A woman votes for the abortion referendum at a polling station in San Marino, Sunday, Sept. 26, 2021. Tiny San Marino is one of the last countries in Europe which forbids abortion in any circumstance — a ban that dates from 1865. Its citizens are voting Sunday in a referendum calling for abortion to be made legal in the first 12 weeks of pregnancy. (AP Photo/Antonio Calanni)

SAN MARINO (AP) — San Marino residents on Sunday voted overwhelmingly to legalize abortion, rejecting a 150-year-old law that had criminalized it and making the tiny republic the latest majority Catholic state to approve the procedure under certain circumstances.

Some 77% of voters approved making abortion legal in the first 12 weeks of pregnancy. It will also be legal beyond that point if the woman’s life is in danger or if her physical or psychological health is at risk because of fetal anomalies or malformations, according to official returns broadcast on San Marino RTV.

Turnout for the referendum was 41% in the microstate of 33,000 people surrounded by Italy.

San Marino, one of the world’s oldest republics, had been one of the last European states that still criminalized abortion. With Sunday's result, it now joins other similarly Catholic states like Ireland, which legalized abortion in 2018 and neighboring Italy, where abortion has been legal since 1978. Abortion is still illegal in Malta and Andorra, and Poland introduced a near-total ban on the procedure this year.

The San Marino referendum was set after around 3,000 people signed a petition drive to overturn the microstate’s abortion law, which dates from 1865. With the “yes” votes winning, San Marino’s Parliament must now take steps to legalize the procedure.

Women in San Marino seeking an abortion usually go to neighboring Italy for the procedure. But proponents of the referendum say that puts an undue financial burden on them and penalizes women who have gotten pregnant as a result of rape.

Sara Casadei of the “Noi Ci Siamo" campaign that pushed for the referendum, was pleased with the outcome.

“We supported this for the simple reason that it seemed right that women have a choice and aren't forced to go somewhere else, but to have the services on our own territory," she said.

Opponents argue that in San Marino, even minors can receive free contraception at pharmacies, including the morning-after pill. The Catholic Church had strongly opposed the measure.

Voter Federica Gatti said as she cast her ballot that a woman’s decision to terminate a pregnancy or not involves “several personal, religious and moral reasons,” but that the state “must provide its citizens this opportunity.”

Another voter, Elisabetta Matteini, said she was against having the procedure personally since it took her a long time to conceive her son. But she said it should be available to avoid women resorting to “people who have no competence, putting their life at risk.”

In the buildup to the vote, the bishop of San Marino, Monsignor Andrea Turazzi, said the Catholic Church was “decidedly against” the decriminalization initiative, though he said the campaign had raised awareness about the need to provide better services and care, especially for mothers in need.

The Vatican firmly opposes abortion, holding that human life begins at conception and that all life must be protected from conception until natural death.

“For us, its inconceivable that a mother resorts to abortion because of some economic troubles,” he told Vatican News.

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Nicole Winfield reported from Rome.

News from © The Associated Press, 2021