Many Spanish doctors declare themselves to be conscientious objectors, making access difficult for women seeking the procedure.
Zaragoza, Spain — Mercedes Sobreviela, a gynecologist in this city in northeastern Spain, believes the decision to have an abortion is a matter for women. He says that the “right decision” for a woman is “whenever she wants”.
But as a doctor in Spain, Sobreviela believes she too has a right to choose, and has chosen not to have an abortion.
His public hospital, the Hospital Clinico Universitario de Zaragoza, doesn’t even take him. In fact, no public hospital in the Aragon region, where 1.3 million people live, intervenes.
Sobreviela said, “It is that we are doctors, doctors by profession do favors, to help live, we don’t have to decide who is going to stay or not.”
Spain liberalized its abortion law in 2010. Previously, women were only allowed to have an abortion in exceptional circumstances, but new laws allow all women to undergo the procedure without restriction in the first 14 weeks of pregnancy.
But the map of places where abortion can be prescribed is less determined by national law than by Spanish doctors. In large numbers and throughout the country, doctors forbid performing them.
Spain’s situation offers a glimpse of what to expect for other countries at a time when separate measures in Texas and Mexico have restarted the debate over access to abortion. Conservative Texas lawmakers have practically banned abortion in the state, while across the border, Mexico’s Supreme Court ruled this month to decriminalize abortion in that country.
Uncertainty in Mexico is whether doctors will provide the service, a question many doctors in Spain have already answered.
They called themselves “honest objectors,” a term coined by pacifists who refused military service. And like those who professed a moral duty not to go to war, many Spanish doctors say performing an abortion would violate their oath to do no harm—a commitment, they say, that extends to the fetus. is spread.
“One thing is that abortion makes you feel good or bad, each person will have their own criteria,” says Maria Jess Barco, another gynecologist in Zaragoza, who is an objection. “There’s one more thing that I have to do. That’s a different thing”.
The conscientiousness objection has taken hold in other countries, such as Italy, where it was invoked by doctors working in hospitals that mostly do not perform abortions. And in Argentina, there have been limited efforts to liberalize the abortion law passed last year in that country.
According to recent government figures, five of Spain’s 17 autonomous communities – on par with the states – do not have any public hospitals offering abortions. Women can continue to have abortions in private subsidized clinics, but in many cases they have to cross regional boundaries to obtain it.
Erica Espinosa, 34, had to do just that in 2015, when her gynecologist in the city of Logrono didn’t want to have an abortion after she requested it.
“Doctors try to convince you that you don’t want your baby because you want to have an abortion,” Espinosa says. “I had a feeling of doing something secretly.”
There are no official figures on how many objectionable doctors work in Spain. But the country’s left-wing coalition government is so concerned that in July Equality Minister Irene Monteiro proposed changing existing abortion laws to put limits on doctors’ ability to object.
“The prudential objection cannot be inconsistent with the rights of women, nor should it be an impediment for them to exercise their right to voluntarily abort pregnancy,” the minister said in a written statement.
These statements have received strong criticism from sectors of the Spanish medical community.
Eva Maria Martin, a pharmacist who heads the National Association for the Defense of the Right to Conscientious Objection, a group that defends medical objections, called the proposals unfair and accused the government of “radical feminism”.
“It is in the ideology of gender to the beast that women have the most freedom, leaving men lethal,” he said.
Martin said that doctors have a duty to oppose any law that prompts them to take steps deemed unfair.
“When there is a serious conflict between your conscience and the law, you cannot morally deny it,” she said, as evidence of her opinion against abortion as she had nine children.
Some doctors have advocated for abortions in public hospitals. But they say it has rarely been easy, not only because of the objectionable physicians, but also because physicians are rarely trained in procedures during medical school.
When doctor Abel Renucio arrived at the Santiago Apostol Hospital, a center in the rural town of Miranda de Ebro, his team decided to offer an abortion at first. Since members of his team were not trained to do them, he taught himself using World Health Organization protocols.
“The technique is simple,” said Renucio, a gynecologist. “We had no previous experience, but with the will it can be done.”
However, the desire to expand abortion options may be an exception.
Silvia di Zordo, an Italian researcher with the Access to Abortion in Europe project, which studies barriers to abortion, said many elderly doctors defending abortion rights developed their ideas after seeing the results of interventions. . Debate on legalization but many of those doctors have since retired.
“New generations don’t have that experience or that memory,” he said.
Among the provinces where abortion is no longer practiced is Jane, an area full of olive groves in Andalusia, southern Spain.
Juana Perragon, a feminist activist in the area, said that for a time there was a clinic that offered them, although it was not subsidized by the state and charged women about $400 for the operation.
But that clinic has been closed for years for remodeling, Paragon said. Now, about 150 miles away, many women are forced to move to Seville to have abortions.
“You see a clear proof of what the law is, in the face of the very distant distance that exists between the texts of the laws and then their application,” Paragon said, adding that a large part of Spain is socially conservative and continues to abstain from the law. to disagree. “It’s impossible to have an abortion in Jane.”
Spanish doctors such as Sobreviela, who objected in Zaragoza, said the debate was not as clearly defined as some activists have raised it.
The abortion law passed in 2010 was somewhat ahead of the state of Spanish society at the time, he said, and caught many doctors off guard.
Sobreviela said he recalled attending a meeting at a Zaragoza hospital to discuss the new law, and asked doctors and others to raise their hands on the protests. “99 percent of us had honest objections,” he said. “All, but all medical groups, nursing, assistants, orders.”
In her day job, Sobreviela continues to focus on antenatal care, diagnosing pregnant women for signs of birth defects such as Down syndrome or heart problems that can be found in the fetus.
Sometimes, she said, most of the time when the defects can be fatal, a mother asks about a miscarriage. Sobreviela says those can be very difficult conversations.
But it also warns those who decide to terminate their pregnancy. Under Spanish law, doctors can explain the possible “psychological and social” consequences of termination of pregnancy.
Sobreviela said that a day earlier, a patient had come to her after her fetus was diagnosed with heart problems.
“Girl, Fatal. I stayed with him for later, and he wanted to: ‘But he’ll be super soon, right? I want them to take the problem away from me,’” Sobreviella recalled as the woman Was going to go ahead with the abortion.
“I told her: ‘Look, the problem isn’t going to go away, they’re going to take the pregnancy away,’” he said. “The problem comes when the pregnancy doesn’t happen, when you have to live with your conscience.”
Roger Tol Pifare contributed reporting from Barcelona.