Deficiencies in social and health care during voluntary termination of pregnancy in Spain: Women’s experiences and perceptions

Abstract

Objective To explore women’s experiences with health and social care during voluntary termination of pregnancy (i.e., abortion) in Spain and to identify areas for improvement in the quality of care provided throughout the process. Methods A qualitative study was conducted using semi-structured interviews with 30 adult women who underwent a voluntary termination of pregnancy in Spain between 2013 and 2023. Participants were selected to ensure diversity in age, educational level, and geographical region. Interviews were analysed in Atlas.ti using a two-phase deductive-inductive approach, whereby an initial coding framework informed by the literature was refined through the inductive identification of emergent codes and themes from the data. Results Women’s experiences were strongly influenced by the quality of care received throughout the abortion process. During the pre-abortion stage, participants reported inadequate information and guidance, insufficient sensitivity and empathy from professionals, non-consensual practices, stigmatizing attitudes, attempts to dissuade them from abortion, and barriers to access from conscientious objection and uneven service provision. During the abortion procedure, women described insufficient information about the intervention, inadequate pain management, denial or improper administration of anaesthesia, and impersonal or unsympathetic treatment during recovery. In the post-abortion stage, deficiencies included inadequate medical follow-up, pressure to adopt contraceptive methods, and limited access to psychological support. Overall, participants’ accounts revealed a pattern of shortcomings that negatively affected their emotional well-being and experiences across all stages of the process. Conclusion The findings highlight systemic deficiencies in health and social care during voluntary termination of pregnancy. Improving abortion care requires person-centred, non-judgemental, and evidence-based services that guarantee adequate information, respectful treatment, timely access, informed decision-making, effective follow-up, and psychological support. Strengthening professional training and implementing mechanisms to monitor and improve quality of care are essential to safeguarding women’s sexual and reproductive rights and enhancing their experiences throughout the abortion process.