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ROME – Vatican City is perhaps the most famous microstate in Italy, but there is another – a small territory called San Marino, which, over the weekend voted to decriminalize abortion in certain cases despite protests from church leaders.

Situated in Central Italy, east of Florence, San Marino is a mountainous state and traces its origins to a fourth-century monastic community, thus claiming to be both the world’s oldest existing sovereign state and oldest constitutional republic.

Though clearly influenced by Italy, San Marino often runs ahead of neighboring Italy. During the pandemic, for example, when vaccines were still largely unavailable to tourists or foreigners not inscribed in Italy’s national healthcare system, San Marino offered the Chinese vaccine, Sinovac, to both of these categories upon appointment.

However, the small state has lagged behind Italy on other matters. While Italy legalized abortion in the first 90 days for health, social, or economic reasons in 1978, the procedure had been outlawed in San Marino until this weekend.

In the Sept. 26 referendum, citizens of San Marino voted overwhelmingly to legalize abortion, with the state’s Interior Ministry reporting 77 percent of ballots asking to decriminalize abortion in the first 12 weeks of pregnancy and beyond if there is a risk to the mother’s physical or psychological health, or due to fetal abnormalities or malformations.

Previously, abortion was a crime punishable by three years in prison for the woman who obtained it, and six years for the doctor who performed the procedure, although these cases were rarely prosecuted, since women usually crossed the border into Italy to obtain their abortions.

San Marino, which, like Italy, has a strong Catholic presence, was one of the few remaining countries in Europe to ban abortion, inculding Malta, Andorra, and Vatican City.

Supporters of the referendum argued that the criminalization of abortion placed excessive financial burden on women traveling to Italy to obtain one and was an extra burden for those who had been raped.

Opponents, however, argued that minors in San Marino are legally able to obtain contraceptives from pharmacies, including the so-called “day after pill,” making the push for abortions later on in pregnancy largely irrelevant.

San Marino’s ruling Christian Democratic Party firmly opposed the referendum, asking citizens to vote No in order to “defend the right to life.”

In addition to San Marino’s swath of prolife communities, the state’s bishop, Andrea Turazzi, also voiced strong opposition to the referendum, saying in a statement ahead of the vote that “without ifs, ands, or buts, we are for the welcoming of life.”

“It is not to be defended as an abstract principle, but as the welcome of a person: the one who is conceived, albeit fragile and defenseless,” he said.

Turazzi insisted that the Church “is on the side of the mother and the future father,” and does not want women to be left alone either before or after the birth of her child.

“In her, motherhood shines in an admirable way,” he said, adding that the voluntary termination of a pregnancy “is never without consequences for the woman,” due to the unique bond she shares with the child she carries.

The Church, Turazzi said, believes that abortion is never an easy decision for women, but is “always a tragedy.”

“We don’t want to leave any stone unturned to find alternatives,” he said, insisting that it is society’s responsibility to ensure that no new life faces insecurity, mistrust, loneliness, a lack of care, or a lack of protection for economic reasons.

Turazzi said voting is always a right and a duty, but urged proper reflection, and a listening to all sides of the argument before making one’s decision, especially in a matter as important as abortion.

With scientific progress being what it is, and with a growth in social awareness in recent years, Turazzi insisted that there is much to be done to welcome new life without problems or burdens, saying, “We believe that the development index of a society is not evaluated so much with the economy, but with respect for the rights of all, beginning with those who are fragile, defenseless, and unborn.”

Turazzi has not yet issued a statement following the publication of the initial results in favor of the decriminalization.

Follow Elise Ann Allen on Twitter: @eliseannallen