Wednesday, December 8

Abortion can be an obstacle course in Spain

Conscientious objection of doctors and nurses is violating the rights of women to abort in public health centers in Spain. The ideological motivations of many of the health professionals hinder the provision of a public service such as the right of women to voluntarily terminate their pregnancy, provided for in Law 2/2010 on sexual and reproductive health. The latest episode of these obstacles occurred in Madrid, where a public hospital has refused to perform a therapeutic abortion, as one of the doctors at the center has denounced, who in turn was the one who wanted to interrupt her pregnancy. Although, the problem is old. Statistics from the Ministry of Health indicate that 85% of the interventions are carried out in private clinics, most of them arranged and therefore at no cost to the woman. And in 2010, when the so-called deadline law was approved, they were 98%.

Therefore, the Government plans reform the abortion law, to try to reconcile the right to conscientious objection with the right of women to have a freely decided motherhood. The reform will include other measures to try to make abortion a full right, because as Sílvia Aldavert, coordinator of the Associació Drets Sexuals i Reproductius (DSIR) warns, conscientious objection is something “quite frequent” but there are others. other impediments, like the territorial inequalities, not have a health card or be a minor. All this despite the fact that abortion, “even though it may not seem like it”, is one of the “most frequent” interventions. In Catalonia, for example, there are about 20,000 a year.

An example of the paradox of the health system is the fact that the Hospital de la Santa Creu y Sant Pau, a public center although privately managed, does not perform abortions. Its professionals only perform “medical terminations of pregnancy” in those cases in which the disease of the fetus is incompatible with life or when there is a real danger to the mother. Thus, when the patient decides to undergo an abortion (understood as the woman’s right to voluntarily interrupt her pregnancy because she does not want to have a child, even if her health is not in danger), it is usually referred to the Vall d’Hebron Hospital.

“Conscientious objection when having abortions in Catalan public schools is quite common,” said Silvia Aldavert, Coordinator of the Associació Drets Sexuals i Reproductius.


The Hospital de Sant Pau is one private foundation of which the Barcelona City Council, the Generalitat of Catalonia and the Catholic Church are part. Center sources equate this referral of patients for abortion in other hospitals to other referrals that also occur in interventions such as “transplants” or “cancer treatments.” “We always serve women [que desea abortar] and we accompany her to another service. We don’t leave her alone “, these sources justify.

Sources from the Ministry of Health assure that everything the public health system of Catalonia It “guarantees” the woman’s right to abort. “In the same way that there are centers that do not perform a type of surgery, there are others that do not perform abortions. Hebron Valley and the Clinic are the two hospitals with the most experience in abortions “, justify these sources. They clarify that this is a matter of “internal circuits” and that the important thing is that the woman is always “cared for” and has “her right guaranteed.”

“Bad information

According to the complaints collected by L’Observatori de Drets Sexuals i Reproductius de DSIR, there are, for example, pregnant women who are successively referred from one service to another, something that slows down the whole process, already painful in itself. There are also doctors who misreport to patients. “Some tell them that you can only have an abortion before the 14th week of gestation. It is not true: you can legally abort beyond the 14th week “, complaint Aldavert. And this, he insists, it is happening in Catalan public centers.

“Some women have been sent to so many places, that in the end they decide to have the baby,” Silvia Aldavert. Coordinator of the Sexual and Reproductive Rights Association


It ensures that these conscientious objections to abortion are not only explicit, but also implicit: “Some women have been sent to so many places, they have been moved so much that in the end they decide not to have an abortion.” Sometimes voluntarily terminating a pregnancy becomes a “obstacle race”. Aldavert recalls that any “restriction” has a “direct hit” in the lives of women, something that the public authorities “should not allow.”

Lists of objectors

It is unknown how many conscientious objectors there are in Catalonia because there is no record of the same, something that demands associations such as Drets Sexuals i Reproductius, which serves about 6,000 young people a year. “We ask that professional associations publish the listings with conscientious objectors. But, beyond that, we ask that in the public network there are no objectors because the State recognizes the right to abortion, “claims Aldavert.

“Abortion is a Taboo subject and that is why you want to manage in a hidden way. Have a very important ideological weight. And there is no political will to make this a priority. There is not public campaigns information on how to abort and many professionals they are not well informed on this issue: either they don’t know the law, or they don’t know the circuit, “denounces Aldavert. He insists that women are not always offered an alternative.

“The number of objector gynecologists is very high because practicing an abortion is something unpleasant and risky”, José María Simón, President of the International Federation of Catholic Medical Associations.


“The body control and the life of women is the fundamental pillar that sustains the patriarchy. The actual extreme right and the ultra-conservative movements They are clear about it and therefore dedicate their forces to maintain this control to maintain their privileges. Professionals also have ideologies and the health system is still a reflection of society, but the law and public institutions should not allow conscientious objection to prevent a woman from aborting, thus violating her fundamental rights “, reflects the expert. It highlights the case of Italy, where there is an abortion law but where, at the same time, “80% of professionals are objectors.” “Women go to Holland to have an abortion.”

According to the president of the International Federation of Catholic Medical Associations (FIAMC), Jose Maria Simon, “the number of gynecologists who refuse to perform abortions is very high”, although it does not specify how many conscientious objectors there are in Catalonia. “Because practicing an abortion is something unpleasant, risky,” he justifies. Simón clarifies that conscientious objection does not exist only in relation to abortion, but also in other cases, such as euthanasia.

An “alternative” for patients

According to Ministry of Health, Conscientious objection, which is regulated by law, is a right that can be exercised “individually, not as an institution.” The department, like the Col·legi de Oficial de Metges Barcelona (COMB), has neither figures nor estimates on how many conscientious objector doctors there are in Catalonia, but ensures that has not received cases of women affected by this problem.

“Conscientious objection cannot override the patient’s right. We are not aware that this is happening. If there are cases, they are very punctual “, declare sources of Salut. They exist that conscientious objector physicians must always offer them a “alternative” to patients.

Regarding the registry of objector physicians, in 2011 a bioethics committee studied if it should be created, but finally the idea was abandoned to prevent it from “blacklists”. Also for a matter of “confidentiality”.

For his part, Official College of Physicians of Barcelona (COMB) is also not aware of data on conscientious objector physicians. But in a 2010 document, the COMB makes it clear that the objection “Does not exempt, in no way, the duty of assistance in the process prior to and after the intervention that is the reason for the objection. “The text also states that the directors of the centers must” ensure ” make assistance to citizens “compatible” with the exercise of conscientious objection by professionals.

Any woman who wishes to have an abortion should go to her Sexual and Reproductive Health Care (ASSIR) of reference, dependent on the Institut Català de la Salut (ICS). After three days of reflection, they will offer you a drug abortion (with a pill, up to nine weeks gestation) or a instrumental abortion (from 10 weeks of gestation). The latter is only practiced in accredited clinics to make a pregnancy termination.

Objector pharmacists

There are also no figures on how many pharmacists There are conscientious objectors: apothecaries who refuse to dispense the emergency contraceptive pill to be taken for the next 72 hours to unprotected sexual intercourse.

According to the Official Col·legi de Farmacèutics de Barcelona (COFB), in these cases the professional “must indicate to the person the closest point to get the pill “ and also “must enable the treatment to be carried out under the appropriate conditions”, both in terms of “time” and “displacement”, so that this delay “has no consequences” on the efficacy of the pill.

The COFB also recalls that conscientious objection when dispensing the abortion pill “cannot be arbitrary” and must be before “individually notified” to the corresponding school.

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