Legalized abortion in Catalunya, Spain: Women’s experiences with accessing care
Abortion
Awarded 2012
Small Research Grants
Bayla Ostrach, MA
National Network of Abortion Funds
$15,000

Women in Catalunya (an autonomous nation often seen by outsiders as part of Spain) currently have legal access to publicly funded abortion care for any reason in the first trimester, and under a set of qualifying circumstances in later trimesters, within a public health system. This makes Catalunya a rare departure from the overwhelming example of countries throughout the world where abortion is illegal, heavily restricted, or otherwise difficult to obtain. Even in the many European countries, some parts of North America, and seventeen states in the US where abortion is legal, available, and publicly funded for eligible women, gestational limits, waiting periods, mandatory counseling, and burdensome travel to reach a provider may apply. But many women in Catalunya, who arguably live in a setting of ideal abortion access, also experience delays, bureaucratic obstacles, and logistical hassles when they navigate the public health system to obtain care; and may also face the same social and stigma-related difficulties that most women seeking abortion report. If women who ostensibly have the best possible access to abortion still encounter obstacles to care, what does this say about the efficacy of abortion law reforms? About the enforcement of new policies in public health systems? About the extent to which even legal abortion, because of stigma, may be offered only grudgingly and not as an equal part of a full spectrum of reproductive health care? Through an intensive mixed-methods study grounded in Applied Medical Anthropology, this study combines data collected over ten months in anonymous surveys (n=350), open-ended interviews (n=22), and participant-observation (two or more days per week in a contracted clinic and with a women’s health NGO). Women’s experiences with, and perceptions of, various obstacles to abortion access in the public health system; and other obstacles, are analyzed alongside the perceptions of abortion providers and women’s health advocates, to illuminate the impact of policy changes on the accessibility of legal abortion in the region. These findings have implications for policymaking, health system reforms, and public health.

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