Catalonia still working to expand access to abortion services

Every year there are an average of 20,000 abortions in Catalonia, the vast majority of them in the Barcelona area and other large cities.

And while around 80% of these are done through the public health system, around 40% of publicly-funded abortions are actually performed in private clinics paid by the government according to figures from 2020 to mid-2022 that Catalan News was able to obtain from the Catalan health department. 

Around half of all abortions, regardless of funding source, are done in private centers.

How we got here

Catalonia first legalized abortion almost 86 years ago at a time when it was only legal in a handful of other parts of the world. This, however, did not last long: the law was overturned by dictator Francisco Franco when he won the Spanish Civil War in March 1939 a mere year and two months later, forcing women to carry unwanted pregnancies to term or those with more resources to travel abroad. 

Women in Catalonia had to wait over 45 years to have abortions again legally when it was authorized across Spain in 1985 for three main reasons: to protect the woman's physical or mental health, in the event of a rape, or if the pregnancy involved severe fetal abnormalities. Although not officially legal on demand, for the most part women would be granted authorization by citing mental distress. 

By 2010 a new law came into effect making abortion legal upon request until week 14 and afterwards under specific circumstances. It also for the first time ever made the procedure available through the public health system - up until then women had had to fund their own abortions. 

"In 2010 we found we had the private clinics [that had been providing abortions since 1985] and the public network that did not have the resources or experienced professionals," Sívia Adalvert of the Associació de Drets Sexuals i Reproductius told Catalan News. 

Because of this, the government began paying private clinics to provide abortion care, and yet 12 years later a considerable number of women continue to receive publicly-funded services in private health centers. 

Unequal access

While it is generally easier to access abortion services in Catalonia than other parts of Spain and Catalan health authorities have been making strides when it comes to expanding care in parts of the Pyrenees and western, southern, and central Catalonia in recent months, sexual and reproductive health centers remain unevenly distributed across the territory. 

In order to have a publicly funded abortion, a woman must first go to what is known as an ASSIR, a sexual and reproductive health center. But, for example, in Terres de l'Ebre, Catalonia's southernmost region, there is only one in Tortosa for the region's four counties. 

"Women from Alcanar or Flix are an hour away from Tortosa and have to go there for a referral," Selene Alberich, a feminist activist from Terres de l'Ebre, told Catalan News. Tortosa is also home to Terres de l'Ebre's only hospital where abortions are performed, which as of this spring also allows women to have surgical and not only medication abortions. 

In other cities women may be able to get an abortion, but not choose between surgical or a medication one. As of only very recently, when medication abortions were only permitted until week 9 rather than week 14 of pregnancy as they are now, women would be forced to seek surgical ones elsewhere if they wanted to meet the 14-week cutoff. Some are still forced to travel if they need or prefer a surgical procedure.

Júlia, from Granollers, was 24 at the time of her abortion last year, and told Catalan News that she knew from the very beginning that she did not want to have a child. "I told the doctor that I wanted to do the abortion, but no, I had to wait three days and reflect," she said. 

Once she was granted authorization to have it done three days later, she was provided with a list of private clinics in Barcelona, 30km away from her hometown, that she could call to make an appointment for a surgical abortion as they only offer medication ones in Granollers. 

"I was lucky my partner had a car and he brought me to Barcelona," she said. "If you live in Lleida or in the Pyrenees or far away from Barcelona or Girona or Tarragona then maybe you have to do three or four hours by car to do the abortion."

Certain areas also have more conscientous objectors than others. While the Catalan health department refused to provide Catalan News with this information citing doctors' right to anonymity, a March 2021 report in El Crític found that 42% of public health system gynecologists were opposed to the procedure. This figure, the outlet estimates, is even higher in the Lleida area: 67% in 2020. 

And yet, every year there are hundreds of women who travel to Catalonia from beyond the Pyrenees for abortion care: since 2020, over 1,000 French women have had abortions in Catalonia, while around 300 who live in Andorra, population 81,000, have. 

France only extended the legal timeframe within which women can have abortions upon request from 12 weeks to 14 weeks in February; before then, they were forced to travel abroad to meet other countries' less restrictive deadlines. Women in the Pyrenean microstate, on the other hand, are faced with a total abortion ban, one of the few of its kind in Europe, upheld by the country's co-prince the Bishop of Urgell.