Berlin – The medical care for abortions in Germany is poor, the regional differences are large and Berlin plays a special role in two senses. This is how the results of a research cooperation between CORRECTIV.Lokal, FragDenStaat and the Berliner Zeitung can be summarized. According to the Pregnancy Conflict Act, however, the federal states are obliged to ensure a “sufficient range of outpatient and inpatient facilities for carrying out abortions”. On the other hand, joint research has shown that only in the city states of Berlin, Bremen and Hamburg are abortions practically part of the public, basic medical care.
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For the research, in which a four-strong team from this newspaper was involved, all public hospitals in Germany with a gynecological department were asked about their willingness to perform abortions. This results in a database of 309 hospitals. In Berlin, there are six clinics belonging to the Vivantes Group and two Charité locations. While all public clinics in Berlin and the other two city-states carry out abortions, nationwide only about every second hospital asked stated that they offer abortions. On the other hand, public care is hardly guaranteed in the other federal states, which means that some of them violate the Pregnancy Conflict Act.
Abortions in all public hospitals in Berlin
With the exception of liberalization in the GDR, abortion has been illegal in Germany for more than 150 years and is therefore the only medical intervention that falls under Section 218 of the Criminal Code. Under certain conditions, however, he remains unpunished. Medical personnel can also refuse to perform or participate in abortions.
For research
This research is part of a cooperation between the Berliner Zeitung and the platform for freedom of information FragDenstaat and CORRECTIV.Lokal. The network implements data-driven and investigative research together with local editorial offices.
Collectively, more than 300 public clinics were surveyed on abortion. The results are in a database with further information online at correctiv.org/pregnancy termination.
From this, the Berliner Zeitung developed a series on the subject of abortion lasting several weeks.
According to the Federal Statistical Office, almost 100,000 abortions were carried out in Germany in 2020. With a few exceptions, the number has been falling continuously since the mid-1990s. Mainly because the proportion of women of childbearing age is falling – the proportion of abortions remains about the same. More than nine out of ten abortions take place in Berlin, but also throughout Germany after the consultation indication. The people therefore decide, without any criminological or medical justification, that they want to have the pregnancy terminated. Berlin also plays a special role here: In the past six years, the number of abortions in the capital has risen constantly, with around every tenth abortion in 2020 being taken up by Berliners.
Whether this is also due to the good supply situation in Berlin could not be clarified with the joint research of the Berliner Zeitung and CORRECTIV.Lokal as well as FragDenstaat. In Berlin, all publicly owned hospitals with a gynecological department carry out abortions according to all exceptions. At the same time, Berlin has the densest network of counseling centers in Germany that issue a counseling certificate. Unintentionally pregnant women need it in order to be able to have an abortion with the counseling indication. It is comparatively easy to end an unwanted pregnancy in the capital.
Southern Germany is undersupplied
Across Germany, on the other hand, every fourth public clinic from which data could be obtained for research stated that they did not carry out any abortions at all – not even when it was medically necessary. Two thirds of these clinics come from Bavaria. The research also found that most hospitals that offer abortions do so primarily under the medical or criminology exemption. Three quarters of the hospitals carry out abortions with a medical indication and 58 percent also with a criminological indication. This means that the most frequently required indication, termination after mandatory counseling, is offered least frequently in public hospitals: Only every second public hospital that was successfully surveyed for the research stated that it also carried out terminations after the counseling indications. The Pregnancy Conflict Act does not explicitly distinguish between medical, criminological or counseling indications. Secure medical care must apply to all exceptions.
Abortion according to Section 218 of the Criminal Code
An abortion is generally punishable in Germany. However, there are three exceptions, so-called indications, in which the abortion remains unpunished.
consultation indication
An abortion is not punishable if the woman concerned follows the guidelines of the so-called counseling regulation (§ 218a, paragraph 1 StGB). Specifically, the unintentionally pregnant woman must seek advice from a state-approved conflict counseling center at least three days before the termination and must then present the doctor with a counseling certificate as confirmation of participation when the termination is made. An abortion is possible with prior mandatory counseling within the first twelve weeks after conception.
Medical indication
An abortion is not punishable if there is a danger to the life of the pregnant woman or a serious impairment of her physical or mental health (§ 218a, paragraph 2 StGB).
Criminological indication
An abortion is not punishable if the pregnancy is based on a sexual offence, for example rape (Section 218a, Paragraph 3 of the Criminal Code). An abortion with a criminological indication is possible within the first twelve weeks after conception.
Research reveals a dramatic undersupply, especially in southern Germany. In Bavaria, only 34 hospitals offer terminations at all, that is two fifths of the public clinics. And only every tenth clinic in Bavaria stated that they ended pregnancies even after the counseling indication. There were eight hospitals in total, three of them in Munich alone. Termination with prior mandatory counseling is by far the most common indication for termination in Bavaria. The evaluation of the counseling centers also shows that Bavaria has some catching up to do here: There are no counseling centers in a total of nine districts, and there are counseling centers in almost two dozen other districts, but they do not issue any counseling certificates. But that’s exactly what more than 90 percent of unintentionally pregnant women need in order to be able to end their pregnancy with impunity.
In addition to the hospital research, CORRECTIV.Lokal conducted a survey among those affected. The non-representative evaluation refers to almost 1,300 respondents who had at least one abortion in the past 15 years. For example, every fourth respondent stated that they had driven more than 25 kilometers to have their own abortion. Almost 30 percent of those surveyed also reported problems with medical care. An experience that can be confirmed by the representative data from the joint research by the Berliner Zeitung, CORRECTIV.Lokal and FragDenstaat.