How do I go to counseling 1

Termination of pregnancy: advice, procedure, appointments

Unintentionally pregnant: what now?

For a woman, being pregnant is one of the most blatant things that can happen. For many it is the greatest happiness - but if the pregnancy is unwanted, it can be the greatest disaster one has ever experienced. Around 95,000 women in Germany decided to terminate their pregnancy in 2016. The reasons for the decision are varied and very personal. But there are a few points that are particularly often decisive for the decision to terminate an unplanned pregnancy: "In our annual statistics for 2016, the reasons mentioned most frequently were Education and professional situation, completed family planning and family and partnership problems", says doctor Dorothee Kleinschmidt, who also works as a family therapist and consultant at pro familia.

Abortion: What You Need To Know Before You Begin

In Germany, every woman who wants to have an abortion for herself is currently obliged to go to a recognized counseling center for pregnancy conflict counseling. Because according to Section 218 of the Criminal Code, termination of pregnancy is still punishable in Germany. According to Paragraph 219, the intervention remains unpunished if you can show a counseling certificate. In addition, there must be three full days between the consultation and the medical intervention. This means that if you had the consultation on December 1st, you can only make an appointment with the gynecologist for an abortion on December 5th.

Aborting Pregnancy: How To Find A Doctor

In pregnancy conflict counseling, you not only get the necessary counseling certificate, but - and this is at least as important - a list of doctors and medical practices who carry out abortions. "The women can then use these addresses to make an appointment for the procedure," explains Kleinschmidt.

It is quite difficult to find a doctor to perform the procedure without going through the lists of the advice centers. It is actually a risk for doctors to make public that they are performing abortions. The last time the gynecologist Kristina Hänel felt this, her case was hotly debated. The doctor from Gießen had stated on her practice website that she was doing abortions. Since this medical service has to be paid for (in most cases by the patient herself), Hänel interpreted her information as an advertisement for the procedure. And abortion advertising is there prohibited by law in Germany under Paragraph 219a.

Something that Dorothee Kleinschmidt also sees critically: "This is not the first time that doctors have been sued and sentenced to fines. Paragraph 219a, which bans advertising for abortion, is by the way an old law from 1933. That is no longer up-to-date, "she says. "The operation is not illegal. So it is absolutely incomprehensible why doctors do the abortion but cannot publicly admit it."

The fact that doctors in Germany have to reckon with consequences if they make public that they are performing abortions also has another effect: on the one hand, the fact that women are basically dependent on the doctor's list of the advice centers their right to information restricted. On the other hand, they also have no chance to choose the doctor freelywho is to perform the procedure.

Dorothee Kleinschmidt also sees it this way: "If it were easy to find out which doctors carry out abortions on the Internet, as in Austria, women could inquire independently and choose an appropriate practice," says the pro familia advisor and adds: "With the complicated one Access is restricted to women’s right to information and timely care. "

Pregnancy conflict counseling: how does the counseling work?

Although the discussion about Paragraphs 218 and 219 has flared up again since Kristina Hänel, the provisions currently still apply. This means: If a woman finds out that she is pregnant but not having the child and therefore wants to terminate the pregnancy, she must go to the pregnancy conflict counseling service. But how does such a consultation actually work? What is being discussed there? What do you have to be prepared for? And what attitude do women have when they come to counseling?

"While some women see the decision to terminate a pregnancy as a natural right, others come with the expectation that they have to justify themselves and represent their motives," says Dorothee Kleinschmidt. She emphasizes: "Pro familia stands for the woman's self-determined decision a. That is why we clarify right at the beginning of the consultation that the woman will receive a certificate of advice after the conversation if requested. "She says:" The woman should feel that she can talk openly about her thoughts, feelings and ambivalences. We treat the solutions that the woman has found for herself with respect and do not allow us to judge her decision. "

"The woman does not have to talk about her motives for an abortion"

But what if you are not interested in advice at all? What if you have already decided for yourself that you do not want to have the child? "The woman does not necessarily have to get involved in the consultation," says the family therapist. "That is regulated by law: If a woman does not want to talk about her motives, she can also get a certificate of advice," says Kleinschmidt. "This certainty is very important for some. Some reasons for the decision are so intimate and privatethat the woman doesn't want to talk about it. Especially after experiencing violence or even rape, it can be important for women to decide for themselves when and with whom they want to talk about what they have experienced, "the counselor knows.



Termination of pregnancy in minors: is that possible?

What if the pregnant woman is under 18? Do adolescents need parental consent in order to have an abortion? "That depends on the age of the young woman," says Kleinschmidt. "Legally, it is hardly possible for young people under the age of 14 to abort without their parents' consent. From the age of 16 it is usually assumed that the young person can decide for themselves whether they want to have an abortion"says the doctor.

"Between 14 and 16 years of age there is a margin of discretion: Can the young person understand the procedure? Can they weigh the consequences? It can also happen that the anesthetist does not perform an anesthesia without the consent of the parents," says Kleinschmidt. "That can become an additional hurdle."

And what happens in such a case? "If the parents do not want to agree to an abortion, a court can make the decision instead of the parents," said the counselor. "But that is a complicated way and it can lead to delays. It is particularly difficult if the young person breaks off the pregnancy against the declared will of the parents and then continues to live with the family." Kleinschmidt knows this from experience: "In such cases you need a lot of support and it is best to mediate between the conflicting parties and to avoid an escalation."

Aborting Pregnancy: Two Methods

All in all, no matter how certain you are of your decision and no matter what reasons you have for wanting an abortion - for example, because you are still a minor, you are still in the middle of your studies or training, or you simply don't want any children - Advice is part of it. Although mandatory, it can also be an opportunity and support. In addition, you can not only talk about your own concerns and feelings here, but there is also an initial medical explanation about the The termination of pregnancy himself: "On the one hand there is operational termination, on the other hand the drug termination", says Kleinschmidt." If the woman chooses the drug method, she can also take the tablets at home, which is now allowed in Germany. "The doctor explains further:" The woman takes two different drugs. The abortion is initiated with the first, but the woman does not feel that much of it, "says Kleinschmidt." After two days, she takes the second drug. This causes the uterus to contract and bleed. In 80 percent of women, the pregnancy is terminated in the first four hours after taking the second tablet, "says the doctor and consultant.

Possible after-effects of an abortion

The decision to end a pregnancy is beyond doubt one of the most difficult decisions ever. And especially if a woman decides to have an abortion because she thinks she has no other option, an abortion can have consequences: "Sometimes women can find the abortion to be psychologically very stressful," says Kleinschmidt. "This is more likely to be the case if the woman feels compelled by external circumstances to terminate the pregnancy even though she would have liked to have the child."

In conclusion, Kleinschmidt also emphasizes: "However, the picture that psychological problems very often occur in women after an abortion cannot be confirmed based on our experience and research. Of course, it is a life event after which one cannot simply return to the agenda but a lot of women are sure that it was the right decision for them. "


All information about the process at a glance:

  • Pregnancy is determined by a pregnancy test and an appointment with the gynecologist.
  • The appointment for pregnancy conflict counseling is required by law. All concerns, worries and fears about pregnancy and a possible abortion can be discussed here - but it does not have to be. The consultation can also take place anonymously if you wish, you don't have to give your name. It is also possible to come to the appointment with a companion.
  • The termination of pregnancy can only take place if you have a counseling certificate. The counseling center also gives you a list of medical practices in which abortions are carried out.
  • After the consultation you have to wait three full days before you can have the abortion carried out by the gynecologist. As a rule, there is another preliminary medical examination in the practice 24 hours before the procedure.
  • There are two options: medical abortion with tablets and surgical abortion, which also involves anesthesia.
  • Termination of pregnancy is only possible up to the 12th week of pregnancy, i.e. 12 weeks after fertilization of the egg cell. This is why it is important to act quickly if you want an abandonment. The period of 12 weeks also applies if there is a criminological indication for the termination, i.e. if the pregnancy was caused by a criminal offense such as rape. If there is a medical indication for a termination, for example because the mother's health or psyche would be endangered if she had the child, it is still possible to terminate the pregnancy after the 12th week of pregnancy.
  • The patient usually has to bear the costs of an abortion herself. They amount to between 200 and 570 euros, depending on the practice.
  • You can find more information about abortion and more details about the costs at: www.profamilia.de/schwangerschaftsabbruch.pdf
  • Exceptions and further information on the legal situation can be found at: www.bmfsfj.de/schwangerschaftsberatung218.pdf

Recognized advice centers are, for example: