The health system in Galicia, northwest Spain, was ordered to compensate a woman who lost her uterus after a hospital refused to do an abortion as an emergency obstetric procedure and sent her 354 miles to Madrid, so that she nearly lost her life. The events happened four years ago. The woman learned that the fetus she was carrying had an anomaly incompatible with life only seven months into her pregnancy, due to errors during antenatal diagnosis.
She was then unable to find anyone who would terminate the pregnancy, either in her own town in Galicia or in any of Galicia’s other public hospitals. Eventually, the Galician public health service, SERGAS, declared that “in order to respect the professionals’ right to objection on moral grounds”, the authorities would pay for termination of the pregnancy in a private clinic in Madrid, by which time she was into her 32nd week of pregnancy.
She had to make the trip by car with her partner. She had been having vaginal pains for some days but was told by the hospital it was just wind. In fact, the pain was due to an irregularity in her uterus, affected by the pregnancy. By the time she arrived at the clinic in Madrid, she was bleeding heavily and had to be transferred to a hospital for an emergency caesarean section to remove the fetus, which died soon after. Her uterus had to be removed to stop the bleeding, so now she is unable to have any more children.
The Galician public health service has been ordered to pay out €270,000 in compensation for negligence. This negligence has caused “physical and psychological damage for which there is no compensation”, according to the magistrate who ordered the payment. The woman has been receiving counselling since her loss. Following the court’s decision, the President of Galicia made a public apology to Paula – not her real name – on behalf of the authorities, while declaring he would looking for a formula that would reconcile the right of Galician women to an abortion with doctors’ rights to object on moral grounds to carrying out an abortion.
Paula’s lawyer, Francisca Fernández, says that her client’s case is by no means an isolated one. She has been involved in two other cases where women are suing the public health services in Galicia on account on consequences of conscientious objection. Objection to performing an abortion on moral grounds is covered by Spain’s 2010 abortion law (Article 19.2) but only as long as it does not affect the patient’s access to care. The 2010 law also says that the termination of pregnancies due to fetal anomaly or incurable illness should preferably be carried out in public health service centres as they are more complicated and often required in later pregnancy.
Yet a report entitled “Deficiencias e inequidad en los servicios de salud sexual y reproductiva en España” compiled by 13 organizations and published by Médicos del Mundo, highlights that in 2014, not one abortion was carried out in public hospitals in Aragon, Extremadura, Castile-La Mancha and Murcia: all were referred to private clinics.
The President of the National Federation of Family Planning (FPFE), Luis Enrique Sánchez, believes that one of the main reasons that some public hospitals don’t carry out abortions is that the health authorities have not insisted on it as an obligation, allowing gynaecological units to dodge the issue, citing organizational difficulties, a shortage of surgeons or other resources for doing so. “It’s a lack of political will from those in charge of health,” says Sánchez.