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

A long-awaited change to Germany’s punitive abortion laws is underway, but some believe it stops far short of what's needed. Here’s what you need to know.

Do Germany's planned changes to abortion laws go far enough?
A woman receives a consultation at a catholic pregnancy advice centre in Baden-Württemburg. Photo: picture alliance/dpa | Marijan Murat

In January this year, Germany’s traffic light coalition – made up of the Social Democrats, Free Democrats and Green party – announced its intention to undertake “the biggest reform of family law in several decades”, introducing sweeping protections for same-sex couples and non-traditional families.

Centre-stage in these reforms was a drastic overhaul of Germany’s outdated reproductive laws – stripping away a controversial clause on advertising abortion that has remained unchanged since the 1930s.

Discussing the move, Justice Minister Marco Buschmann (FDP) said the current state of abortion law in Germany created an “unacceptable situation” where doctors faced criminal proceedings for trying to help people stay informed. “That doesn’t belong in our times,” he said.

On the face of it, it seems like the long decades of feminist campaigning has paid off. But a closer look at Germany’s current abortion laws suggests that the planned reforms may only scratch the surface. 

What’s are the current abortion laws – and how will they change? 

Once of the most controversial aspects of current abortion law in Germany is Paragraph 219a, a Nazi-era clause forbidding doctors from “advertising” the availability of abortion services or sharing information on the procedure with patients. 

The government has promised to dispense with this paragraph and, earlier this year, Buschmann announced that the cabinet had agreed on a draft bill to do just that. With this initial move to allow doctors to provide information to pregnant patients, the long road to reform has already begun.

READ ALSO: Why Germany is planning to overhaul abortion information laws

However, the much-publicised and in-the-works repeal of Paragraph 219a is only one piece of the many barriers to abortion in Germany. At present, the coalition has not announced a formalised intention to abolish Paragraph 218, which continues to fundamentally criminalise abortion, leaving pregnant women to manoeuvre within tightly-defined exceptions to the law.

A pro-choice protester in Berlin wears a mask with "away with §218" on it.

A pro-choice protester in Berlin wears a mask with “away with Paragraph 218” on it. Photo: picture alliance/dpa | Paul Zinken

The prospect of changing this status quo remains murky, couched in extremely careful language. The coalition contract does clearly state that access to cost-free abortions should be a part of reliable healthcare. But when it comes to fully decriminalising the act of abortion, the document only announces that a commission on reproductive self-determination and reproductive medicine will examine options for regulating abortion “outside of the framework of the criminal code”. No concrete promises there.

Katrin Helling-Plahr, FDP parliamentary group spokesperson for legal policy, was actively involved in negotiating this section of the coalition contract. Plahr has long advocated for more progressive laws on reproductive medicine, and greeted the demise of Paragraph 219a as long overdue

Responding to a request for comment on the coalition’s cautious language, she reiterated plans to appoint an exploratory commission, but made clear that her party did not necessarily regard a total decriminalisation of abortion as legally or ethically viable. 

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,” she wrote.

Abortion access remains fraught

Meanwhile, individuals seeking to terminate a pregnancy in Germany are often left with little choice but to travel abroad for care, to one of the many European nations with fewer barriers to abortion. 

As long as Paragraph 218 stands, those seeking legal abortions in Germany face mandatory and often aggressively pro-natalist counselling, a waiting period and strict time limitations, with abortions only available in the first 12 weeks of pregnancy. And even when eligible for a legal abortion, finding a provider to perform it is another matter entirely. 

A recent story from investigative news site CORRECTIV.Lokal showed the barriers faced by individuals seeking to terminate a pregnancy in Germany, including poor access to abortion providers, discriminatory treatment, patchy insurance coverage of the costs and extensive bureaucratic burdens. As the Green parliamentarian Ulle Schauws pointed out, despite more readily available information on performing doctors after the removal of 219a, the actual sparse landscape of abortion coverage won’t automatically become any more densely populated.

The difficulty of accessing contraception 

Abortion access isn’t the only thorn in the side of folks who would rather not be pregnant. 

In 2015, Germany finally made the morning-after pill available over the counter, without a prescription. Though many people are able to obtain it without too much hassle, there’s evidence to suggest that different pharmacies handle the situation differently – with some taking a more invasive approach. 

When US citizen Courtney Harrison tried to get emergency contraception at a German pharmacy, she found the experience intensely personal and far removed from the ease of obtaining most other over-the-counter medications. Before being given the medication, she was brought back to a separate room and had to speak with multiple staff members. 

“They had to ask a bunch of questions and I had to fill out a form,” she said, questioning the necessity of sharing “intimate details” with two different people just to obtain an over-the-counter medication. 

A woman holds the morning-after pill at a pharmacy

A woman holds the morning-after pill at a pharmacy. Photo: picture alliance/dpa/dpa-tmn | Benjamin Nolte

“I hope people who need Plan B here in Germany don’t face judgement when they have to personal answer questions about their reproductive health and sex history. I felt embarrassed and overwhelmed,” she added.

While reforms to access to contraception aren’t specifically on the cards, the traffic light coalition has pledged to ease the financial burden of obtaining it.

In the coalition pact, the parties say they want to give health insurance companies the ability to cover the cost of regular contraception “as a statutory benefit”, as well as making free contraceptives available for those on low incomes. Emergency contraception is already covered by health insurance – but only after a visit to the GP. 

They also want to invest in research for contraceptives “for all genders” – presumably including the much-awaited pill for men. 

READ ALSO: What you need to know about the abortion law battle that divides Germany

Do the reforms go far enough?

Though the traffic-light coalitions have made pledges that go far beyond anything posited by the previous conservative-led government, some campaigners question whether the changes set out will be enough to make a meaningful difference. 

At present, potential expense, legal issues and a mountain of bureaucracy often limit women’s access to reproductive healthcare. That, and the ever-debated Paragraph 218, that continues to consider abortion a criminal offence. 

“In Germany my body belongs, de facto, to the state,” journalist and campaigner Mithu Sanyal said in an interview with Deutschland Funk. “You can see that in a law like Paragraph 218: the state can decide whether I get an abortion or not.”

Though the coalition has also pledged to make abortions free of charge and tackle the information and access issues, the legal issues remain a sticking point. 

Speaking to broadcaster RBB24, Sabrina Odebrecht, who works at a pregnancy advice centre in Berlin, said she thought it was right for women to be offered counselling before an abortion. But, she added, they should have the right to choose whether to accept it without fearing legal consequences. 

“I think it is wrong to criminalise the procedure in principle, to criminalise and frighten women and doctors,” Odebrecht said. “That is why Paragraph 218 should finally be dropped.”

So despite the incoming changes, the debates surrounding abortion law are far from over. 

Member comments

  1. I wonder are these pro choice people and ministers the same ones who want to force people into vaccination?
    Everyone should have a choice. But I dont think abortion should be touted as a cure all. Decriminalise it and allow the parties involved to openly discuss options. It just can not be made too easy it is a very serious thing. Not a quick fix.

  2. Florida just changed their law and I find it reasonable. It gives women an option, but not an open-ended one that takes into account fetal development.

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HEALTH

Klinik-Atlas: How to use Germany’s new hospital comparison portal

The German government has launched a ‘Bundes-Klinik-Atlas’ which provides information on services and treatment quality at almost 1,700 hospitals throughout Germany. Here's what you need to know.

Klinik-Atlas: How to use Germany's new hospital comparison portal

Whether you’re a foreign resident or a local, it can be tricky to navigate hospital care in Germany. 

Now the German government has launched a new nationwide ‘Klinik-Atlas’ aimed at making it easier for people to compare different services in hospitals. 

If a patient needs care at a hospital or clinic, such as a knee operation, cancer treatment or to get their tonsils out, they can look through the state-run comparison portal to compare the services offered and their quality. The portal is intended to help patients make a decision on where they want to access care. 

It was launched on Friday May 17th and so far includes details on 1,700 hospitals throughout the country. 

Why has the Klinik-Atlas been launched? 

The German government believed there was a need to get more information on hospitals out there to the public. 

Health Minister Karl Lauterbach, of the Social Democrats (SPD), said comprehensive information on how to find good care is now more accessible to everyone with the new portal. 

He said that transparency was needed in view of the 16 million hospital treatments that take place in Germany per year and the 500,000 new cancer patients per year alone. Most patients are unsure which clinic or hospital is best suited for their treatment, he added. 

Compared to existing information portals, the Klinik-Atlas is particularly unique in the way it prepares data for patients, Lauterbach said: “With just a few clicks, they can compare clinics and find the best clinic in their area for the treatment they need.”

READ ALSO: Which of Germany’s hospitals are among the ‘world’s best’?

Patients can see and assess hospitals side by side instead of having to “hop from clinic to clinic”, added Lauterbach. He called it “clear guide” to help people sift through the maze of health care. 

However, there’s been a mixed reception to the project, with hospitals raising some concerns.

How does it work exactly?

One thing to keep in mind is that the site, which is located at www.bundes-klinik-atlas.de, is only in German, but it is fairly simple to use. 

– On the site you can see a map with all the clinics in your area, as well as the number of beds they have and treatments they offer. Each clinic is scored on the quality of its care. The score is based on the number of patients per nurse, taking into account the severity of the cases. Lower values equate better scores in this case.

A sign at a Charité Campus points to the Central Emergency Department.

A sign at the Berlin Charité points to the Central Emergency Department. Photo: picture alliance/dpa | Sebastian Gollnow

– You can also enter your place of residence and an illness or a very specific treatment in the portal. The system offers search suggestions if you don’t know the specialised term. According to the ministry, 28,000 treatment and 13,000 disease definitions are stored.

– There is a kind of speedometer display to help patients categorise their cases. The ‘faster’ you go, so to speak, i.e. the further the needle moves to the right, the better. For the time being, there are two speedometers – for the number of annual cases of a treatment and for the number of nursing staff in the hospital. The speedometers have five coloured elements to which the needle can point – from ‘very few’ to ‘very many’ cases, for example. 

What else can you find out?

A comparison shows that there are “huge differences within a very small area”, said Lauterbach. For example, there are 48 hospitals in Berlin and the surrounding area that perform bowel cancer operations, but only 18 of them are certified as specialist centres.

In the case of severe bowel disease in children, there are clinics that perform more than 70 operations a year, while others only perform four.

It is not the case that large clinics are automatically always ‘the winners’. There are also small clinics that are extremely specialised.

The portal is to receive its first update in a few weeks’ time and will then include complication rates for treatments. Figures on the number of specialised doctors will follow.

The information will be updated regularly, according to the Institute for Quality and Transparency in Healthcare, which is coordinating the implementation. At the moment the data is lagging, featuring case numbers from 2022. The information comes from several sources, including clinics and health insurance company invoices.

READ ALSO: How could Germany solve its worsening GP crisis?

How’s the reaction so far? 

According to the ministry, there were more than five million hits in the first three hours of the comparison launching, with some page views also experiencing a brief hitch due to the volume of traffic. 

But not everyone is for it. The German Hospital Federation said the portal does not provide patients with any additional information and even adds more bureaucracy to hospitals’ workloads. The hospital sector recently expanded its own online overview portal. The Deutschen Krankenhaus Verzeichnis’ or ‘German Hospital Directory’, which has existed since 2002, was updated to include more search functions. 

The German Patient Protection Foundation said that people want to know about the range of services and quality. “But the ‘hospital atlas’ lacks crucial information,” said CEO Eugen Brysch. “The quality of patient management in the clinic is not recorded.”

The German Social Association welcomed the comparison site, but added: “It remains to be seen how great the added value for patients really is.”

READ ALSO: How Germany is planning to save its ailing hospitals 

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