Ayuso surrounded in another conflict over abortion: public hospitals in the capital do not guarantee women's right

The decision for a woman to carry out the voluntary termination of her pregnancy is a constitutional right that the Community of Madrid, presided over by Isabel Díaz Ayuso, does not uphold in the capital. The Madrid native, who has shown various contradictions over the years regarding her stance on the right, refused to draw up a list of conscientious objectors, an essential step to guarantee women's rights.

However, Ayuso's Executive had to initiate the procedure to establish this registry last April, after the Supreme Court urged it to do so. The purpose of this mechanism is to know which healthcare professionals avail themselves of this right and, based on that information, to be able to organize the necessary resources so that individual objection does not end up preventing women from accessing a legally recognized service in public healthcare. Nevertheless, Ayuso's Government keeps the creation of the registry paralyzed while its judicial battle with the Ministry of Health continues.

The situation has been reflected in a file from the Madrid Health Service (Sermas) to contract private centers to perform voluntary terminations of pregnancy for patients referred from public hospitals. According to an investigation published by 'EL PAÍS', the tender document expressly acknowledges that "in some public hospitals" in the region "the performance of abortions cannot be guaranteed," among other reasons, due to the conscientious objection of healthcare personnel. The document corresponds to a framework agreement promoted by the Hospital Universitario El Escorial to have external centers to which patients can be referred when the service cannot be performed with their own resources.

The data advanced by the media also highlight the reduced weight of Madrid's public healthcare in this service. In 2024, the last year with available figures from the Ministry of Health, 18,149 voluntary terminations of pregnancy were performed in the Community of Madrid. Of all of them, 99.53% were performed in private centers, while the participation of public hospitals was residual.

The situation coincides with the position Ayuso has maintained in recent months regarding the registry of objectors. On October 9, 2025, during an intervention in the Madrid Assembly, the president refused to create what she called a "black list" of objecting doctors. "No one will be singled out for having an abortion, but neither for not doing so. And no doctor will be singled out for performing an abortion or for not wanting to perform one," she affirmed then. In that same intervention, she even responded to the parliamentary left: "Does that seem too little to you? Well, go somewhere else to have an abortion."

The Community defends, however, that abortion is available in its public hospitals. The Ministry of Health has assured EL PAÍS that "this service can be provided in any public hospital in the Community of Madrid" and added that, at the same time that Sermas guarantees access to the service, it also protects "the absolute freedom and right of the doctor to object."

Law of the "unborn conceived" to curb abortion rights

The plenary session of the Madrid Assembly approved on July 2, with the favorable vote of the PP and Vox, the law promoted by the regional president, Isabel Díaz Ayuso, to recognize the unborn conceived, for administrative purposes, as another member of the family unit.

This law allows families to access aid and tax benefits derived from the birth of the baby from the moment pregnancy is accredited, although in some cases a minimum number of weeks of gestation is stipulated. This law was approved in an expressly convened plenary session, as it was planned to be raised to the last one of the ordinary session period, that of June 18, but the Assembly Bureau paralyzed the processing of the text the day before after the PSOE-M warned that the administrative file that reached the Chamber was incomplete.

Thus, the 'nasciturus' will be taken into account from the moment pregnancy is accredited in aid that uses family unit income as a criterion, such as scholarships to study Bachillerato or the first cycle of Early Childhood Education. In addition, families with two children who are expecting a third will be able to access it from the day after the end of the 14th week of gestation. The text establishes the need for a specific certificate of "family assimilated to large family", the obtaining of which will be mandatory to access the benefits, and which will be valid until three months after the expected date of delivery.

And in the case of multiple gestation, each of the conceived will be taken into account separately for the purposes provided in the law. During the processing of the law, three amendments from the PP have been incorporated. One to homogenize the minimum week of gestation required in each case, another that enables the Government to develop the norm through decrees and regulations, and a last one to guarantee that the procedures can be carried out both telematically and in person. The law will be in force from the day after publication.

From "legal and safe" abortion to policies for the "unborn"

The vision of the right to abortion of the Madrid president has changed over the years. Ayuso now defends that, "every life matters from the first breath" and her Government is "legislating for the unborn", statements that represent a shift from the position she expressed in 2023, in an interview on 'Antena 3' with Susana Griso, when she stated that abortion "should be legal, safe", although she qualified, "infrequent", which evidences a contradiction between her defense of the right to abortion and the current policies of her Executive, aimed at incentivizing the continuity of pregnancy through different public supports.