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Abortion in Spain: where the law doesn’t reach

New measures are required to neutralize the hurdles standing in the way of full implementation of legislation passed in 2010

El País
Aborto hospitales Madrid
Healthcare personnel preparing a surgery room at Isadora Clinic in Madrid.Andrea Comas

Since 2010, Spanish legislation has recognized a woman’s right to get an abortion within defined time limits. It was a crucial step forward at the time, yet recent experience shows that its scope and application remain very deficient in a democratic society that has fully integrated abortion as a legitimate option.

However, in recent years there have been growing signs of a counter-reformist reaction in social sectors that put their own intolerance ahead of other people’s legally protected freedoms, or even prioritize their nostalgia for the days when individual and intimate beliefs, such as religious faith, claimed to exercise an improbable superiority over the beliefs of others: nobody ever forces anyone else to have an abortion; the law only aims to protect the rights of those women who wish to exercise it without having to provide reasons to anyone in particular.

Barely 6.2% of the nearly 100,000 abortions performed annually in Spain are taking place in public hospitals

Among the immediate causes of this precarious situation is the high number of “conscientious objectors” among doctors in Spain’s public healthcare system. Other, more diffuse causes have to do with social and media pressure exercised by the Catholic right, encouraged by similar currents in the United States and Latin America whose chief goal is to question and socially undermine the exercise of a right that is protected by law.

The figures are overwhelming. Barely 6.2% of the nearly 100,000 abortions performed annually in Spain are taking place in public hospitals, while a further 8.12% are being done at specialized centers that are part of the public system. Most are being performed at subsidized private clinics. In five regions of Spain – Extremadura, Madrid, Castilla-La Mancha, Murcia and Aragón – as well as in the exclave cities of Ceuta and Melilla, on the northern coast of Africa, no abortions at all are being performed through the public healthcare system. And the 2010 law, contrary to the dire predictions made by its detractors, has not resulted in a rise in the procedures. What it has done instead is to improve the guarantees for women who find themselves in the difficult situation of seeking a pregnancy termination.

Section 30.2 of the Spanish Constitution protects conscientious objection (originally practiced by young men who refused military service), but the subsequent law meant to regulate the concept was never drafted. Instead, laws covering military service, abortion and euthanasia have set the terms for conscientious objection, each within its own field. But the 2010 abortion law specifies that the exercise of this right should never undermine a woman’s right to end her pregnancy. As a result, abortions are almost the exclusive domain of private centers, given the hurdles and collective conscientious objections alleged by public health professionals.

Looking past cold data and statistics, some light has been shed on a reality that is normally experienced in silence due to the stigma that still surrounds abortion, thanks to recent testimony by Marta Vigara, a doctor at a Madrid public hospital, and by the writer Lara Moreno. In the first case, Dr Vigara was forced to get an abortion at a private clinic because her own colleagues at Clínico San Carlos Hospital refused to perform it, even though she had lost amniotic fluid and there was a serious risk to the fetus and to herself. In the second case, the author showed how much darkness still surrounds a voluntary, legal procedure that clinic bureaucrats classified as performed for “medical causes” in her case even when it wasn’t.

The experiences shared by these two women, as well as those implied by the cold statistics, suggest an urgent need for new measures that will guarantee that pregnancy terminations are performed within the terms set out by the law and provide a definitive push to this right.

Last week the governing Socialist Party (PSOE) introduced a proposal in Congress that was backed by all parties, save for the Popular Party (PP) and the far-right Vox, to penalize the harassment of women outside abortion clinics. This initiative paves the way for a realistic and practical way to curb the detestable pressure that is placed on women who are seeking a procedure that is always difficult. The proposed changes to the criminal code involve sanctions of up to one year of prison or community work. Following in the path of countries such as France, Austria, United Kingdom, Ireland and Germany, and a few states in the US, the proposal seeks to neutralize further demonstrations of backward, anti-democratic attitudes. A full 89% of women who went to get an abortion felt harassed and 66% felt threatened, according to a survey by the Association of Accredited Abortion Clinics (ACAI).

Besides penalizing this kind of rigorously uncivil behavior, the Equality Ministry also wants to reform abortion legislation to create a mandatory register of healthcare professionals who are conscientious objectors, in line with the one set out by the recent euthanasia law, and despite the fact that a few regions of Spain have yet to fulfil this legal obligation.

Abortion rights have made significant progress in countries such as Argentina and Mexico in recent years, but also experienced notable setbacks in Poland and in the US state of Texas. The opposition spearheaded by the Christian right across the world is also trying to grow in Spain, but neither the government nor the relevant medical and professional associations can feel intimidated in their defense of the free exercise of a right that has been voted on and backed by parliament, the headquarters of popular sovereignty.

English version by Susana Urra.

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