ROME (AP) — Tiny San Marino is one of the last countries in Europe which forbids abortion in any circumstance — a ban that dates from 1865. On Sunday, its citizens can vote in a referendum calling for abortion to be made legal in the first 12 weeks of pregnancy.

The ballot proposal also calls for abortion to be permitted beyond that point if the woman’s life is in danger or if her physical or psychological health are at risk due to fetal anomalies or malformations.

Women in San Marino seeking an abortion currently go to neighboring Italy, which legalized the procedure in 1978.

San Marino is one of the world’s oldest republics and has a population of some 33,000. The referendum was set for Sunday after some 3,000 Sammarinesi, as its citizens are called, signed a petition drive. About 65% of signatories are women, said Karen Pruccoli, a San Marino entrepreneur who spearheaded the drive.

“We had asked the political sphere to make a law'' legalizing abortion, Pruccoli said in a telephone interview Thursday. “When we realized that the political sphere didn't want to enact a law, we decided to have the referendum.”

No opinion polls have been conducted. If “Yes” votes prevail, San Marino's Parliament will need to legalize abortion.

Antonella Mularoni, who leads the “No” camp, noted that in San Marino, women, including minors, can receive free contraception at pharmacies as well as the so-called “morning-after” pill. But all abortion, for whatever reason, is a crime in San Marino, she stressed, and her campaign aims to keep it that way.

When Sammarinesi go to Italy to access health care that might not be available in their homeland — say, a transplant — their public health service reimburses them, but not for abortion since it's a crime in San Marino.

The “Yes” camp says that puts a financial burden on San Marino citizens who must go to Italy for an abortion.

Critics of San Marino's abortion ban say it also penalizes women who have been raped.

“If you are prevented or if your access to the support services is hampered because of the stigma — you may fear that because you don’t want to make it known that you do not intend to carry on with the pregnancy — then it’s even less likely that you will turn to the police and report the rape,” said Joanna Nelles, executive secretary of the Council of Europe's monitoring mechanism for the Istanbul Convention on combating violence against women. Nelles spoke with the AP in a phone interview Thursday.

Younger women in San Marino tend to be more favorable toward abortion rights, Mularoni acknowledged. “Many of the girls go to school in Italy. They consider (abortion) an acquired right.”

Pruccoli said young men in San Marino are supportive as well. "They study in Italy, they study abroad. They are more forward-thinking. They understand that San Marino can't have a law that's more than 150 years old,'' she said, referring to the 1865 ban on abortion.

Other tiny countries in Europe are considering easing abortion bans. This spring, a lawmaker in European Union member nation Malta presented a bill to scrap part of the criminal code that makes abortion a crime punishable with up to three years in prison. The provision is rarely enforced, with the last known jailing for abortion occurring in 1980, according to Maltese officials.

In Gibraltar, a tiny British territory on Spain's southern tip, voters in June endorsed legislative changes to ease an abortion ban and allow the procedure up to the 12th week of pregnancy if a doctor deems the woman's physical or mental health is at risk or if there is risk of a fatal fetal abnormality.

Andorra, a microstate bordering Spain and France, has a total ban on abortion.

Italy's abortion law, fiercely lobbied against by the Catholic church, allows health personnel to refuse to perform abortions for reasons of conscience. In some southern regions, as many as 80% of gynecologists have claimed conscientious objector status, leaving a shortage of available personnel, particularly in rural areas.

“These percentages (for objectors) are higher than those for practicing Catholics in Italy'' said Mularoni, who leads the ”No" camp ahead of the referendum. She attributes Italian doctors' refusal to perform abortions to them seeing sonograms that show fetal organs. "It's not just an argument of being Catholic,'' she said. Catholic teaching forbids abortion.

Rights were slow to come for women in San Marino. They received the right to vote in 1960. A 1982 referendum seeking to end a law which stripped San Marino women of their citizenship if they married a foreigner failed. The law was later changed to allow them to keep their citizenship.

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Nicole Winfield in Rome contributed to this report

News from © The Associated Press, 2021