Italy’s Constitutional Court has barred Sicily from advertising jobs reserved for health workers willing to perform abortions, but said on Friday the southern region could find alternative ways to safeguard access to the service.

Faced with high refusal rates among doctors on moral or religious grounds, Sicily last year passed a law requiring public hospitals to set up dedicated abortion wards and hire staff willing to carry out the procedure.

Prime Minister Giorgia Meloni’s government challenged the measure, saying it would create special hiring tracks that would discriminate against other medical staff.

“The court highlighted that recruitment procedures limited to non-conscientious objectors are incompatible with fundamental principles,” the court said in a statement.

However, it added that Sicily’s public hospitals could enter agreements with private facilities to ensure abortion services were provided.

Sicily’s regional government had no immediate comment.

Abortion has long been contentious in Italy, a predominantly Roman Catholic country, but it has been legal since 1978. It is permitted within the first 90 days of pregnancy, or later if the mother’s health is at risk or if there are foetal abnormalities.

However, recent data show the service can be hard to access, especially in the more conservative south, with fewer than half of Sicily’s hospitals offering abortions in 2022.

Health workers may opt out by declaring an ethical or religious objection, provided the woman’s life is not in immediate danger.

The Constitutional Court said separate recruitment would not guarantee access to abortion services across the island because workers could still declare themselves objectors after being hired.

The objection “can, in essence, be exercised at any time during the employment relationship without any consequences,” the statement said.