Alberto Stolzenburg
Speeches:
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Recent developments in Spain
Recent events and the legal, police, political
and social developments that have taken place
in Spain in recent years are part of a global and
conservative campaign and have generated in the
new political context of this country vast concern
for the rights of women regarding equality and
sexual and reproductive health.
The various recent historical stages are
discussed, from the Second Republic (1936-
1939) and the military dictatorship of Franco
(1939-1975) to democracy (1975-2012)
in relation to the legislation and practice of
induced abortion, in particular highlighting the
achievements and shortcomings of the Abortion
Law of 1985 and the current Law on Sexual and
Reproductive Health and Voluntary Termination of
Pregnancy, in force since July 2010.
The current political situation is described, with a
Conservative Government and absolute majority
in Parliament, and the statements of its main
representatives regarding the change of the current
law until end of year. Furthermore, we also present
the upcoming trial of professionals from an abortion
clinic in Barcelona and the attempt by retrograde
sectors and anti-choice groups to use this case to
put pressure on the Government and public opinion
in favour of a radical restriction of the right to abortion. -
CS11.2
Reasons for the use of medical versus surgical abortion in Europe
Alberto Stolzenburg
Clínica Ginecentre, Málaga, SpainAlthough most countries in Europe have similar abortion laws and belong to the most advanced category in the world, the implementing regulations can in practice facilitate or hinder access to abortion care. In the same way, since the legalisation of Mifepristone in France in 1988, the use of specific drugs in the abortion practice has spread in Europe unevenly but there are still significant differences from one country to another.
We classify the countries as follows:
- Countries with high prevalence of medical abortion
- Countries with prevalence of medical over surgical abortion
- Countries where both methods are used with similar frequency
- Countries with a predominance of surgical over medical abortion
- Countries with high prevalence of surgical abortion
The main reasons affecting the use of medical versus surgical abortion are:
- Legislation, administrative and health regulations
- Legalisation of Mifepristone
- Legal and off-label use of prostaglandins (Misoprostol)
- Where (type of health care facility, inpatient and outpatient care)
- Public or private institution
- Who performs abortions (gynaecologists, general practitioners, nurses, midwives)
- Conscientious objection
- Preference for usual practice ("culture") by health professionals and also the women
- Access to continuing vocational training, dissemination of knowledge (medical guidelines: WHO, RCOG, IPPF, NAF etc.)
- Scientific research, especially use of drugs in abortion care
- Political factors (conservative or liberal governments)
- Economic factors
- Cultural and religious factors
This paper reviews the impact of these factors in different European countries and regions.
Proposals are presented to improve the availability of the most appropiate method for each woman, according to their special circumstances.
Our top priorities: medical safety and free method choice for the women -
Abortion in Spain: recent developments
Alberto Stolzenburg ACAI, Spain
The current 2010 Law on Sexual and Reproductive Health and Voluntary Termination of Pregnancy recognizes for the first time abortion as a fundamental women's right. It clearly sets the health dimension of this right and provides legal certainty as well. Women have access for free to abortion on demand up to 14 weeks, in case of maternal and fetal pathology up to 22 weeks and beyond 22 weeks for very severe and incurable diseases. When the majority of Spanish society has gone in the last years through democratic values regarding abortion, the Government strives to change the current law even though 80% of the population reject the draft law and 68% of their own voters believe that women should decide themselves. Meanwhile the abortion rate in Spain keeps stable and is similar to other countries of Western Europe. The preliminary draft of Justice Minister Gallardón specifies these and other realities and seeks to placate the most reactionary wing of the Spanish right. In this way, abortion will be allowed only under two conditions: rape and serious maternal diseases, eliminating fetal deformations as a reason. At the same time, it establishes a medical and legal journey of such magnitude, that in practice it makes abortion impossible even for the legal reasons mentioned. In addition, this law penalizes severely health professionals, deepening the stigma and the legal uncertainty that have marked them. The draft law is pending approval by the Council of Ministers. An approval that has been awaited by the strong social and political opposition and internal contestation among the Executive and the ranks of the Popular Party. If finally the Parliament approves the draft this year, Spain would have in 2015 the most restrictive law of the democratic era.