Rome: Difference between revisions

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'''OVERVIEW'''  

In Rome, you will find many health care resources. You need a prescription to obtain birth control pills, but you can find condoms with no prescription required. Emergency contraception (the morning after pill) is available for purchase without a prescription (since 2015), which is a positive update after years of required prescriptions. You can get an STD/STI test at one of the many clinics in the city, and there are some nationwide support networks. Maternity leave of five months is required for all pregnant women who are employed. Abortion is legal during the first 90 days of gestation, and it's free for Italian citizens. Foreigners will need to pay for an abortion procedure. There are many health care professionals who do not provide abortions due to their moral or religious beliefs so, if you need an abortion, it is imperative to secure a physician who is willing to perform the procedure.  

[[File:Florence italy bc.jpg|200px | thumb|left|frame|'''Birth control purchased in Florence, Italy for 13 euro''']]

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].

In Italy, you need a prescription for hormonal birth control, like birth control pills or shots. You don't need a prescription for condoms. According to a 2015 study,  65.3% of Italian women (of reproductive age) used a contraceptive method, and 48.9% of Italian women used a modern method. It was estimated that 11.4% had unmet family planning needs.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref>

[[File:Lusinelle italy.jpg|300px | thumb|right|frame|'''Lusinelle birth control purchased in Italy for 13 euro''']]

* To see a comprehensive list of contraception options in Italy, click [http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=IT here].

* Once you have a prescription for '''birth control pills''', you can them at local pharmacies ("farmacia" in Italian). There are over 20 brands registered in Italy. Some brands you can expect to see are Novogyn 21, Microgynon, Ovranet, Loette and Miranova. To see a full list, click click [http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=IT here].

* If you want an '''IUD''', you can get Mirena in Italy.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=IT IPPF Italy]</ref>

Some birth control pill brands are around 13 euro per month.

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

In Italy, you can purchase two emergency contraceptive types (morning after pills) without a prescription. LNG EC (like Escapelle and NorLevo 1.5mg) and UPA EC (like ellaOne) are now available over-the-counter from pharmacies for women who are 18 years of age or older. If you want LNG EC, you must get it from a physician (not a pharmacist). If you want UPA EC, you must go to a pharmacy and specifically ask the pharmacy clerk for it, since it's not on the shelves. Also, if you're under 18 years old, you'll still need a prescription to purchase them. However, for all other EC brands, you do need a prescription.<ref>[http://www.ec-ec.org/emergency-contraception-in-europe/country-by-country-information-2/italy/#pub1 European Consortium for Emergency Contraception - Italy]</ref>  

This is a major improvement over past Italian laws, when all EC required a prescription. This caused much distress for women in the past, and you can read a personal account a foreign student's difficulties trying to access EC in the past [http://www.xojane.com/it-happened-to-me/i-was-refused-emergency-contraception-in-italy here]. Fortunately, since April 2015, UPA EC has been available over-the-counter, and since October 2015, LNG EC has been available over-the-counter.

* In Italy, you can purchase emergency contraception/the morning after pill ("pillola del giorno dopo" in Italian) at pharmacies. For many brands, you no longer need a prescription, which is a new update as of 2015. Some brands you can expect to see are ellaOne (this is an anti-progestin pill, and it's considered the most effective but it's a bit more expensive). There's also some progestin-only brands (which are cheaper but usually not effective after 3 days), such as Lonel, NorLevo 1.5mg, Unlevo 1500 and Levonelle. For all of these brands, you should take the pill as soon as possible after unprotected sex in order to prevent pregnancy. For more details about accessing these pills with or without prescriptions, see the section above ("Laws & Social Stigmas").

* If you can't access dedicated emergency contraception, you can use birth control pills as replacement EC. Remember that, in 28-day packs, only the first 21 pills can be used. You can take Novogyn 21 (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Microgynon or Ovranet (for both of these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). There's also Loette and Miranova (for both of these brands, take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).

Note: "RU-486 (Mifegyne) is a pill used under medical supervision in a hospital that terminates a pregnancy within 49 days after implantation of the fertilised egg. It is legal in Italy however some regional governments have opposed the use and therefore the drug may not be readily accessible in all localities."<ref>[https://www.angloinfo.com/how-to/italy/healthcare/pregnancy-birth/termination-abortion Termination of Pregnancy and Abortion in Italy]</ref>

If you want an LNG type of birth control (like Escapalle or Norlevo), you can get it for around € 13,10. If you want UPA EC (like ellaOne0, you can get it for around € 26,90.

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

There are no travel or residency restrictions related to HIV or STI status in Italy. If you want to work in certain professions (like medicine), you may be required to take an HIV test, but you results will be confidential.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=15 ITALY - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>

* "If you are a woman I'd recommend Sant'Anna which is a public women's health consultorio in Parioli. I've been there for various gynaecological issues and I'm pretty sure they'd test you for STDs."

* Struttura Complessa di Dermatologia Infettiva, Istituto Dermatologico San Gallicano (IRCCS), Rome, Italy

* Reparto di Epidemiologia, Dipartimento di Malattie Infettive, Parassitarie e Immunomediate (MIPI), Istituto Superiore di Sanit� , Rome, Italy

* Università del Sacro Cuore di Roma: Offers HIV treatment. Address: Largo Agostino Gemelli, 8. 00168 Roma.

* [http://www.lila.it Lega italiana per la lotta contro l'AIDS]: Address: Corso Regina Margherita, 190/e, 10152 Torino. Phone: +39 011 431 0922. Fax: +39 011 521 7552. E-mail: lila@lila.it  

* [http://www.anlaidsonlus.it/ AnlAids]

* If you have a yeast infection, you can ask for a local version of Fluconazole at the pharmacy.

* Since 2007, Italy has had a national HPV immunization program, targeting 12 years olds.<ref>[http://www.hpvcentre.net/statistics/reports/ITA_FS.pdf Italy: Human Papillomavirus and Related Cancers, Fact Sheet 2016]</ref>

* In Italy, there is no national PrEP policy or clinical trials. However, [http://www.lila.it/it/ Lila] and [http://www.plus-onlus.it/ Plus] are two activist groups working on PrEP in Italy.

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

In Italy, you can find pads, tampons and menstrual cups. For pads, they can be found in most supermarkets and you'll have many brands to choose from. For tampons, there are less options. You'll typically find OB (without applicator) or Tampax (with applicator). The prices in the supermarkets are generally better than at pharmacies. For menstrual cups, you have a few options. If you want DivaCup, contact Michele and Barbara Fenati at [http://lamadreterra@tiscali.it La Madre Terra]: Tel: 0039063611823. Fax: 00390645424411. If you want MoonCup, you can have it delivered from the UK to Italy -- check out the [http://www.mooncup.it/ Italian MoonCup website] for details. For LadyCup, check out [http://it.ladyteen.eu/ Lady Teen] and [http://www.popolini.it/ Popolini]. For Lunette, check out [http://www.iosolodonna.it/ Io Solo Donna]. At [http://www.cybertuba.org/ Tuba Bazaar] you can find menstrual cups and panties.

If you're looking for an English-speaking gynecologist in Rome, check out [https://www.doctorsinitaly.com/ Doctors in Italy], which is a health service offered by B.M.M.I. Below, we have also provided some recommended gynecologists and clinics:

* [http://www.cdcsantafamiglia.it Casa di Cura Santa Famiglia]: "The Santa famiglia via dei gracchi IS great!!! There is a convention so it's free." "It's free because it the same as the Hospital Fatebene fratelli, but I think that you can have a room for yourself paying for something." Address: Via dei Gracchi, 134, 00192 Roma, Italy. Phone: +39 06 328331.

* [http://www.fabiamater.it/dove.php?lang=en Fabia Mater Clinic]: "Excellent structure is fabia mater clinic side street from via prenestina. Clean great place and personnel." Address: Via Olevano Romano, 25, 00171 Roma, Italy. Phone: +39 06 215921.

* [http://www.aied-roma.it/ OK Roma]: Recommended affordable option for gynecological exams and women's health care. "We offer health services in many areas of medical, psychological and social assistance. We are actively committed to the recognition of important civic rights. We fight all forms of discrimination and violence. We listen to young people and help them to gain awareness on sexuality and prevention." Email: comunicazioneroma@aied.it

In Italy, all pregnant employees are entitled to maternity leave. If a woman is applying to a job, she is not legally required to tell the employer that she is pregnant. Under the law, pregnant workers are required to take five months' maternity leave, and the woman is entitled to 80% of her regular pay from social security. The employer is often required to make the difference so that the pregnant woman receives 100% of regular earnings. When the woman returns to work, she must receive the same position and responsibilities that she had before the pregnancy. In certain circumstances, maternity leave can be converted into paternity leave.<ref>[http://www.elexica.com/en/legal-topics/employment-and-benefits/18-leave-in-italy Leave in Italy]</ref>

* For a pregnancy information website in Italy IVG, check out [http://www.gravidanzaonline.it/contraccezione/IVG.htm Gravidanza Online] (in Italian)

* "If you want to know where the Roman women go to deliver children, I can say that traditionally, there are two places and equipes considered the best in town for giving birth. # 1) The hospital of [http://www.fatebenefratelli-isolatiberina.it/It/MaternitaLibrettoInformativoDipartimentale FatebeneFratelli] on the Isola Tiberina. They work jointly with # 2) Clinica Santa Famiglia, a small clinic in via dei Gracchi where you can be addressed if you want a little more privacy and ready to spend some money. Both are working for NHS and the best obstetrician and gynecologists work there. What kind of expat are you? if you are extraeuropean you may need an insurance. If you are from UK, you don't (yet)."

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

In Italy, abortion is fully legal for the first 90 days of gestation, according to Law No. 194 (passed in 1978). The father does not need to give consent. However, if you're under 18, you will need parental consent (unless the abortion is due to a health emergency). During this 90-day period, all reasons for an abortion are permitted, including to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, risk of fetal impairment and economic or social reasons. While it is not formally available "upon request," the law is so open-ended that any woman can find a legal reason for an abortion that fits into the permitted criteria.  

There are certain steps that must be taken in order to obtain an abortion. First, a woman must usually apply to an authorized health or welfare agency or a physician of her choice. If she goes to an agency, she will be receive a consultation, during which time she may be encouraged to not seek out termination. If she goes to a physician, the physician must inform of her rights and the availability of welfare facilities. Following the consultation, if the woman wishes to terminate her pregnancy, the physician must issue a certificate. This certificate confirms the pregnancy and the request for an abortion, and it must be signed by the woman and physician. If the pregnant woman is under 18, parental authorization is required (unless there are serious health risks -- in which case, parental preferences may be overruled). Following the issuing of the certificate, the woman must usually then undergo a one-week reflection period. This reflection period is legally required unless an urgent abortion is necessary. Once the reflection period is complete, the woman may go to an authorized medical facility and request an abortion. Note that abortions must be performed in public hospitals or authorized private facilities. There are no specialized abortion clinics in Italy.

After the first three months of gestation, abortion is only permitted to preserve the physical/mental health of the mother or if the fetus has a genetic deficiency. If abortions are performed that are outside the legal provisions, penalties may be levied.  

'''Important Note:''' You must confirm a physician that will provide an abortion procedure for you. In Italy, medical care providers are not required to perform abortions. If medical personnel are opposed to abortion on moral or religious groups, they are legally allowed to declare their conscientious objection and they're exempt from performing or assisting in an abortion procedure. Seventy percent of Italian gynecologists (and 83% in some conservative regions) are conscientious objectors so do not perform abortions, as of 2016, and a nationwide survey found that 1,200 gynecologists out of well over 10,000 performed abortions. This means that some women spend considerable time trying to find and secure a gynecologist who is willing to perform the exam. It's critical that you secure a physician that does not hold moral objections and can perform the procedure. For more information about this issue in Italy, check out [http://www.nytimes.com/2016/01/17/world/europe/on-paper-italy-allows-abortions-but-few-doctors-will-perform-them.html this article] and [https://broadly.vice.com/en_us/article/abortion-legal-italy-conscientious-objectors this article].

If you have an Italian health card, abortion is free. If you're a foreigner, you will need to pay for the procedure. In case of emergency, like a miscarriage, abortion is free for foreigners, too.

* Check out this [http://www.rometown.it/4/lgbt_associations_3287217.html list of LGBT organizations in Rome]

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