The Minister for Equality, Irene Montero, during an act at the Lekuona Fabrika cultural space in Errentería, in the Basque Country, on May 22, 2023.Jose Ignacio Unanue (Europa Press)
The reform of the abortion law was approved on February 16. Among its objectives was the return of the ability to decide without authorization of fathers and mothers to minors under 16 and 17 years of age —which the PP had withdrawn in 2015—, and also guarantee the right to voluntary interruption of pregnancy (IVE) in public hospitals and that all women can do it as close to their home as possible. But, with the powers in Health in the hands of the autonomous communities, the regulation requires them to reorganize their resources to make this possible. And that hasn’t happened yet. Now, the Ministry of Equality has sent a letter to all the autonomies “so that they guarantee that all the measures related to the IVE that the new Law on Sexual and Reproductive Health and the Voluntary Interruption of the Pregnancy”
In Spain, despite the fact that abortion has been a right for decades and that the previous legislation already contemplated that IVEs be given in public health, reference was also made to accredited clinics. And the vast majority were performed in these centers: of the 90,189 that were reported in 2021, 76,064 were in private centers, 84.3%, according to the latest report from the Ministry of Health.
Because? Because since abortion was decriminalized in 1985, the public system has not restructured its services to be able to do so and since then, women who go to their health center or hospital to access this right have been referred to these clinics private, in which they do not pay unless they go directly, without having previously gone through the public system, since it is a free benefit, financed by the State. Even so, there are still women who do pay for this service.
It happens when you go directly to one of these accredited clinics, without having gone through the health center or hospital first. In these cases, the average cost is around 400 euros, but it varies depending on the territory, the center, the week of pregnancy and the specific circumstances of each abortion; it can range from less than 200 euros for a pharmacological abortion (with pills) to more than 1,000. And the reasons can be multiple, from not being able or not wanting to wait, to the privacy that is sometimes decided to maintain around this issue, still a taboo and a stigma in many places.
In Madrid, public hospitals deal with 0.7% of the voluntary interruptions of pregnancy, last year, two of 15,188; in Castilla y León, the public system only took care of 60 abortions, of the 2,597 that were reported; Castilla-La Mancha, one of 3,203; Andalusia, 10 of 17,487; Valencian Community, six of 8,013; Extremadura, none of 1,284… And so each and every one of the autonomies.
For that to change, as the reform of the law establishes, a restructuring of the health system is necessary. Heads of the Gynecology service and experts in the sector explained to this newspaper last year that public centers are not prepared to accept the more than 70,000 voluntary interruptions of pregnancy that are carried out each year in private clinics (generally subsidized), either due to lack of resources, training or doctors willing to do so, which is an obstacle found in most centers: conscientious objector professionals.
Equality, with the letters sent, “urges” the autonomous communities to start taking the necessary steps to reorganize their public network, and specifically points out the issue of professionals: “That all the autonomous communities take the necessary steps to guarantee that there are non-objecting doctors in all public hospitals, including, if necessary, the hiring of doctors”, and points out that the law “is clear in this regard and proposes the creation of records of objectors in each autonomous community in order to guarantee women’s access to their right to abortion, always respecting the right of doctors to conscientious objection”.
