Abortion remains difficult to access in Germany

In 2019, more than 1000 individuals from Germany contacted Women on Web.(see prepublication of the research https://www.medrxiv.org/content/10.1101/2020.09.08.20190249v1)

Requesting help for safe abortion, people listed lack of finances, fear of judgement, abortion stigma, and logistical barriers among the reasons why they could not access abortion care in Germany. The testimonies demonstrate that mandatory counseling and waiting period reinforce perceived barriers to access abortion, which are of special relevance to vulnerable groups such as adolescents and undocumented immigrants. The research reports that almost half of the participants prefer to keep their abortions private and secret from their family and partner due to concerns over privacy, judgement, feeling of shame, fear of abuse and violence. People also reported judgement in medical institutions and by medical staff among their reasons to resort to telemedicine abortion to self manage their medical abortions. The research adds to the growing evidence of the impact of obstacles to abortion access in law and practice. 

In response to the disruptions in public health systems and to the restrictions in accessing equal health care during a time of increased demand for services, WHO declared that abortion is an essential healthcare to be safeguarded and has recommended self-care interventions to be implemented for safe abortion care. WHO supports self-managed abortions up to 12 weeks of pregnancy and recommends expanding telemedicine mechanisms for safe abortion provision, to reduce barriers that could delay care.  

German authorities have long remained unresponsive to various demands put forward by the CEDAW Committee and civil society organizations to decriminalize abortion (Section 218 of the German Criminal Code), remove mandatory counseling and 3 day waiting period before abortion. On September 28th, 2020, International Safe Abortion Day, we urge German authorities to ensure access to safe abortion. Together with Doctors for Choice Germany and Alliance for Sexual Self-Determination, we ask the German government to:

• Decriminalize abortion and remove Section 218 and section 219a from the Criminal Code,
• Remove the mandatory counseling (Schwangerschaftskonfliktberatung-pregnancy-conflict counseling) required before abortion,
• Avoid stigmatising language in the Criminal Code (i.e. Section 219, “protecting the unborn life),
• Ensure access to abortion in line with guidelines by the World Health Organisation, including with regard to self-managed medical abortion and telemedicine abortion services,
• Develop and implement an evidence-based policy on access to abortion information, counselling and service.

We urge policy-makers to trust women and pregnant people to make their own decisions over their bodies, avoid practices that stigmatize abortion and delay care. 

We suggest that a reform in German abortion regime is overdue and Germany can not fall behind international healthcare standards.