Madrid Begins Procedures for Abortion Objectors’ Registry Following Court Order
Madrid, April 2, 2026 – The Community of Madrid has officially begun the administrative process to establish a registry of medical professionals who exercise their right to conscientious objection regarding direct involvement in abortion procedures. The draft order from the Ministry of Health was published on the Transparency Portal this Wednesday, opening a 30-day public consultation period.
This step marks the commencement of the registry’s creation, mandated by a ruling from the Superior Court of Justice of Madrid (TSJM). The TSJM’s decision upheld a precautionary measure requested by the State Legal Service, acting on behalf of the Ministry of Health, in response to the regional government’s administrative inaction.
Judicial Mandate and National Coordination
The national legislation stipulates that each Autonomous Community must create a registry of health professionals who object to participating in abortion procedures. While the judicial resolution did not demand immediate creation, it compelled the Community of Madrid to initiate the necessary administrative steps and implement the registry in accordance with protocols agreed upon within the Interterritorial Council of the National Health System (SNS).
On December 16, 2024, the SNS approved coordination instructions for implementing the registry across all health administrations. This agreement was unanimously adopted with the participation of all autonomous communities and is considered a binding instrument for administrative coordination.
Ministry of Health’s Ultimatum and Legal Action
In light of this, on October 14, 2025, the Ministry of Health issued a formal request to Aragon, the Balearic Islands, and the Community of Madrid, granting them one month to respond regarding the registry. After the deadline passed on November 15, the Minister of Health announced that the government would initiate legal proceedings.
Consequently, the department led by Mónica García announced on January 16 the filing of an administrative contentious appeal. At that time, the Minister of Health for the Community of Madrid affirmed that the regional government would defend, “with the Constitution in hand,” the freedom of objection to abortion.
Community of Madrid’s Stance and Ayuso’s Opposition
The Community of Madrid has argued that creating the registry is an organizational measure requiring regulatory development, and its precautionary imposition could preempt the outcome of the main legal process. The autonomous administration also maintained that the healthcare provision for voluntary termination of pregnancy is fully guaranteed within its health system through its own organizational mechanisms. In cases where all professionals in a particular service exercise conscientious objection, patients are referred to authorized centers that can provide the service.
The Ayuso Executive has asserted that the Community “is complying with the guarantee of the right to conscientious objection for doctors and with the provision of voluntary pregnancy termination services.” Miguel Ángel García, the government spokesperson, recently stated, “We have self-organization capacity recognized by law, by the Statute of Autonomy of the Community of Madrid.” He added that their administration has “perfectly organized the service to make a right, such as that of doctors, compatible with the provision.”
Ayuso has repeatedly insisted that she will “never label” or “point out” doctors who do not wish to perform voluntary terminations of pregnancy, famously stating, “Go elsewhere to have an abortion.”
Minister Warns of Potential Disqualification
Conversely, the Minister of Health has warned the President of Madrid that her refusal to create the objectors’ registry could lead to her disqualification from holding public office, under Article 410 of the Penal Code.
Related elements have highlighted the ongoing tension: Ayuso’s warning that she will “never create” a “blacklist” of objecting doctors and García’s denunciation of Ayuso’s “ultra drift” for not presenting the registry, accusing her of “attacking women and the law.” The Ministry of Health has also criticized Madrid and Andalusia, noting they account for almost 50% of abortions, with 99% of them referred to private centers.
