ABSTRACT

Structural factors made the process of obtaining and providing legal, publicly funded abortion through the health system in Catalunya more difficult than it should have been, according to policy at the time. This research identified a clear disconnect between policy and practice. To reiterate one glaring example, nearly half of all women who participated were not aware the health system referral voucher they had already obtained from health system staff would fully pay for their abortion. Like two parallel elevators going to two different floors, one traveling upward and one traveling down, practical access to abortion care in the Catalan public health system began to deteriorate, in part due to austerity cuts and bureaucratic/structural failings, even after policy changes expanded legal access to abortion in Spain and Catalunya, ostensibly increasing women’s rights to seek such care.