Activists of the "Unione Donne Sammarinesi" San Marino's women union camp celebrate in San Marino, Sept. 26, 2021, the victory in a referendum to decriminalize abortion in certain circumstances.

San Marino votes to legalize abortion, ending a 150-year-old ban

After a highly charged campaign in the small republic, the “yes” vote to legalize abortion won with 77% of votes — and a voter turnout of over 60%.

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The small republic of San Marino voted overwhelmingly to legalize abortion in a historic referendum held on Sunday, putting an end to a 150-year-old law that made abortion a criminal offense punishable by three to six years in prison.

The 24-square-mile country — landlocked in northeast Italy — was one of the last European countries to completely ban abortion, even in cases of rape and incest. Other tiny nations, such as Malta, Andorra and the Vatican continue to have blanket bans on abortion.

Related: Undocumented women face shrinking options for reproductive health care under Texas abortion law

After a highly charged campaign, the “yes” vote to legalize abortion won with 77% of votes — and a voter turnout of over 60%.

“We were shocked. We think that San Marino was ready to be part of Europe and part of the civil and modern countries of the world.”

Karen Pruccoli, San Marino Women’s Union, president

“We were shocked,” said Karen Pruccoli, president of the San Marino Women’s Union. “We think that San Marino was ready to be part of Europe and part of the civil and modern countries of the world.”

The feminist group had pushed for a referendum this past spring after watching activists in the UK territory of Gibraltar take a similar approach. Pruccoli said that after 18 years of lobbying for the legalization of abortion and being vetoed by conservative governments, they felt they had no other choice.

“We were going to use a referendum to get to where we wanted to go, because our politicians were not willing to legislate and legalize abortion in our country,” Pruccoli said.

Related: In Thailand, new abortion freedoms face spiritual resistance

To secure a legal referendum, the group needed to gather a thousand signatures from a population of 33,000. In the end, they garnered 3,000.

Throughout the campaign, dozens of posters were plastered across the tiny country; some called for citizens to vote for legal and safe abortions, while others had a photo of a fetus with the words: “Even at 12 weeks, I’m a child.”

The ruling conservative Christian Democracy Party also weighed in by calling on citizens to vote “no.”

“The 77% of people who voted ‘yes,’ most of them have voted for [the Christian Democracy Party],” Pruccoli said. “So, there’s a gap between what the political party wants the voters to vote and what [voters] really sense to be right.”

The Catholic Church also played a big role and strongly opposed the measure. Pruccoli said Sunday’s results suggest some Catholics may think differently from the church when it comes to social issues like abortion.

Related: Abortion is illegal in Malta. Activists are trying to increase access.

San Marino has a long history of independence and Catholic influence. It sits atop Mount Titan about 10 miles from the Adriatic Sea, with picturesque views from three different castles that tourists flock to. The country was founded in the fourth century by Saint Marinus, a stonemason from present-day Croatia who was fleeing persecution in the Roman Empire, and has remained sovereign ever since. It claims to be the world’s oldest and smallest republic.

For decades, people in San Marino have been traveling to neighboring Italy where abortion has been legal since 1978 and paying up to $2,000 for the procedure. But in recent years, abortion access in Italy has been hindered by the increasing number of doctors who refuse to carry out the procedure, leaving some areas void of abortion providers.

Antonella Mularoni, from the opposition committee One of Us, said that she fears Italian women will now be coming into San Marino for abortions.

“If you have a legislation which is more favorable to abortion rather than the Italian one, of course, you might have women coming to San Marino.”

Antonella Mularoni, One of Us

“If you have a legislation which is more favorable to abortion rather than the Italian one, of course, you might have women coming to San Marino,” Mularoni said.

It’s still unclear what San Marino’s abortion law will look like. Legislators have six months to draft a bill before voting on it in parliament. But Mularoni, who is a former head of state of San Marino, said she didn’t like the wording included in the referendum question, which would allow for on-demand abortions until the 12th week, and afterward, if the mother’s health is at risk or in cases of fetal malformation.

Related: Catalonia’s temporary tele-abortion services are a game-changer

“We are very much worried that when there are children who are diagnosed with some pathologies, they could be theoretically aborted until the ninth month,” Mularoni said.

However, abortions after the second trimester are extremely rare, according to Irene Donadio, senior lead on strategy and partnership for the International Planned Parenthood Federation.

Many abortion laws in Europe have similar wording to San Marino’s referendum, but the medical process for late-term abortions is rigorous.

Having a total ban on abortion “tells a lot about the position of women in that society, since the state considers that their life is not worth saving,” Donadio said. “That their well-being, their mental health and their health is not worth protecting.”

She hopes the win in San Marino will inspire more debate in small countries with abortion bans like Andorra and Malta, which are already seeing an increase in abortion rights activism.

“It will be a galvanizing effect because it’s an extra pressure,” Donadio said. “It’s important to have the capacity to look beyond the frontier and see that it’s not fair, it’s simply not fair that the women in those countries are treated the way they are.”

But Donadio said the progress made in Western Europe isn’t necessarily being seen in Eastern Europe. Last week, a new bill was introduced into the Polish Parliament that would make all abortions a criminal offense.

“It’s a very long process to change the mentality and to ensure that politicians start respecting women and their needs and their safety,” Donadio said.

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