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HEALTH

What are Spain’s abortion laws for foreign residents and visitors?

With news that millions of women across the United States could soon lose their right to an abortion, we look at what the abortion laws are in Spain and find out if women overseas can fly to Spain to have the procedure.

What are Spain's abortion laws for foreign residents and visitors?
Women with slogans written on their bellies reading "Yes to life, but I choose" and "Priests and judges stay away from my body", during a protest against a proposed reform of the country's abortion law in 2012. Spain has recently banned the harassment of women having abortions. Photo: Dani Pozo/AFP

What happens if you find yourself in a difficult situation and need to terminate your pregnancy because of health or psychological reasons or even personal circumstances? Is it possible to get an abortion in Spain?

Abortion has been legal in Spain since 1985.

The initial version of Organic Law 9/1985 law allowed abortion in three cases: in criminology or rape cases within the first 12 weeks, if the pregnancy posed a threat to the physical or mental wellbeing of the pregnant woman (without a limit) or if the fetus could be born with serious physical or psychological defects within the first 22 weeks of gestation.

Then in 2010, the Law on Sexual and Reproductive Health and the Voluntary Interruption of Pregnancy was approved, allowing any woman over the age of 18 to terminate a pregnancy of her own free will during the first 14 weeks of pregnancy.

Foreign visitors

Spanish abortion law also allows foreigners to travel to Spain and have the procedure done here. Of course, foreign patients must also abide by the law set out above – ie. voluntary abortions are not possible after 14 weeks of gestation, but they can take place up until 22 weeks if there is a serious risk to the health of the pregnant woman or if the fetus has serious abnormalities or an incurable disease.  

Be aware, however, that if you are under the age of 18, you will need your parents’ consent if you wish to terminate a pregnancy.

Foreigners who do not reside in Spain cannot get abortions through the Spanish public health system and will have to pay for it privately instead. This is because they are not registered with the health system and do not pay social security to be able to access it.

Abortion clinic

Is it possible for foreigners to get an abortion in Spain? The short answer is yes. Photo: Scott Olson/Getty Images/AFP

This means that you will have to go to a private clinic or hospital instead. 

There are many private abortion clinics across Spain that are willing to treat foreign visitors, particularly in the country’s big cities, where you’ll be able to find a doctor who can speak to you in English or maybe even your own native language.

According to the latest stats from the Spanish government, there are a total of 207 authorised private abortion clinics in Spain. 

It’s unlikely that your health insurance from your home country will cover for procedures abroad, but it’s best to check with them first. 

If not, you’ll have to pay yourself. Prices for an abortion at a private clinic in Spain start at €300. 

Foreign residents

If you’re a foreign resident in Spain who is legally registered as living here and paying into the social security system, then technically you will be able to receive an abortion for free through the national health service.

However, in reality, this is not always possible as many doctors across Spain refuse to perform abortions, calling themselves “conscientious objectors”.

FOCUS: How women in Spain face barriers despite abortion being legal

So many doctors deny the procedure across the country, that there are 11 provinces in Spain, where no public hospitals have carried out voluntary abortions since the law allowed it in 2010, according to data from the Health Ministry

Furthermore, eight of these provinces have not reported abortions in the past 30 years. 

This means that if you live in Huesca and Teruel in Aragón; Ávila, Palencia, Segovia, Soria or Zamora in Castilla y León; Cuenca, Guadalajara and Toledo in Castilla-La Mancha); and Cáceres in Extremadura, it could be almost impossible for you to get a termination through the public health system.

Across Spain as a whole only 6.20 percent of all abortions, according to the most recent data from the Ministry of Health, were performed in public hospitals. Another 8.12 percent were performed in specialised centres of the public network, while a huge majority (almost 86 percent) were performed in outpatient centres of private clinics.

If you go straight to a private clinic, it’s unlikely that your social security will cover the procedure, however if you go to your public health doctor or gynaecologist first, they may be able to refer you to a private clinic, meaning that social security may be able to cover it. Be aware though, the waiting times will be a lot longer if you do it the second way. 

READ ALSO: Where in Spain is primary healthcare most overburdened?

Last month, Spain announced that it had criminalised the harassment or intimidation of women going for an abortion under new legislation approved by the Senate.

This means anti-abortion activists who try and convince women not to terminate their pregnancies could face up to a year behind bars.

According to the latest Spanish government data, the number of voluntary abortions decreased in 2020 by 10.97 percent compared to the previous year, registering a total of 88,269. 

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HEALTH

What is Spain’s trouble-ridden Dependency Law?

The landmark legislation introduced in 2006 was supposed to widen the safety net for dependent people, but a person on the waiting list for services offered by Spain's Dependency Law died every 13 minutes in 2023.

What is Spain's trouble-ridden Dependency Law?

What is Spain’s Ley de Dependencia?

Spain’s Dependency Law (Ley de Dependencia) was passed in 2006 under the Zapatero government.

It was essentially put together in order to try and construct a social, psychological and financial framework of support for dependent people. In the words of the law itself, the aim was to: “to regulate the basic conditions that guarantee equality in the exercise of the subjective right of citizenship to the promotion of personal autonomy and care for dependent persons.”

To do this, it created the System for Autonomy and Care for Dependency (SAAD), and the benefits and services offered were put in place to give dependent people not only more support but dignity.

READ ALSO: What’s life in Spain like for people with physical disabilities?

However, the law (and system) has been dogged by backlogs and delays ever since. In 2021 the Spanish government injected hundreds of millions into the system to try and improve performance, but recent reports in the Spanish media suggest that things have barely improved — as of December 31st 2023 there were 296,431 people still on the waiting list.

How does the Dependency Law work?

The support available depends on the level of dependency, something which is examined by a medical expert and then graded on a scale. In theory, the dependency level can be changed depending on how the recipient’s needs develop over time.

The law outlines the Basic Activities of Daily Living (ABVD) that the SAAD is designed to assist with: “the most basic tasks… which allow them to function with a minimum of autonomy and independence, such as: personal care, basic domestic activities, essential mobility, recognising people and objects, finding their way around, understanding and carrying out simple orders or tasks.”

The three degrees of dependency are as follows:

  • Moderate dependency (1st degree) – someone who needs help once a day to complete basic activities.
  • Severe dependency (2nd degree) – someone who needs help 2/3 times a day to complete basic activities.
  • Great dependency (3rd degree): someone who needs ongoing, permanent assistance to manage their basic needs and activities.

What are the different types of dependency?

Dependencies can be wide-ranging and often have crossovers. The law defines dependency as “the permanent state of people who, for reasons of age, illness or disability, and linked to the lack or loss of physical, mental, intellectual or sensory autonomy, require the care of another person or persons or substantial help to carry out basic activities of daily living or, in the case of persons with intellectual disabilities or mental illness, other support for their personal autonomy.”

So the four main dependency categories are physical, mental, sensory, and mixed.

  • Physical – disability or mobility issues due to age, injury or illness, that makes someone dependent on another for physical support.
  • Mental – when a mental condition (such as dementia, for example) means a person is no longer capable of making decisions or problem solving and rely on someone else to do it for them.
  • Sensory – a loss of a sense, such as blindness, makes someone dependent on another for help.
  • Mixed – someone who suffers from two or more types of dependency

What does the law offer to dependent people?

Essentially care, whether in the home or at a residency centre, or financial assistance for people caring for loved ones.

The degree of dependency is tied to the care coverage:

1st degree: 10-20 hours/month
2nd degree: 21-45 hours/month
3rd degree: 46-70 hours/month

The average amount of home help is 33.8 hours per month, which rises to 57.9 hours for 3rd degree dependencies.

The financial benefit received by those who care for a dependent relative at home is €240.17 — €369.6 in the case of 3rd degree decencies.

The average amount of state benefit linked to a residential place for 3rd degree dependents is €575: less than a third of the real cost of these services.

READ ALSO: Can I claim UK Personal Independence Payments (PIP) in Spain?

Why is the law trouble-ridden?

However, as progressive as the legislation is on paper, in reality things haven’t worked out like that.

In 2023 alone, 40,447 people died while waiting to be assessed or cared for. This works out to 111 people dying a day in Spain while on the Dependency Law waiting list.

As of 31 December 2023 there were 296,431 people still on the waiting list. The time it takes to even process a dependency application and arrange care intervention takes almost a year (324 days).

But these failures aren’t for a lack of trying (or more specifically, money) by the government. In 2021, Spain’s Ministry of Social Rights approved a shock plan that increased state funding for the SAAD to the tune of €600 million. This money was mainly used to try and resolve the backlog in case applications and widen the coverage of benefits offered.

However, the plan hasn’t really worked as anticipated.

This seems to be for two main reasons: firstly, the complexity of the procedures taking a patient from application to dependency diagnosis and finally to care — in other words, slow bureaucratic processes getting in the way.

Secondly, the cutting of funding at a regional level has made an already overwhelmed system even more stretched.

Much of the money for the Dependency Law comes from regional authorities, and in 2023 nine regions reduced their funding for dependency services, including Catalonia (by 57.3 million), Andalusia (51.6 million), Valencia (40.6), Madrid (15 million), Extremadura (11), Asturias (10.8), Cantabria (8.7), Castilla y León (7.4) and Murcia (1).

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