Wednesday, August 4

Conscientious objection, end of reflection period or obstetric violence: these are the Equality plans for abortion

To overturn the Abortion Law more than a decade after its approval will be one of the priorities of the Ministry of Equality in the face of the new political course. Irene Montero’s department is already working on the reform, and although a long consultation process awaits the standard, it has advanced some of the keys that it expects to be included. There is still no text proposal, which aims to be ready by the end of the year, but the announcements have already raised dust in the medical colleges, who have charged against some of these measures through the body that represents them, the General Council of Colleges Medical Officers (CGCOM).

The brochures that ultra-Catholics give to women at the door of the clinics: “When you have an abortion, part of you also dies”

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The minister advanced some of the project’s master lines last Thursday at the inauguration of More sexual and reproductive health. Towards the modification of the organic law 2/2010, a series of meetings with experts and organizations conceived as a starting point to articulate the reform. Already Antonia Morillas, the director of the Women’s Institute, who is entrusted with the task, had advanced her priorities with a view to making abortion “an accessible right, without barriers and obstacles and that does not depend on the place of residence.” declared the day of his appointment.

Among the intentions is the decriminalization of abortion, which is still found in the Penal Code as a crime, the promotion of sex education or guaranteeing access to contraception. Also eliminate the need for consent for girls of 16 and 17 years old and the three days of reflection, include obstetric violence and surrogacy as gender violence, establish measures against harassment in clinics or regulate conscientious objection of the sanitary, something that Montero defended as “essential” to guarantee access to abortion in public health.

Currently the prevailing model in Spain is that of concerts with private clinics. Thus, women do not pay for abortion while these centers took on the task more than 30 years ago due to institutional neglect. To assume this provision in the public health network, which is what the law approved in 2010 points to, the centers must organize their services and personnel based on who are or are not objectors. The norm recognizes the right of physicians, but they must declare it “in advance and in writing” so that “access and the quality of care of the provision cannot be impaired”, the law reads, but that, nevertheless, “is something that in practice it is not fulfilled “, denounces Silvia Aldavert, coordinator of L ‘Associació drets sexuals i reproductius de Catalunya.

It does not even happen in the provinces where there are no clinics to arrange the service, which means that thousands of women are forced to travel to others to have an abortion. In these cases, the public health network does not assume the interventions either, and one reason that some communities often refer to is the conscientious objection that would occur in the public service. However, the objection “is an individual right”, recalls Aldavert, “that is, a hospital and an entire autonomy cannot object, so it would be a breach of the current norm”. There are also no data on how many objectors there really are.

A registry endorsed by the Constitutional Court

Equality sources explain that one of the possibilities being studied is to regulate it in a similar way to the recently implemented euthanasia law. The norm goes one step further and obliges administrations to create a registry of objector professionals so that the Administration “can guarantee adequate management of the service” and which will be subject to strict confidentiality and data protection. And it still advances even more through the manual of good practices for the implementation of euthanasia of Health, in which it clarifies that it is an “individual, not collective” right, which health centers must know to “organize” services , but that it cannot be used to “discriminate” the professional in any way.

The CGCOM, for its part, has shown its disagreement with what it has interpreted as an attempt to “hinder” the exercise of the right: “Training the conscience of doctors to expand the number of doctors available” is “unconstitutional” and would be considered “unacceptable, illegal and unfair,” he signed in a statement. Asked about the viability of the registry, its president Tomás Cobo alludes that “it cannot be said that it is illegal”, but he does consider it “not very useful” and “we are afraid that it does not have the confidentiality it should have”. The records were endorsed by the Constitutional Court in 2014, after the appeal of the Navarrese PP against which this community developed. The judges considered that it was a measure “for organizational purposes and for an adequate management of the provision” of abortion and not “a limit to the exercise of the right to conscientious objection,” the ruling reads.

The period of reflection, “tutela del Estado”

Eliminating the compulsory consent for 16 and 17-year-old girls to abort is another of the pieces that the Ministry wants to include in the future reform of the law. This was how the 2010 rule established it, which in its article 13.4 recognized that consent corresponded exclusively to them, although it specified that parents should be informed of the decision. It was in force for five years, until in 2015 the Government of Mariano Rajoy reformed the law to prevent minors from voluntarily interrupting their pregnancy without the authorization of their parents or legal representatives. It was the last resort that the popular ones resorted to to satisfy the most radical sectors after Alberto Ruiz-Gallardón’s reform attempt, which proposed the most restrictive abortion rule in democracy, failed thanks to feminist pressure.

The idea most expanded by the ultraconservative sectors was that, supposedly, many adolescents interrupted their pregnancy without telling their mothers or fathers. An argument repeatedly denied by the specialized associations, clinics and family planning centers that serve these girls. According to a study carried out by the Association of Accredited Clinics for the Voluntary Interruption of Pregnancy (ACAI), between January and September 2014, 12.38% aborted without consent; the vast majority were emancipated girls from other countries, young people in a situation of family distress or others who claimed to be at risk of being mistreated.

This long-awaited reform by feminist organizations will also be accompanied by another of the historic demands: the suspension of the three-day reflection period. The law currently provides that, when a woman requests to voluntarily interrupt her pregnancy in the first 14 weeks of gestation, she must receive all the information on benefits, rights and aid “to support maternity” – they are delivered in an envelope whose content depends of each autonomous community – and wait three days before the intervention.

For Aldavert, it is “an imposition of the control and tutelage of the State over the body and the decisions of women”, which are not applied in any other benefit. Also from ACAI they value the proposal positively, since clinical practice has shown that “when a woman goes to interrupt her pregnancy, she has thought deeply about her decision,” explains Francisca García, president of the association. Extending the situation “implies lengthening a process that must be short in terms of time, both from a medical, emotional and personal point of view,” he adds.

Putting an end to the harassment and harassment actions denounced by the clinics in which voluntary interruptions of pregnancy are practiced will be another of the priorities that the reform of the regulations will tackle. There are several centers that are affected daily or weekly by the activity of ultra-Catholic groups that are placed at their doors or in the immediate vicinity and approach the women who enter to try to convince them not to abort or hand them blaming brochures with biased information about the intervention.

The route has not yet been decided, but the Women’s Institute is considering the establishment of so-called “security zones”, that is, a minimum distance around the centers in which there can be no demonstrations or activities of this type. , as is already the case in other European countries. The PSOE, which has also been favorable to this measure, has in turn registered in Congress an initiative for the Penal Code to punish these acts with prison sentences. However, clinics believe that regulation cannot wait for the law to be passed. The “harassment”, points out García, “is systematic” and has been taking place for years, which is why he demands “immediate protection to exercise what is a right and a health benefit” through urgent reforms.

Violence in childbirth as gender violence

Another novelty that has been discussed in recent days will be the recognition of surrogacy and obstetric violence, that which occurs in the context of childbirth, as a form of gender violence. According to sources from the Women’s Institute recently explained to, the reform “still has to make an important journey of dialogue, consultation and participation, so it is premature to determine specific issues”, but several axes are considered in this regard. : it plans to deepen awareness and training of health professionals, “modernize” current protocols and provide pregnant women with “all the necessary information on their rights”, as well as “prevent, detect and punish behaviors that violate them”.

The intention has been harshly contested by the General Council of Official Medical Associations, which reject the concept, assure that “it does not conform to the reality in our country” and consider that it “criminalizes the actions of professionals who work under the principles of Scientific rigor and medical ethics “. That despite the fact that the UN has described it as a “generalized phenomenon” and has even come to condemn Spain in 2020 for the case of a woman who reported to the body.

Asked about this, Cobo attributes the testimonies of women who denounce these practices to “isolated cases of unfortunate experiences” from which “a generality cannot be created” and reiterates his opposition to the use of “such aggressive terms to refer to medical treatments for which there is an informed consent and who have scientific evidence “. “We are willing to collaborate in protocol reviews and change what has to change, but seriously, launching alarms of this type is not prudent,” says the president of the council, with whom Morillas has already announced that he will meet.

Associations such as El Parto es Nuestro lament the Council’s “denial” and recall that the opinion issued last year by the United Nations urged Spain to “adopt public policies to combat this violence.” The organization defends that there are “many interventions that are performed routinely” – among which are usually episiotomies, the excessive administration of drugs or the growing trend towards caesarean sections – that “have nothing to do with scientific rigor and medical ethics “and that they” move away “from the indicators of care at childbirth established by the WHO and the Ministry of Health itself, they denounce.

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