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HEALTH

How German reproductive laws are pushing women to seek therapy abroad

High costs and restrictions around egg donation are driving international women in Germany to seek reproductive therapy abroad. But the traffic-light coalition has promised that change is on the way.

A woman takes a pregnancy test.
A woman takes a pregnancy test. Photo: dpa/CLARK

Berlin resident and freelance writer Laura Rosell is currently 37, and “always wanted kids,” but isn’t ready to have them yet.

As a compromise, this spring she bit the bullet and underwent egg extraction for the purpose of freezing eggs for the future. It wasn’t her first choice.

“I never thought I’d be pushing 40 while having to inject myself with a pricey cocktail of hormones to preserve any sliver of a chance of maybe being able to make babies one day with the love of my life,” she wrote in an essay on Medium

And she struggled with the decision: in a much-discussed post in International Women In Berlin, Rosell spoke frankly about her worries regarding the costs of the procedure, which isn’t covered by German health insurance.

“Financial struggle has been my entire adult life,” she said candidly. Freezing eggs meant losing what little financial cushion she had.

“I go back to being broke: unable to travel, unable to take time out to write my book, unable to socialise much (and meet men) — basically all the things I want to do before I’d feel ready to have kids in the first place,” she explained.

But other avenues to motherhood are difficult in Germany as well—with Rosell’s age, she foresaw potentially impassable obstacles to any attempt to adopt. Meanwhile egg donation remains illegal in Germany, both with regards to availing oneself of donor eggs, and to altruistically donating extra eggs from an expensive extraction-and-freezing procedure to other women.

“I asked about donating my eggs to someone else if I don’t use them, and the doctor told me this is one of the countries that prohibits donating eggs,” she recounted.

In the end, to preserve her chance of having children further down the road, Rosell accepted the costs. “Two weeks of prep, thousands of dollars… and I got just three eggs,” she wrote.

READ ALSO: OPINION: Germany, we need to talk about sexism

Labyrinthian procedure

The dilemma that Rosell was faced with is a familiar one for women in a country in which reproductive issues are tangled up in a labyrinth of laws and high costs.

In-vitro fertilisation (IVF), while legal, is comparatively expensive in Germany, a fact that drives many women to seek care elsewhere.

While IVF and egg freezing were often cheaper in countries like Poland, Bosnia and the Czech Republic, it isn’t merely a question of cost—the freedom to avail oneself of donor eggs, or in turn to donate away excess eggs from an extraction procedure for personal freezing, remains out of reach in Germany.

Expat women who responded to Rosell’s post on Facebook spoke of traveling to Denmark, for instance, to be able to have egg donation as an option.

Eggs are prepared at a fertility clinic in Berlin. Photo: dpa | Rainer Jensen

But Germany’s new centrist coalition plans to bring about changes. At least regarding the cost of basic IVF and which constellations of parental units are able to benefit, hope is on the horizon.

The coalition agreement promises improved financial support for IVF, with full coverage of the costs, independent of familial status and sexual orientation. Restrictions on age will also be up for critical review.

Yet the question of enabling egg donation remains a matter for a new special commission to explore, along with strictly altruistic surrogacy.

‘Swift implementation’

The Free Democrats (FDP) have introduced drafts of legislation in the past in support of legalising egg donation, but these failed to make it past the previous coalition of Union and SPD.

In public debates surrounding the issue, the German Medical Association (Bundesärztekammer) came down in favour of regulated legalisation, while assorted lobbying groups, including organisations with theological ties, argued against it.

“Other parties are still going through the process of consolidating their opinions on these topics,” Katrin Helling-Plahr, legal spokeswoman for the FDP told The Local.

She expressed confidence that the traffic-light coalition’s plan to appoint a commission on reproductive self-determination would “contribute to an open and broad debate” around the opportunities offered by reproductive medicine.

“Then we could also see further possibilities for reforms towards a modern law—with elements like the legalisation of egg donation or surrogacy for purely altruistic reasons,” she said.

“With the coalition contract, we have succeeded in reaching a new beginning in the legal framework for reproductive medicine,” said Helling-Plahr. She promised that her party would work for a “swift implementation” of these goals in the area of reproductive medicine, and would “continue to advocate for the legalisation of altruistic surrogacy and egg donation.”

The timeline for all these intended and potential changes, however, remains up in the air.

The aforementioned goals are under the aegis of the Federal Ministry of Health,” explained Helling-Plahr. “They are currently working to a timetable that at this point in time I haven’t seen.” 

READ MORE: Do Germany’s planned changes to abortion laws go far enough?

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OPINION & ANALYSIS

Why the Greens are the real winners of Germany’s state elections

German state elections don't tell us everything about the public mood, but the past few votes have revealed some pretty clear winners and losers. While support for the SPD is flagging, the Greens are growing in stature by the day, writes Brian Melican.

Why the Greens are the real winners of Germany's state elections

It’s one of the peculiarities of Germany’s federal system that we’re almost never more than six months away from an election being held somewhere. Alongside the national elections (Bundestagswahl) usually every four years, each of the 16 states also hold ballots (Landtagswahl) on varying cycles; then there are local and mayoral elections, too. As such, rolling campaigning and more-or-less continuous election analysis are a part of life here: “What does Election X say about Government Y?” is a question you will always hear being asked somewhere.

Nevertheless, regional elections have a habit of clustering – and generally come at points when national governments would rather not have people poring over electoral data. And this year, after barely six months in office, Olaf Scholz’ novel tri-partite traffic-light coalition has already been faced with three regional elections – in Saarland (27th March), last week in Schleswig-Holstein (8th May), and yesterday in North-Rhine Westphalia (15th May). On a regional level, the popularity of the Social Democrats (SPD), Greens and Free Democrats (FDP) has already been thoroughly tested. 

Understanding state elections

The key thing to remember about German regional elections are that they both are and aren’t about national politics. Firstly, here’s how they aren’t. At a basic level, these regional elections are simply about voters choosing a government to deal with state-level remits (mainly health, education, and housing). They will vote first and foremost on these issues.

Personality politics are also important: long-serving German state premiers frequently garner the unofficial honorific Landesvater or Landesmutter –  literally: ‘father/mother of the state’ – and benefit from high personal approval ratings, allowing them to withstand changes in mood at national level. So it is by no means infrequent for voters to return completely different parties in regional than at national elections. By way of example, while Olaf Scholz, SPD, remained a popular Landesvater figure in Hamburg, Merkel’s CDU still won more Hamburg votes at national elections.

READ ALSO: EXPLAINED: Why Sunday’s state parliament vote in NRW is important for German politics

Then again, regional elections also are about national politics. That’s because they never take place in a vacuum (except for in Bavaria, of course, where everyone always votes CSU). Even the most beloved of state premiers faces an uphill struggle if their party is currently making a hash of things in Berlin. What is more, the larger and the more representative the Bundesland, the more results of its elections can show swings in voter mood which may be of national relevance.

The Greens’ slow ascent from their mid-2000s funk to their current swagger began in Baden-Württemberg: winning control of this state populated by 11 million people and many of Germany’s top industrialists showed that voters trusted them to be part of a government. That set the ball rolling and by the time of last year’s national election, the Greens were already in power in half of federal states. Incidentally, it is often overlooked that state governments make up the Bundesrat, the second chamber of parliament, which can accept or refuse laws made by the Bundestag. So shifts in power here can be of national relevance.

This dichotomy has the predictable effect that, in the aftermath of every Landtagswahl, the losing parties usually claim that it was simply a regional ballot with nothing to say about national politics while the winning parties play up the significance at federal level.

Olaf Scholz and Thomas Kutschaty

Chancellor Olaf Scholz (SPD) congratulates Thomas Kutschaty, SPD candidate in North Rhine-Westphalia, after the party wins 26.7 percent of the vote. Photo: picture alliance/dpa | Kay Nietfeld

An SPD disaster 

This is why it is very bad news for Olaf Scholz and the SPD that their only victory in spring 2022’s three Landtagswahlen was in dinky little Saarland, a state whose population is smaller than that of a major city like Cologne and whose local politics are so marked by rivalries and infighting as to have little-to-no relevance nationally. Despite winning an absolute majority in the regional parliament at Saarbrücken (a rare feat in proportional representation), there was no way the SPD could claim a national bearing – and, to its credit, didn’t try to do so either.

In Schleswig-Holstein, the SPD wasn’t expected to unseat the CDU’s Daniel Günther, a likeable and well-liked premier coming to the end of five years at the helm of a surprisingly successful Jamaica coalition with the Greens and the FDP. Here, too, the national relevance was relatively low: Schleswig-Holstein has only 3 million inhabitants and few large towns and cities. Nevertheless, losing over half its seats while the Greens and CDU gained by the same amount was not a good result for the SPD.

What was disastrous, however, was last night’s result in North-Rhine Westphalia. With a population the size of the neighbouring Netherlands (17 million) and everything from Germany’s largest urban conurbation down to isolated mountain regions, NRW is often considered a microcosm of the country as a whole. As something of a swing state, parties which succeed here often go on to win the next national election (if they aren’t already in government).

READ ALSO:

What is more, unlike in Schleswig-Holstein, NRW was the SDP’s to win. Until last year, its premier was the luckless Armin Laschet (remember him?), who plumbed popularity depths in his failed bid to become Chancellor. He then left a badly-damaged CDU-FDP administration to Hendrik Wüst, a successor whose profile, if he had one at all, was defined by various low-level corruption scandals (including a regrettable incident where he sold slots with the then-NRW premier, Jürgen Rüttgers, to high-paying commercial lobbyists…).

Hendrik Wüst (CDU)

Re-elected NRW state premier Hendrik Wüst (CDU) celebrates his victory. Photo: picture alliance/dpa | Rolf Vennenbernd

Even if Wüst proved to be an unexpectedly good campaigner and the SPD’s Thomas Kutschaty remained oddly faceless, the fact that Olaf Scholz himself got involved and that the SPD still ended up with its worst showing in NRW ever is nothing less than a serious defeat for both the Chancellor and his party – one which, in my view, underlines how Scholz has not yet lived up to expectations.

Nevertheless, he is in luck. Firstly, the electoral cycle means that this upset is occurring at the beginning of his term; there will be time to recover. Secondly, although Wüst gets first crack at forming a government, the Greens are his only real potential partner – and will take a lot of courting. NRW Greens are on the more left-wing end of the spectrum and will play the field, potentially trying to usher in a mini traffic-light coalition in Düsseldorf if it looks feasible later.

READ ALSO: OPINION: Scholz is already out of step with Germany – it’s time for a change of course

Growing support for Greens

So after the post-Merkel rout, the CDU has scored an important and much-needed victory, but harnessing it to get momentum nationally may yet prove difficult. Indeed, it’s the Greens who have come out of the last two weekends with a new swing in their step. Following a disappointing national election last year, they have once again hit their stride, due in no small part to the Ukraine reminding voters of why renewable energy is important on the one hand and the impressive figures cut by Robert Habeck and Annalena Baerbock in government on the other.

For the FDP, things are not looking so good. Despite negotiating a disproportionately high amount of their manifesto into last year’s agreement, they are suffering the fate of many a junior coalition partner: a lack of profile. On strictly regional terms, they lost votes to the popular Daniel Günther in Schleswig-Holstein (perhaps unavoidably, despite a good record as part of his coalition) and to the not-yet-popular Hendrik Wüst (following lacklustre performance in government in Düsseldorf).

Greens party posters NRW

Posters featuring Greens candidate Mona Neubaur highlight the link between fossil fuels and Russia’s authoritarian leadership. Photo: picture alliance/dpa | Roberto Pfeil

Worryingly for Christian Lindner, however, this may be harbinger of history repeating itself. Essentially, FDP voters tend to get enthusiastic for a business-friendly go-getter type who promises to lower taxes and slash regulation, only to later turn their back on him when, once part of a coalition government, he proves unable to deliver the small-state free-for-all promised. That’s what happened to Guido Westerwelle in the 2009-2013 administration, in any case.

There is, however, one bit of unadulterated good news for all parties and indeed our country as a whole: the AfD lost vote share everywhere. The populist outfit didn’t even make it into parliament in Schleswig-Holstein and only just scraped in in NRW. It would seem that, in times of crisis, voters don’t want to add to the list of potential disasters by putting populists anywhere near power. This is a hypothesis we’ll be able to test in just under six months’ time, by the way, when Lower-Saxony goes to the polls on 9th October. 

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