IVG, a few hundred of these received before
    the introduction of law 194, in collaboration with CISA. As a consequence of constant
    moral objections on the part of every member of staff in the city hospital, the AIED section
    of Ascoli Piceno, from 1978 to date, thanks to an agreement with the health authority,
    guarantees its patients a path to IVG, in the practise, and during the hospital stay, the
    operation and discharge, an experience which is probably unique in Italy.
    The method the practise uses is principally characterised by the speed in which the patient
    is seen: in almost all cases a woman can be given an internal examination and an ultra
    sound scan to determine date, within a week of the request.
    Extremely close attention is paid to counselling which is entrusted to the same health
    worker who will be working alongside the doctor in the hospital: as well as providing the
    patient with the fullest possible information on the practical aspects of the IVG we also give
    the woman ample time to make an informed decision about the termination of her
    unwanted pregnancy and help her to make a choice of effective contraception.
    The operation is carried out using the KARMAN method, and from 1980 to date, without
    general anaesthetic, except in extremely rare cases, and is carried out with a strict limit of
    three people in theatre: the AIED staff, and the patient.
    We find the following very interesting: the percentage of patients who return to the practise
    after the operation was maintained at about 30% up to the 70?s, around 40-50% during
    the 80’s and 90’s and about 50% rising to a high of 60% from 2000.
    Conclusions: - The woman’s satisfaction with the entire IVG process is the element which
    we feel guarantees an increased percentage of returns for check - ups and the possible
    preventions of recurrence. 

    In the hospitals where these operations are not carried out, as per law, there is the
    possibility of provision for an alternative service, with a possible forward role for lay
    consultants, for the quality of care of the IVG service and the prevention of unwanted
    pregnancies, in consultation with the health authority.
    The IVG process also needs projects that provide for the intervention of local institutes to
    promote the use of intrauterine contraception and offer free services for the immigrant
    population and those on low incomes.
    The clinical evidence will be described and considerations made on the IVG phenomenon,
    the application of the law, the freedom of choice of surgical method and doctor.