Spain could be the next European country to explicitly include the right to abortion in its Constitution at the same time the national government in Madrid is pressing regional governments to create lists of medical professionals who are conscientious objectors to abortion.
In 2025, France became the first country in Europe to enshrine abortion as a constitutional right. In Spain, though the Socialist minority coalition government led by Prime Minister Pedro Sánchez filed a bill in October to change the Constitution, analysts believe the proposal has almost no chance of passing. They say the effort is a political tactic to raise abortion as a prominent issue in upcoming regional elections.
The proposed constitutional change would add a new clause to Article 43 of the 1978 Constitution, stating: “The right of women to voluntary termination of pregnancy is recognized.” It adds that “the exercise of this right shall, in all cases, be guaranteed by the public authorities, ensuring its provision under conditions of effective equality, as well as the protection of women’s fundamental rights.”
Constitutional changes require approval by three-fifths of the Spanish Parliament or a simple majority in a national referendum. But both the center-right People’s Party and the far-right party Vox have said they will support neither the amendment nor a referendum, making passage of the constitutional change impossible.
The coalition supporting Mr. Sánchez holds its majority in the Congress of Deputies by only one seat. Spanish political analysts believe Mr. Sánchez’s objective is to make abortion an important issue in next year’s regional elections, which his party looks likely to lose, at the same time it faces multiple scandals and the inability to pass a budget.
The Socialist government led by Mr. Sánchez “needs to stoke fear of the ‘far right’ and the supposed ‘social cuts’ that [a far right] victory would entail,” Miguel Gómez, president of Professionals for Ethics, a Catholic organization dedicated to promoting human dignity and the common good in public life, explained in an email to America. “Abortion is a card they can play.”
This latest round of the abortion culture war in European politics broke out at the end of September, when the Madrid city council passed a motion to include information on post-abortion syndrome among health information tracked by the city health officials. City council members from the far-right Vox party proposed the measure. It was supported by the center-right People’s Party and approved.
The reaction from the political left was swift. Speaking from at a conference in Copenhagen, Mr. Sánchez promised, “The government will protect the right to abortion in the face of the sectarian ideology of the P.P. and Vox.” By Oct. 14, the government had formally set in motion the legislative process to amend the constitution.
An important part of the debate has been the question of doctors and nurses who conscientiously object to performing or assisting with abortions.
A change to Spain’s abortion law in 2023 added a requirement that regional governments, which manage their respective provincial public health systems, establish registries of conscientious objectors to abortion. That measure had also been included in the 2021 law that decriminalized euthnasia and assisted suicide. The requirement has been controversial.
Supporters say it ensures that there are doctors available to perform abortions so the government can fulfill its obligation to ensure women have access to abortion. Objectors to the law, including many doctors, consider the registry a “black list” meant to intimidate and eventually discriminate against medical professionals who refuse to participate in abortions. They also argue that if any list is needed to ensure access to abortion, it should be a registry of doctors willing to perform them, not of those who are unwilling.
Most regional governments—whether governed by the political left or right—have created the required registries. Four, including the Madrid region, which includes the nation’s capital, are out of compliance and received letters from the ministry of health in October warning that they have a month to get started on their registries or be taken to court.
The regions of Asturias, Aragón and the Balearic Islands agreed to comply, but the regional president of Madrid, Isabel Díaz Ayuso, a young, charismatic and very popular People’s Party member, reiterated her previous refusal to create a list of abortion objectors on the grounds that it violated Spain’s Constitution.
Though Ms. Ayuso personally supports legalized abortion, she has repeatedly lamented the high number of abortions that take place in Madrid and described abortion itself as a social failure. She told her opposition in the regional Parliament that if they did not like her policies they should “go somewhere else to get an abortion.”
Abortion access advocates responded with a demonstration against Ms. Ayuso.
In 2024, 106,172 abortions were carried out in Spain, according to a government report. Nationally, 78 percent of them were conducted in private clinics that are contracted with the government to provide the procedure. At the regional level, though, the percentage of abortions that take place in public health centers varies.
In Madrid, 100 percent of abortions are conducted in government-contracted private clinics. But in Galicia, La Rioja and Navarra, about 75 percent of abortions take place in public health centers. In the Balearic Islands, which has not yet created a registry of conscientious objectors to abortion, 61 percent of abortions take place at publicly operated hospitals or clinics.
According to Mr. Gómez, registries of objectors appear to be inevitable in Spain, but what consequences that may have for registrants over the long term is unknown. So far, the group has not found any negative consequences or instances of professional discrimination because of the registry. Professionals for Ethics explains in its Guide to Conscientious Objection that Spain’s Constitution confirms the right to object because of conscience to abortion with the expectation that medical professionals should be free to do so without fear of institutional sanction or retribution.
Nevertheless, Mr. Gómez warns, “just the registry itself is an attack on freedom of thought and puts doctors at risk.”
“If there weren’t going to be negative consequences, what would be the point?” asked Manuel Martínez-Sellés, president of the Medical College of Madrid. According to Dr. Martínez-Sellés, many doctors who object to performing abortions have not registered and will not do so. He is among those who have refused to add their names to the list.
If the government is intent on ensuring that access to abortions is secured at all public hospitals, it may find itself caught in a conundrum of its own making, Mr. Gómez said. He noted that in Melilla, a Spanish exclave on the coast of North Africa, all the doctors in the region have registered as conscientious objectors to abortion.
And some abortion access advocates warn that adding the abortion amendment to the Constitution does not guarantee greater access to abortion. Speaking with the Spanish news site Newtral, María Garrote, a professor of constitutional law at Complutense University in Madrid, argued that including abortion explicitly in the Constitution would make it easier in the future for legislators to regulate abortion, even to add restrictions or conditions on the procedure.
In any case, the question of abortion restrictions, whether on women or medical professionals, will apparently remain a hot topic in Spain for the foreseeable future.
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