The political clash between the Spanish government, led by Pedro Sánchez, and the Community of Madrid, under Isabel Díaz Ayuso, over abortion rights and the creation of a registry for conscientious objectors remained heated yesterday, characterized by a flurry of accusations and conflicting data. The Prime Minister announced a contentious-administrative appeal before the Superior Court of Justice of Madrid against the Community for its refusal to compile a list of objecting doctors. He warned that Madrid “now diverts more than 99 percent of voluntary terminations of pregnancy to private clinics.” The Madrid president retaliated by defending healthcare professionals’ right to conscientious objection and countered with another statistic: “The PSOE of Castilla-La Mancha diverted 2,000 abortions to Madrid last year.” Both statements were accurate.
Madrid stands as a leading region in the “importation” of abortions from other communities, predominantly from Castilla-La Mancha. In 2024, the Community of Madrid recorded 20,883 abortions, with 18,081 performed on residents of the region. The remaining 2,802, or 13.4 percent, were women from other regions.
Castilla-La Mancha is by far the primary source of these referrals to Madrid. Of the 3,579 women residing in Castilla-La Mancha who underwent abortions last year, 2,021 did so in the Community of Madrid, according to official data managed by Ayuso’s regional government, attributed to the Ministry of Health. This represents almost 60 percent of women from Castilla-La Mancha choosing to terminate their pregnancies. Only two women from this region had an abortion in a public center last year.
This trend is not new for 2024 but has been consistent for years. In 2023, referrals from Castilla-La Mancha to Madrid numbered 2,046, and in 2022, 1,858. Since 2019, cases sent from that region to Madrid have exceeded 11,000. The government of Castilla-La Mancha, led by socialist Emiliano García-Page, indicated they would not engage in a “war of figures” with Madrid and chose not to dispute any of the data, which Ayuso’s government claims are “official” from the Ministry of Health.
Other regions also refer abortions to the Community of Madrid, albeit to a lesser extent. Castilla y León ranks second, with 505 women in 2024 and 366 in 2023. Galicia referred 62 abortions to Madrid last year, while the Basque Country sent 36, and Catalonia, eight.
Last year, one in five abortions in Spain was performed in the Community of Madrid, out of a national total of 106,172. Madrid also presents other significant data: 37.4 percent of women admit to previous abortions, and 1.7 percent (218 women) have had four or more.
Among the three communities with the highest number of abortions-Catalonia, Andalusia, and Madrid-Catalonia performs 55.1 percent in public centers, while Andalusia’s figure stands at a mere 0.2 percent.
Following Sánchez’s announcement of legal action against Madrid, President Ayuso again defended the right to conscientious objection for doctors, arguing they should not appear on any “blacklist” for refusing to perform abortions, nor for performing them. “We are talking about doctors, healthcare professionals, and all those people who, for various reasons, do not have to publicly declare themselves and should not be stigmatized for acting according to their conscience,” the regional president emphasized. She insisted that a court, “and not such a sectarian government that furiously drafts laws,” should decide whether a registry is necessary.
**No Public Interruptions in Extremadura and Aragon**
The reality contradicts Pedro Sánchez’s arguments. According to Ministry of Health data, no public center performed abortions in Aragon, Castilla-La Mancha, and Extremadura in 2024. All interventions in these regions were referred to private clinics or neighboring communities. Furthermore, in the autonomous cities of Ceuta and Melilla, where competencies are not transferred and directly depend on the Ministry of Health, no abortions were performed last year. Consequently, the 14 interventions in Ceuta and 151 in Melilla were exported to other communities, mostly in Andalusia.
This data faithfully reflects a consistent trend across all communities: the majority of Spanish doctors refuse to perform abortions. Thus, the public health system diverting abortions to private clinics-which Sánchez considers “an essential right, turned into a business”-is not exclusive to Madrid. It also occurs in communities like Catalonia, where years of pressure from the Generalitat have led to 69 public centers performing abortions in 2024 (compared to 14 private centers). Of the 21,761 abortions for residents in Catalonia, 45% were diverted by the public health system to private clinics.
The government’s recent moves, insisting on reversing this trend and compelling doctors to register as objectors, have caused some concern among medical collectives. They fear that defending their personal convictions could professionally impact them.
Moreover, when Sánchez stated that 99 percent of abortions in Madrid are referred to private clinics, he understated the figure. According to Health Ministry data, the precise figure is 99.53 percent. Conversely, only 0.47 percent were performed in public centers. Among the three communities with the highest number of abortions-Catalonia, Andalusia, and Madrid-Catalonia performs 55.1 percent in public centers, while Andalusia’s figure stands at a mere 0.2 percent.
**Public vs. Private**
The communities leading in the percentage of abortions performed in public centers are Cantabria (877 abortions in public centers, 88.5 percent), Galicia (2,811, 77 percent), and La Rioja (376, 76.1 percent). At the bottom is Extremadura, with zero abortions in public centers. Castilla-La Mancha had only two last year in such centers (0.06 percent). In Asturias, another community governed by the PSOE, there were 56 abortions in public centers (2.97 percent). In the Basque Country, 182 were performed in public centers, 4.32 percent. In total, in nine communities, abortions in the public health system are less than 10 percent.
With these figures, Ayuso’s PP denounced Sánchez’s “obsession” with Madrid and its president, as the head of the executive only targeted this region for having 99 percent of abortions in private clinics, with the direct criticism: “An essential right, turned into a business. We will not allow it.”
The eight communities with the highest percentage in public healthcare are the aforementioned Cantabria, Galicia, La Rioja, followed by Navarra (74.83 percent), Catalonia (55.14 percent), the Balearic Islands (45.41 percent), the Canary Islands (28.58 percent), and Castilla y León (15.46 percent).
Source: https://www.abc.es/sociedad/castillala-mancha-deriva-madrid-dos-tres-abortos-20251118041821-nt.html
