Accessing emergency contraception in Germany means going to the doctor for a prescription. This is no easy task at night or at weekends, and an “unnecessary barrier,” Ines Thonke of Germany's female heath umbrella organization, the Nationales Netzwerk Frauen und Gesundheit, told The Local.
In 28 other European countries, and 79 worldwide, emergency contraception is available over the counter in a pharmacy. “These countries serve as evidence that over the counter works,” said Thonke.
German health policy makers maintain that the pill has dangerous side effects and warrants a doctor's consultation.
Yet the World Health Organization (WHO) disputes this. “There is no scientific reason to support there being a real risk of serious side effects,” Thonke explained. “The biggest risk is taking it too late.”
For Thonke and Pro Familia – the country's largest family planning organization – this refusal to change the law in Germany comes down to money. “The more women come into a doctor's clinic, the more money they get,” she said.
“Germany's doctor lobby group does not want it [the pill] to go off prescription.
“They are using the argument that women need a consultation but they know full well that this does not happen – receptionists hand out the prescription without a doctor involved.”
Medical, not moral
The Social Democrats, who are the junior partner in the coalition government, agree and have added their voices to those calling for a change to the law. “It is not an abortion drug, as opponents often claim, but an emergency contraceptive that prevents against unwanted pregnancy, which can lead to an unwanted abortion,” party health politicians said in a statement.
And the number of abortions generally drops when a country takes the drug off prescription, a parliamentary committee found last year.
In 2013 the debate over the pill got political, with the ruling Christian Democrat Union (CDU) turning down requests from opposition parties to change the law, twice.
On Thursday in a parliamentary debate, the CDU stuck to their guns. They are, Thonke said, “handling it as a moral issue, not medical one”.
The CDU has two main arguments – there are dangerous side effects and women need a full medical consultation before being prescribed the pill.
Powerful lobby group the National Association of Statutory Health Insurance Physicians backs the CDU, saying in a statement that the “morning after pill belongs in medical hands”.
Germany's Health Minister Hermann Gröhe, also from the CDU, is against changing the law.
But Thonke said: “He is not a medical expert and we believe he has been ill-informed about the matter.”
For the CDU, the interaction between a woman and a medical professional “strengthens a woman's self-determination and gives them a sense of safety,” parliamentary state secretary Annette Widmann-Maus said in the Bundestag on Thursday.
‘The pill is safe’
But the Federal Institute for Drugs and Medical Devices (BfArM) put out a statement earlier in February which said it saw no reason for the drug to be signed off by a doctor.
“There are endless studies that show the pill is safe,” Regina Wlassitschau of Pro Familia told The Local. “Having to go to the doctors, means that women especially in rural areas face difficulties taking it in time.”
Taken within 72 hours, the morning after pill prevents an egg from being released. It does not work if an egg has already been fertilized.
The health ministry maintains that Germany is geared up for women anywhere in the country to access medical help even on weekends.
But Wlassitschau disputed this, and the SPD agree. “Getting a prescription can be problematic for women in lots of rural or Catholic parts of the Germany, where they can face derogatory comments from clinic staff,” the party said in a statement.
Indeed, Catholic clinics can still refuse a woman the drug. Only last year it emerged that doctors at a Cologne hospital had told a rape victim that she could not have it.
The Church subsequently changed their stance, but only for victims of assault – not for women who need it as a result of regular contraception failing.
“Fears that people are more sexually irresponsible in countries where it is available over the counter are absolutely unfounded,” Wlassitschau added.