Background: Sweden has one of the most liberal abortion laws in the world, granting women extensive rights to make autonomous reproductive decisions. At the same time, Swedish policy-makers are keen to protect society’s religious diversity. This ambition is reflected in decisions to grant religious leaders the possibility to provide ‘spiritual care’ in public hospitals. Through interviews with religious representatives in public healthcare institutions, we asked: In what ways would they counsel a religious woman who is seeking their advice about abortion? And how does this advice correspond with Swedish policies on, and provision of, abortion care? Methods: Individual interviews were conducted with religious representatives of the Swedish Church, the Catholic Church, and the Buddhist and Muslim communities. Interviews took place in 2016 and 2017. Findings: We found that informants saw it as their obligation to provide religious people with abortion advice according to religious norms, giving them limited opportunities to harmonise the content of their counselling with Swedish healthcare laws or regulations. Most informants argued that it was their responsibility to inform women about the wrongdoing of terminating a pregnancy, and to provide suggestions about how women could mitigate the sin in order to gain God’s forgiveness. Conclusion: Informants appeared inclined to deliver religious recommendations on abortion that were more conservative than what is established in the Swedish Abortion Act. Main messages: ‘Spiritual care’ in the question of abortion favours the delivery of religious norms at the possible expense of women’s right to non-judgmental abortion counselling. ‘Spiritual care’ is now an integral part of Swedish healthcare institutions. A critical discussion is needed about the extent to which such services should be in compliance with Swedish laws and public health aims on abortion.