Guest post by Ana Ballesteros Pena and Anna Morero Beltrán, COPOLIS Welfare, Community and Social Control Research Group, University of Barcelona. In this post, the authors summarise their new article ‘The consequences of the implementation of the Royal Decree-Law of sanitary regulation RD 16/2012 on migrant women’s health.’ This post is part of the joint blog series on ‘Gender and Migration’ co-hosted by Border Criminologies and COMPAS. Posts of this series will be published in both blogs every Friday until the end of June.

In a previous post on this blog, we provided some examples of the tightening of public policies by the Spanish government targeted towards migrants undertaken in recent years. Here, we would like to summarize the main ideas of our recently published article in which we analyze the consequences of the Royal Law-Decree 16/2012 for Sanitary Regulation (hereinafter, RDL 16/2012) on the health of migrant women. This piece of legislation denies immigrants in irregular administrative conditions access to health care and preventive services, as it only guarantees free emergency health care in cases of pregnancy, childbirth and postpartum, and to immigrants under 18 years of age. The rest of the irregular immigrant population are excluded from health care, hitherto free and accessible to everyone residing in Spain. This has created what human rights organizations have called ‘medical apartheid,’ resulting in a set of violations, including deaths, of the right to health care in Spain.

A protest in Valencia, Spain, against the implementation of RD 16/2012, with the husband of Soledad Torrico Vallejos, a woman from Bolivia who died because she didn't receive appropriate health care. (Photo: Eduardo Luzzatti)
With regards to immigrant women and health care, some studies highlight the barriers which these women have to face in order to achieve an adequate access to health care services, irrespective of their administrative situation, such as differing conceptions of illness and health, the persistence of prejudices and racist attitudes, and linguistic obstacles or bureaucratic red tape―hindrances that are deteriorating within the framework of the new regulation.

Furthermore, if we focus, for instance, on the impact of the RDL 16/2012 in the prevention and detection of, and attention to, gender-based violence, the implications go even further, since primary care plays a key role in this issue. According to the Equality Ministry of the Spanish government, in 2011, this health care level contributed to identifying more than 60% of cases of violence against women detected in the whole area of the National Health System. Specifically, in the case of migrant women, research undertaken points to the over-representation of this group among victims of gender-based violence. Furthermore, public authorities are viewed as a threat rather than a source of protection, due primarily to the fear and guilt of deportation of them or their partners, of being separated from their children, or of being accused of lying, or even fear that the criminal complaint might end up with adverse effects on their administrative regulation process. Moreover, in 2004 Médicos del Mundo add to the existing data that only a minority of the women who are actually reporting male violence are submitting some form of documentation of this violence. For example, in 2012, only 11% of the 128,500 penal complaints included the reporting of lesions. In addition, to make matters more difficult, as a result of the RDL 16/2012, human rights organizations have reported attempts of health care service providers to issue invoices to victims of gender-based violence seeking to report lesions.

Regarding sexual and reproductive rights, research on migrant women and voluntary termination of pregnancy highlights an absence of easy access to contraceptive orientation services and professionals. Therefore, the exclusion of migrant women, as required by RDL 16/2012, from access to voluntary termination of pregnancy generates a clear inequality; due to the lack of financial resources of many of the women, they may seek an abortion outside of the public health care system. The only option these women may have would be to interrupt their pregnancies in an insecure and clandestine way.

'Yo Sí Sanidad Universal' is a platform in defense of the public health system.
Based on the above observations, while policy initiatives specifically aimed at protecting certain vulnerable groups (such as women suffering gender-based violence) are welcome, we find that, at the same time, other public policies restrict the exercise of rights of vulnerable populations, and irregular migrant women in particular. Under these circumstances, we need to pay attention to the inconsistency between different policies. Moreover, in the case of migrant women, it’s essential to examine the different ways in which variables such as race, administrative irregularity or social class are affecting the condition of these women as rights-holders. Otherwise, the inequalities in the protection of human rights will tend to increase.

Our full article (in Spanish) can be read here.

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How to cite this blog post (Harvard style):

Ballesteros Pena, A. and Morero Beltrán, A. (2015) Migrant Women’s Health in Spain: A Snapshot of the Consequences of the Royal Decree-Law of Sanitary Regulation 16/2012. Available at: http://bordercriminologies.law.ox.ac.uk/migrant-women-health-in-spain/ (Accessed [date]).