Some of the last remaining European countries that enforce bans on abortions have sparked massive social movements in recent years: from Poland where 150,000 demonstrated last October in Warsaw after a court ruled in favor of an almost total abortion ban to the outpouring of support in Ireland for a 2018 referendum that repealed an age-old ban —even the miniature-sized British territory of Gibraltar made international headlines after a campaign recently forced a referendum that successfully scrapped the local law that punished abortions with life imprisonment.

But hidden from view, a much quieter battle is unfolding in the sloping, sleepy streets of a medieval city-state tucked inside central Italy. San Marino, population 33,000, is one of the last places in Europe where getting an abortion on request is illegal (The others are: Andorra, Liechtenstein, Malta, Monaco and Poland.)

A priest compared us to Nazis.

Abortions in San Marino are punished with three to six years in prison – for both the woman who requests the abortion and anyone who takes part in the operation, including doctors. The law makes no exceptions for cases of rape or fetal malformation.

That might be about to change after the Union of Sammarinese Women has gathered enough signatures to call a referendum to scrap the restrictions. Campaigners say that the country's restrictive laws are rooted in the long-running influence of the Catholic Church in the small landlocked country. Local politics "does not mirror society, while fundamentalist Catholics are over-represented in the media," Vanessa Muratori, of the women's rights union, told the Italian weekly magazine Internazionale. "A priest compared us to Nazis in World War II. But people think differently, especially among the younger generations."

Unable to have abortions in their country, women often travel to neighboring Italy, where some kinds of abortions on request have been legal since 1978, to secretly have abortions in private clinics for about €2,000. Those who can't afford it usually resort to clandestine abortions in cheaper facilities, Internazionale reports.

In many cases, the secrecy that surrounds abortions increases the social stigma and mental health toll facing women. One young woman who asked not to be named told the magazine she was advised not to say a word about it with anyone.

Women's rights groups have campaigned to scrap the ban since at least 2003, but successive attempts failed to gain the backing of the country's political forces and foundered. Now the referendum, which still must be assigned an election day, could expand Europe's growing list of pro-choice nations — no matter the size.