Spain moves to allow medication abortions in primary care health centres
Health Minister Mónica García announced regulatory changes to permit medical abortions at local health centres, shifting mifepristone administration outside hospital-only settings.
Primary care expansion
On 28 September 2026, marking International Safe Abortion Day, Spanish Health Minister Mónica García announced that her department will incorporate medical abortion into the primary care service portfolio. The initiative aims to allow women to undergo voluntary terminations of pregnancy at local health centres instead of travelling to accredited hospitals or private clinics. Speaking in Madrid alongside Equality Minister Ana Redondo at the opening of an event titled 'Abortar sin barreras', García explained that the reform seeks to make decisions easier by eliminating logistical and emotional hurdles.
We want women to choose the method and to be able to access it through their health centres, with clear, precise information, trained professionals, and support before, during, and after.
Regulatory and pharmaceutical changes
To implement the change, the Ministry of Health is initiating three distinct regulatory steps across the national healthcare system. First, the ministry will amend the royal decree that regulates the authorization of health centres, adapting its requirements so primary care clinics can legally provide voluntary pregnancy terminations. Second, authorities will modify the official technical specifications of mifepristone, an active ingredient currently restricted to hospital use under the supervision of specialists in gynaecology and obstetrics for pregnancies up to nine weeks. Third, the administration will update the Common Services Portfolio of the National Health System to formally include medication abortion in primary care consultations.
The standard medical abortion protocol involves an initial oral dose of 200 milligrams of mifepristone to block progesterone, the hormone sustaining gestation, which detaches uterine tissue. Between 36 and 48 hours later, the patient takes a second pharmaceutical compound that induces uterine contractions and bleeding to expel the gestational contents.
Regional differences in procedure methods
The reform addresses substantial disparities in how voluntary pregnancy terminations are managed across Spain's autonomous communities. In 2024, the pharmacological method predominated in regions where the vast majority of procedures took place in public healthcare facilities.
- Cantabria
- 86.4 %
- Navarre
- 76.5 %
- La Rioja
- 68.2 %
- Galicia
- 68.1 %
By contrast, in autonomous communities where abortions are performed predominantly in contracted private centres, surgical methods continue to account for the large majority of cases.
- Madrid
- 94 %
- Andalusia
- 86 %
The Ministry of Health will present the initiative to the Interterritorial Council to coordinate implementation with regional health authorities and medical professionals across the country.
Legal obligations and conscientious objection
García emphasized that all autonomous community governments have a legal obligation to guarantee access to voluntary pregnancy terminations. The minister stated that regional health departments must comply with national legislation rather than creating administrative obstacles.
Conscientious objection must be organized so that women receive care, and no prejudice can serve as an excuse to block it.
García also added that officials holding government responsibilities must abide by national healthcare law or face ministerial opposition. The proposals now proceed to technical and regional consultations to establish the required clinical workflows and training in primary care centres nationwide.
