The word abortion was left out of a G7 summit statement agreed on Friday, reflecting a rift on the issue between the host, Italy's far-right premier Giorgia Meloni, and her allies.
Leaders of the Group of Seven rich democracies last year committed to addressing "access to safe and legal abortion", in a statement after a summit in Hiroshima in Japan.
But that reference did not appear in the final statement agreed at this year's summit in Puglia -- with diplomats blaming Prime Minister Meloni.
The statement read: "We reiterate our commitments in the Hiroshima leaders' communique to universal access to adequate, affordable, and quality health services for women, including comprehensive sexual and reproductive health and rights for all."
The United States and France had both pushed back after reports that Meloni -- a far-right leader who is opposed to abortion -- was trying to water down the language on women's rights.
A senior EU official had earlier confirmed that attempts to use the more explicit wording had failed.
"We have been defending what was agreed in Hiroshima where the text was more explicit, but it was not possible to reach an agreement on disputes in the room," the official said.
But he added: "What is important is that in the text you have promotion of sexual and reproductive rights."
Election campaign
The issue sparked a diplomatic spat between Meloni and liberal French President Emmanuel Macron, two leaders from contrasting political traditions whose relations were already fraught.
Asked about the issue by an Italian journalist at a G7 press conference on Thursday, Macron noted the French parliament's vote earlier this year to enshrine the right of abortion in France's constitution.
"These are not the same sensitivities that there are in your country today... I regret that but I respect it, because it was the sovereign choice of your people," he said.
Meloni later that evening hit back by noting Macron was facing upcoming legislative elections, saying it was "profoundly wrong" to use a G7 summit for "campaigning".
"The controversy over the presence or absence of the word abortion in the conclusions is totally specious," she said, according to the ANSA news agency.
She said the Puglia statement would recall the language of the Hiroshima text, "in which we already approved last year the need to guarantee that abortion is 'safe and legal'."
The United States also weighed in on behalf of President Joe Biden, who joined Macron, Meloni and the leaders of Britain, Canada, Japan and Germany at the summit.
"The president felt very strongly that we needed to have at the very least the language that references what we did in Hiroshima on women's health and reproductive rights," the official said.
LGBTQ rights
The Meloni-Macron spat made front pages in Italy on Friday, threatening to overshadow the substance of the summit, which was focused on support for Ukraine.
Meloni's office was then later forced to deny a report that a reference to LGBTQ rights had also been removed from the summit statement, saying it was "baseless".
The final copy expressed "strong concern about the rollback of the rights of women, girls and LGBTQIA+ people around the world" and strongly condemned all abuses and violations of their rights and freedoms.
But it did not repeat the line in last year's Japan statement committing to work for the full and equal participation of LGBTQ people in all spheres of society.
And there was no mention of the issue of gender identity, as there had been in Japan.
Macron late Friday tried to backtrack from any controversy, telling journalists there had been "no desire for controversy from me" on the issue.
"I responded honestly" when addressing the issue, Macron said.
Back in Rome on Thursday, Italy's agriculture minister and Meloni's brother-in-law, Francesco Lollobrigida, had questioned whether it was "opportune" for the G7 to have a statement supporting abortion rights with Pope Francis attending the summit.
The 87-year-old pontiff, who upholds the Catholic Church's position that abortion is murder, attended the summit as a guest but is not a signatory to the statement.
Abortion has been legal in Catholic-majority Italy since 1978.
But access is challenging due to the high percentage of gynaecologists who refuse to perform the procedure on moral or religious grounds.
Meloni, a self-described "Christian mother" who has raged against "LGBT lobbies", came to power in 2022.
In April, the Italian parliament passed a measure by her hard-right government allowing anti-abortion activists to enter consultation clinics, sparking outrage from opposition parties.