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Reader question: Is abortion illegal in Germany?

Reproductive rights are in the spotlight across the world, particularly after the US Supreme Court overturned a landmark abortion ruling. Here's what you need to know about abortion in Germany.

Pro-choice campaigners at a counter-demonstration against a pro-life demo in Berlin in September 2021.
Pro-choice campaigners at a counter-demonstration against a pro-life demo in Berlin in September 2021. Photo: picture alliance/dpa | Paul Zinken

The US Supreme Court on Friday June 24th overturned a landmark 1973 ruling, called Roe v Wade, that made abortion legal in the USA.

The news has put a further spotlight on reproductive rights around the world. Readers of The Local recently contacted us to find out about the laws on abortion in Germany. We spoke to campaigners for women’s reproductive rights to help explain what you need to know.

Is abortion illegal in Germany?

It may surprise many people to know that abortion remains technically illegal in Germany, but there are circumstances in which people can end a pregnancy without facing any legal consequences. 

The exceptions include: the abortion being performed within the first 12 weeks of pregnancy, and following mandatory counselling carried out at least three days before the procedure to terminate the pregnancy.

If there is a medical reason for an abortion, then it is not unlawful. This applies, for instance, if the pregnancy poses a danger to the life or physical and mental health of the woman. An abortion can also be carried out if tests identify that the foetus is disabled or seriously ill. Late abortions (after 12 weeks) are allowed if these special factors apply. 

Abortions are also legally possible if they are the result of a criminal act – for example if the pregnancy is the result of rape. 

The termination of a pregnancy is known as Abtreibung or Schwangerschaftsabbruch in German. Around 94,600 abortions were reported in Germany in 2021, according to official figures. 

The rate of abortions per 1,000 women in Germany stands at 6.8 – one of the lowest in Europe alongside Switzerland. The rate of abortions stands at 19 per 1,000 women in Sweden, 17 in the UK, 16 in France and 16 in the US.

People who choose to get an abortion in Germany generally have to cover the costs of the procedure themselves. 

According to the German Centre for Foreign Feminist Policy, which published information by Medical Students for Choice Berlin, abortion in Germany can cost between €200 and €650 depending on the methods involved. People can apply for financial help from their health insurance.

READ ALSO: Is abortion legal in Switzerland?

A pro-choice counter protester at the "March for Life" demo against abortion in Berlin in September 2020.

A pro-choice counter protester at the “March for Life” demo against abortion in Berlin in September 2020. Photo: picture alliance/dpa | Jörg Carstensen

Tell me more about abortion laws in Germany…

There has been a lot of discussion about abortion in Germany in recent years. Germany’s traffic light coalition – made up of the Social Democrats, Free Democrats and Greens – recently announced plans to scrap paragraph 219a – a controversial clause on advertising abortion that has remained largely unchanged since it was brought in by the Nazis in the 1930s.

On Friday, the German parliament agreed to scrap this part of the abortion law. 

READ ALSO: Germany consigns Nazi-era abortion law to history 

It had meant that doctors in Germany were unable to advertise that they carry out terminations, and detail what methods they use – and even resulted in prosecutions, such as the high profile case of Kristina Hänel, a doctor from Giessen in western Germany.

Getting rid of this paragraph paves the way for more accessible information on abortion in Germany.

READ ALSO: Do Germany’s planned changes on abortion go far enough?

But abortion in Germany is still regulated by paragraph 218 of the criminal code, which dates back to 1871. Although the law has been amended to allow for exceptions, pro-choice campaigners in Germany want to see abortion fully legalised. 

Dr Alicia Baier, chairwoman of campaign group Doctors for Choice, said the German coalition government’s plans to get rid of paragraph 219a were a step forward.

But she said much more action was needed – including removing abortion from the criminal code. 

“I think German abortion laws are behind the times,” Baier told The Local. “There are many European countries which regulate abortion outside the criminal law. But in Germany we still criminalise abortion, we still have the obligatory waiting period, and obligatory counselling.”

Baier said abortion didn’t belong in criminal law. “That’s not the place for abortion, it should be regulated in some other law. Like in France – they regulate it in the public health law.”

Although the coalition government has said it wants to set up a working group to look at options for regulating abortion “outside of the framework of the criminal code”, there doesn’t seem much political appetite for big change.

Earlier this year, Katrin Helling-Plahr, FDP parliamentary group spokesperson for legal policy, told The Local: “We Free Democrats are of the opinion that Paragraph 218, as the result of a long societal discussion, represents a successful compromise with regards to protecting the life of the foetus and the right to self-determination of the pregnant person.”

Campaigners at the pro-life 'March for Life' in Berlin in September 2021.

Campaigners at the pro-life ‘March for Life’ in Berlin in September 2021. Photo: picture alliance/dpa | Paul Zinken

Is it difficult for women in Germany to get an abortion in practical terms?

According to campaigners, it can be hard for people to find information on terminating pregnancy and doctors to carry it out depending on where they live.

“I think it really depends on the women themselves and where they are,” campaigner Annika Kreitlow, a research assistant with the Centre for Foreign Feminist Policy, told The Local. 

“I think in Berlin it’s okay – there are a lot of doctors in Berlin and a lot of progressive people move to Berlin. But if you live in the south of Germany, like in Bavaria for example, there are cities which don’t have any doctors who provide abortions at all.

“In the northern islands of Germany, people there also have to fly to the mainland to get an abortion – sometimes they have to travel 200 or 300km to get an abortion.”

Kreitlow also said people in Germany face additional barriers because of the mandatory counselling and three-day wait. 

“You have to be really consistent on finding a doctor who will do that before the 12th week. It depends on the region and also how much knowledge the person has on the situation,” she said. “If you’ve never come into contact with this and don’t know anyone who’s had an abortion, there’s a lot of fake information out there and fake websites.”

She said it’s more difficult for non-Germans.

“If you’re not a native German speaker and you come from somewhere else, it’s also very different to find the right information and distinguish what is real information and what is fake, who to trust and who to talk to,” Kreitlow said. “It’s a very difficult situation but a lot of circumstances make it even more difficult in Germany.”

How do the laws affect doctors?

Dr Baier said there was still a “big stigma” surrounding abortions in Germany – including in the medical profession. Although it is one of the most common gynaecological procedures, it is often hardly discussed at medical schools in Germany.

“In many universities – during six years of study – it’s not mentioned at all, or it’s mentioned in the context of medical law or medical ethics,” said Baier.

“It’s still very taboo in medicine. We wish it was acknowledged as part of medicine because it’s a medical procedure. In Germany, only doctors are allowed to perform them. If we don’t do it, people are left alone and that could cause a lot of health risks.”

Baier said the barriers for women in Germany looking to get an abortion, or for information on it, need to be urgently worked on.

“In some regions of Germany it’s catastrophic and people are treated very badly,” she said. “We have a modern health system but it doesn’t correspond to that at all in this area.”

 

Is there a large pro-life movement in Germany?

There’s a sizeable number of campaigners who are against abortion in Germany.

Pro-life events such as Marsch für das Leben (March for Life) take place every year in Berlin. In 2021 around 4,500 people attended the march, demonstrating against abortion and euthanasia laws. Counter-demonstrators from the pro-choice movement also march on the days of these events. 

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HEALTH

‘Breaking point’: Why German pediatric wards are filling to capacity

Overcrowded patient rooms, days-long stays in the ER, transfer of sick babies to hospitals more than 100 kilometers away: the current wave of respiratory syncytial virus (RSV) infections in Germany is pushing children's hospitals to their limits. 

'Breaking point': Why German pediatric wards are filling to capacity

The German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi) said on Thursday that there was a “catastrophic situation” in children’s intensive care units. 

According to the physicians, a wave of respiratory syncytial virus (RSV) infections can be expected every year starting in the autumn. 

Yet this year “there are fewer and fewer pediatric hospital beds available overall” as well as a lack of nursing staff, Divi Secretary General Florian Hoffmann explained Wednesday on ZDF’s Morgenmagazin.

Because all beds were full in one case, a child was transferred from the Hannover Medical School (MHH) to Magdeburg on Friday night, a distance of around 150 kilometers. 

“My colleagues had called 21 clinics,” said Gesine Hansen, Medical Director of the MHH Clinic for Pediatric Pneumology, Allergology and Neonatology, told DPA. 

The child, who was about one-year old, had an RSV infection, which can be life-threatening, especially for babies and children with pre-existing conditions.

READ ALSO: 7 things to know about visiting a doctor in Germany

‘Catching up’

Some health experts have said that hospitals are now filled to capacity because children had minimal social contact during the pandemic and are now catching up on infections.

According to the Robert Koch Institute (RKI), an estimated 5.6 severe cases of RSV respiratory illness occur worldwide per 1,000 children in the twelve months after birth. 

Within the first year of life, 50 to 70 percent would typically have experienced at least one infection with RSV, and by the end of the second year of life, nearly all children should have experienced at least one infection. 

In the wake of protective measures against Covid-19, however, many such infections had temporarily failed to materialise. 

‘Breaking point’

According to Divi, hardly any clinics had a free crib or free pediatric intensive care bed in the past few days.

“Children have to lie in the emergency room for days,” Hoffmann said.

Yet the peak of the current wave of respiratory infections in children has by no means been reached, Hoffmann said. “The situation in practices and clinics will get even worse in the coming weeks.”

“We are at the breaking point,” said Matthias Keller, head of the Children’s Hospital Dritter Orden Passau already. The rooms are often double-occupied, he said. In some cases, there were too few monitors and not enough equipment for respiratory support.

READ ALSO: Flu season makes a comeback in Germany

A child with RSV being treated at the Olgahospital in Stuttgart. Photo: picture alliance/dpa | Marijan Murat

“Some patient rooms are like bed storage areas, where you really have to crawl over the beds to get to the sick child, because the parent bed is lined up with the patient bed,” said Keller, who is also chairman of the South German Society for Pediatric and Adolescent Medicine.

This has far-reaching consequences for other young children who need treatment. When an infant who has just been resuscitated is admitted to a children’s hospital that is actually fully occupied, a three-year-old has to wait there for the third day in a row for his urgently needed heart operation.

‘Responsibility of politicians’

A wave of infections usually lasts six to eight weeks. In Bavaria, Lower Saxony and Berlin, as well as North Rhine-Westphalia, clinics are reporting a “maximally tense situation,” reported Divi on Thursday.

The Düsseldorf University Hospital, for example, is experiencing a wave of influenza among its young patients in addition to the RSV wave, which is “causing massive problems primarily for children up to elementary school age,” said University Hospital spokesman Tobias Pott.

In the Rhineland, “all beds are completely full” at times, said Jörg Dötsch, president of the German Society for Pediatric and Adolescent Medicine. An ER waiting time of six to seven hours is not uncommon, he says. 

“It is very unpleasant when children and their families have to virtually camp out in the emergency room,” says Dötsch, who is also director of the Clinic for Pediatric and Adolescent Medicine at the University Hospital in Cologne. 

READ ALSO: Healthcare in Germany: How to get a faster appointment with a specialist doctor

What are the solutions?

At their meeting on Thursday in Hamburg, intensive care physicians and intensive care nurses will discuss approaches to solving the crisis. 

One solution may be to temporarily bring nursing staff from adult facilities into the children’s hospitals, says Hoffmann, who is also a senior physician at Dr. von Hauner’s Children’s Hospital at the University of Munich. 

But above all, he says, many more pediatric nursing staff need to be trained. “We need to strengthen nursing,” he explained. “Only then do we have a chance.”

Others said more money needed to be invested in pediatric medicine and vaccines, even if it is less profitable.

“The fact that children’s lives are currently in danger is the responsibility of politicians,” said Jakob Maske, spokesman for the Professional Association of Pediatricians and Adolescents.

“Nowadays medicine has to be profitable – not cure diseases, but make money.”

READ ALSO: How private investors are buying up healthcare practices in Germany

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