Access to abortion in a cross-border region in the Eastern Pyrenees: the case of Hospital de Cerdanya, between Spanish and French legislation.

In the present debate paper, authors seek to bring attention to the situation regarding abortion access in La Cerdanya - El Capcir, a cross-border region in the Pyrenees between Spain and France. Hospital de Cerdanya (HC) is the first cross-border health centre in Europe. It is placed in a high-altitude isolated mountain region, and the few physicians in town are conscientious objectors. An agreement with a tertiary hospital from Barcelona allows a gynaecologist to commute to the region weekly to guarantee the right of women to access abortion. In 2023, 67 abortions have been performed in HC: 58 pharmacological terminations and 9 surgical abortions. The Hospital protocol is described and data on the performed procedures are reviewed. Since requested until provided, mean time to pregnancy termination has been of 6.79 days. Difficulties in accessing health centres and professionals that women living in isolated areas experiment explain the major disparities among abortion rates in different regions, which are notable in Spain. Abortion rate in La Cerdanya is 13.7‰, showing no statistical difference compared to the global Catalan rate. Experiences such as the one at HC may be of interest in developing new protocols to address territorial inequities related to access to abortion.