The Council of Europe, an intergovernmental human rights organization, slammed Italy on Monday over women's lack of access to safe abortions. The procedure has been legal in the country since 1978, but with many doctors refusing to perform abortions for religious reasons, women often struggle to find a willing doctor or choose to terminate their pregnancies in secret and often dangerous ways.

“In some cases, given the urgency of the procedure required, women who want an abortion may be forced to go to other establishments (outside of the public services), in Italy or abroad, or to end their pregnancy without the support or supervision of competent health authorities,” an excerpt from the council report read, according to the Local. The council investigated the situation in Italy after CGIL, Italy’s biggest trade union, filed a petition.

Abortion in Italy is legal within the first three months of pregnancy and can be performed beyond that trimester only if there is a severe threat to the woman or the fetus. The same law that legalized abortion also allows for doctors to conscientiously object from performing abortions. Home to the seat of the Catholic Church, Italy has long been a religious country, and an estimated 70 percent of doctors — 90 percent in some regions — refuse to carry out the procedure, the Local reported.

Doctors who do perform abortions are often subject to discrimination from their colleagues, according to anecdotal evidence. “I must say that, at least in the past, nonobjectors were ghettoized in some cases, so we can’t rule out that that may have played a role in the low numbers,” Marco Bonito, director of the obstetrics unit at the Catholic San Pietro Fatebenefratelli Hospital in Rome, told the New York Times in January.

The government raised fines for women who had illegal abortions from 51 euros, or approximately $58, to 5,000-10,000 euros, or approximately $5,711-$11,421, in February.