Leaders in the state, which has a population of over 30,000, voted against a proposal from citizens to legalize abortion, which can see women imprisoned for between five and six years, Alta Rimini reported.
“It’s incredibile that in 2014, women in San Marino are still treated as criminals for a choice that is their right,” Elena Tonnini from the Movimento Rete, a civil rights organisation in the state, told The Local after 27 council members voted against the proposals compared to 23 in favour.
Tonnini said women from the state mostly go to private clinics in Italy for an abortion or abroad.
Councillors also rejected proposals to recognise the marriage of gay citizens who had wed abroad, with 35 voting against compared to 15 in favour.
“The government here does not recognize basic civil liberties," Tonnino added.
Federico Podeschi became the first gay citizen to marry abroad earlier this year when he wed his British partner, Darren Williams, in London.
The lack of recoginition for the marriage means his husband is not entitled to a residency permit in the state.
Podeschi was among those who signed a petition for the law to be changed. He said in a Facebook post: “I am not a human being in my mother country, only when I’m outside of the Republic.”
Tonnino added that both decisions were hugely influenced by the Catholic Church.
“The Church and words from priests played a big role,” she said.
Although abortions in Italy are allowed within the first three months of the pregnancy, and only after 90 days if the woman or foetus is at risk, they are increasingly difficult to obtain due to the high number of doctors who invoke their conscientious objection.