According to the legal regulations every woman and man is entitled to sexual education and professional counselling for contraception, family planning and everything connected with the issue of pregnancy (§ 2 SchKG)In addition to obtaining counselling on a voluntary basis, counselling in case of a conflict with pregnancy is required by law. The “Schwangerschaftskonfliktgesetz” (Act on conflict situations during pregnancy) includes the aim of counselling: To continue the pregnancy and to protect the unborn life. But the law also says that this counselling has to be open regarding the decision, the woman has to make in her own responsibility.
Under what conditions can women have an abortion?
What does abortion based on the "Beratungsregelung" (regulation of abortion on request after counselling) mean?
What happens during the legally required counselling?
How much does the counselling cost? How much does an "abortion on request after counselling" cost?
What does an abortion with "Indication" (medical opinion) mean? How much does an abortion with medical opinion cost?
Will the doctor, who performs the abortion, also offer me further counselling? Which laws govern the abortion regulation?
How is abortion for minors regulated?
In Germany, abortion is allowed until the 12th week of pregnancy, provided you have received compulsory counselling, or for medical reasons or because of a sexual crime.
The calculation of gestational age is based on the assumption that the conception takes place two weeks after the last menstruation. The 12th week after conception is thus equivalent to the 14th week after the last menstruation. The ultrasound scan is crucial to determine the gestational age.
If a woman considers having an abortion, she should know that it is only permitted under the following circumstances:
- The woman must have taken part in compulsory counselling.
- The procedure may only be performed more than three days after
the counselling was completed.
- The procedure has to be performed by a physician and until the
12th week after conception.
- The decision has to be made by the woman.
The counselling should not be focused on a certain result. This means that the woman herself is the one to take the decision in her own responsibility. “The counselling is supposed to encourage and to establish understanding, not to indoctrinate and patronize”. At the same time the counselling serves the purpose of “protecting the unborn life and to encourage the mother to be and to open up perspectives for a life with the child; it is supposed to help her to take a responsible and conscientious decision”. (StGB § 219)
During the counselling the woman should be informed about available help and her legal rights, especially those, which might help her to decide to continue the pregnancy.
She should be provided with the appropriate benefits and support. The woman should know about the following legal obligations of the counselling:
- She is expected to disclose her reasons for thinking about or wanting an abortion. The counsellor is expected to offer to talk about her reasons and to help her come to the right decision. The woman decides herself whether she will accept these offers.
- The woman should be aware of the legal meaning of an abortion. She should only decide for an abortion if carrying the pregnancy to term would be an unacceptable burden. But the women herself will judge her situation, and it is not the counsellor’s responsibility to assess it.
- The counsellor has to record the vital contents of the counselling and the offered support. The identity of the woman must not be distinguishable. The records are not aimed at controlling the woman and her reasons but the work of the counselling centre.
- All staff members of the counselling centre are obliged to confidentiality. They are not allowed to pass on any information about the client or details of the counselling without their consent. They are not even allowed to give information to anybody, whether a client has been counselled.
- The counselling may be performed anonymously if the woman wishes so. In this case she initially doesn’t have to tell her name at the reception or to the counsellor.
- After the counselling the client is entitled to a written certificate. The certificate has to contain the name of the client and the date of the last counselling. It should contain no details of the counselling.
The counsellors of the Family Planning Centre and pro familia are aware of the difficulties of legally required counselling which a woman may not wish herself. They understand the difficult situation for the woman and try to provide empathetic counselling.
The counselling is free of charge at a registered counselling centre, for example the Family Planning Centre / pro familia, for the woman and accompanying persons.
Costs for an abortion on request are not usually covered by health insurance. The costs for the abortion procedure can only be refunded by the insurance if the personal income or property of the woman is below a certain limit or she draws benefits like BAföG. Details can be obtained at counselling centres or health insurance companies. A refunding of the costs has to be applied for and confirmed in writing by the health insurance company before the procedure. The written affirmation is needed by the abortion clinic. The abortion does not have to be justified. The insurance company may only demand that the woman proves evidence of her income and property. Income and property of husband, family, parents etc. do not matter at all. If the woman is not a member of a statutory health insurance fund she can still apply to a local statutory health insurance company for the refund of the abortion costs if her personal income and property are below a certain limit or she draws benefits like BAföG, Hartz IV etc. If her income and/ or property exceed the limit, the woman has to pay for the procedure herself. If the woman wants to take time off work she is entitled to continuation of payments. She does not have to explain her reasons for taking time off.
An abortion for medical reasons approved by a physician is considered legal. The physician who decides about the approval is not allowed to perform the abortion him or herself. With abortions for medical reasons, counselling in a registered counselling centre is not required. The costs will be completely covered by the health insurance.
Legal grounds are:
Abortion due to a criminal act „Kriminologische Indikation”:
The woman has become pregnant because of a criminal act like rape or sexual abuse. The termination has to be carried out until the 12th week after conception.
Abortion on medical grounds „Medizinische Indikation“:
Continuing the pregnancy poses a serious risk for the woman’s physical or mental health under present or future circumstances. In this case there is no legal time limit. An abortion on medical grounds is also possible if a woman considers an abortion because serious damage of the child's health can be expected based on medical opinion (the former “embryopathische” or “eugenische Indikation”). In this case it is also crucial that continuing the pregnancy would mean a serious risk for the woman’s health.
The costs will be completely covered by statutory health insurance funds. Private health insurance funds cover only abortions for medical reasons. Whether they will in future cover abortions because of a criminal act is not yet known.
According to the law, the doctor performing the abortion has the following obligations:
- He or she should give the woman the opportunity to speak with him or
her about the reasons for her decision to have an abortion.
- The doctor is obliged to inform the woman about the abortion procedure,
its consequences and risks.
Abortion is regulated in the “Schwangerschaftskonfliktgesetz“ (regulation concerning pregnancy conflicts) §§ 2, 5 and 6, “Schwangeren- und Familienhilfeänderungsgesetz” (regulation concerning pregnant women and help for the family) as well as in the §§ 218 and 219 of the StGB. These laws also include the entitlement to education and counselling for contraception, family planning and sexuality. Every woman and every man has the right to receive professional counselling in the Family Planning Centre / pro familia.
Basically the same rules apply both for minors and adults. Within 12 weeks after the conception the minor is deemed to be able to decide herself whether to terminate the pregnancy or not. Even girls under 18 must not be forced by anyone to continue or terminate the pregnancy. Minors can attend the counselling sessions on their own or accompanied by a close person of their choice.
Many doctors only perform an abortion for minors with consent of a person with parental responsibilities. Exemptions are possible and the doctor may establish whether the girl has the capacity to give valid consent to the abortion. With girls above the age of 16 this will usually be the case.
Minors below the age of 14 require the consent of their parents. Abortions for medical reasons will be covered by the health insurance funds. Starting from the age of 15, minors can also apply for refunding of the abortion costs at a statutory health insurance company.
Mental distress during and after an abortion is mostly overestimated. Many studies show that ongoing negative consequences are infrequent. Most women experience high levels of distress before the abortion when they have to make the decision and feel anxious about the procedure. After the procedure most women feel relieved. Although some women feel sad and depressed for several weeks. Ongoing psychological problems may be more common among women who had not been free to make the decision themselves because of pressure from relatives or a difficult life situation. Also moral objections of their community or insensitive treatment by health care providers can make coping more difficult, as well as the need to conceal the pregnancy and abortion or lack of support. The most important aspect is that you are free to take your own decision with as much time as possible. You can get professional support in a Family Planning Centre or in a counselling centre. Try to find people you can talk to and who will support you during the difficult time of the abortion. Above all, you should find a counselling centre and abortion clinic in which you are treated friendly and your decision is respected.
