Abortion policy in Germany: spotlight on Berlin

Introduction

Abortion has been a heated debate in global politics and society, yet it is the duty of (democratic) governments to provide choices for their citizens to ultimately decide. Germany has made a number of changes to its abortion law, mirroring its myriad political transformations. The country’s capital, Berlin, has been at the centre of numerous political changes and this is reflected in the varied abortion policies there throughout the 20th century. This policy paper will hence outline abortion policy in Germany, highlight pro-abortion movements in Berlin and provide recommendations to national policymakers for providing safe and legal access to abortion. 

Women’s movements in Berlin in the 20th century

Post-1945, women’s committees campaigned for gender equality and the right to democratic participation. In 1947, 2,000 anti-fascist women’s rights organisations gathered in Berlin for a conference, culminating in the founding of the cross-zonal Demokratischer Frauenbund Deutschlands (DFD) (Democratic Women’s League of Germany). Following political tensions between the US and the USSR, the Western Federal Republic of Germany (BRD) was founded on 23 May 1949, followed by the formation of the German Democratic Republic (DDR) in the East on 7 October 1949. The division of Germany also saw the division of Berlin into East and West. 

In the DDR, the DFD had limited independence from the state and was used to legitimise policy (Bouillot, 2021). It had up to 1.5 million members at its peak but was viewed with scepticism by the younger generation (Schröter, 2020; Bouillot, 2021). Organisations affiliated with the church were influential, focusing on peace, theology and gay rights. In East Berlin, groups participated in educational radio broadcasts and paid tribute to the lesbians murdered under National Socialism (Sänger, 2021). According to Dr. Eva Sänger, a professor at the  Universität zu Köl,n these groups expanded civil society’s scope for action but had limited opportunity to mobilise against state restrictions (Sänger, 2021). In the West, the DFD criticised militarisation and nuclear armament and was banned in 1957 (Hervé, 2021; Schröter, 2020). After internal divisions within West Germany’s growing student movement in 1968, one spokeswoman threw a tomato in frustration over sexism during a board meeting. This sparked the establishment of more women’s organisations and the growth of the movement. Abortion and the role of housewives were key topics in the 1970s, with the women’s movement becoming more fragmented in the 1980s. Before reunification, women’s movements in the West had limited public visibility, in comparison to growing mobilisation in the East (Hertrampf, 2021). The Unabhängige Frauenverband (UFV) (Independent Women’s Association) was founded in East Berlin in December 1989. It criticised what it saw as the exclusion of women’s issues from the political transition and the possibility of increased economic restrictions for women, imported from the West. It took part in elections in the DDR, and in a reunified Germany had a Minister serve in the transitional government which then was dissolved in 1998 (Sänger, 2021). 

Reunification brought together two radically different movements: inspiration from Western countries along with the influence of Communists Clara Zetkin and Rosa Luxemburg from the East (Stitz, 2021). Today, women’s movements have become more professionalised, yet face issues with funding and sustaining membership (Sanyal, 2021).

West Berlin women’s movements for abortion

1871 saw the introduction of Paragraph 218, which outlawed pregnancy terminations and forced women to undergo illegal and unsafe procedures (Hanisch, 2019). After the end of the Second World War, the Western zones in Germany repealed the Nazi policy for the death penalty for abortion under specific circumstances but it remained “prohibited” (Binışık, 2019). In the Soviet zone, the authorities replaced Paragraph 218 with legislation that made abortion widely permissible (pro-familia Bundesverband, 2017).

Protests in the West and the growth of the women’s movement in the 1960s brought Paragraph 218 to public prominence (pro familia Bundesverband, 2017). Calls for a Fristenlösung (legal abortion during the first trimester) became more common. In 1971, women on the cover of Stern magazine broke societal taboos (and the law) by declaring they had undergone pregnancy terminations. Journalist Alice Schwarzer spearheaded the campaign, drawing inspiration from feminist movements in France.   

The subsequent campaign united different women’s groups and representatives held meetings in Dusseldorf and Frankfurt (Schenk, 2019). The Aktion 218 campaign was instrumental in organising demonstrations, including against a proposed legal reform that would implement an Indikationslöesung for abortion in the event of risk to the mother’s life, rape, or foetal disability (Schenk, 2019). In 1972, the Brot und Rosen group in Berlin published a guide to abortion and contraception, two years before it organised a ‘teach-in’ about Paragraph 218, attended by over 2,000 people at the Technische Universität (Schenk, 2019b; Szemkus, 2019). Indeed, 1974 marked a turning point for pro-abortion campaigners. The Aktion letzter Versuch took place across West Germany in March 1974, putting pressure on the FDP and SPD political parties to approve new legislation. 

Civil society organisations played a considerable role in the protests. The Frauenzentrum Westberlin (West Berlin Women’s Centre) in Kreuzberg, which helped West German women access abortions in the Netherlands – with many of them travelling to Berlin to receive support that was unavailable elsewhere – organised a vacuum aspiration demonstration, the first of its kind in West Germany (Feministische Projekte in Berlin 1974-78, 2019). The broadcaster NDR refused to air a film with Alice Schwarzer on abortion (Hitz, 2019). This caused Panorama’s managing director to share footage of an empty studio in protest (Hanisch, 2019). The Frauenzentrum Berlin was home to numerous working groups, one of which evolved into the Feministische Frauengesundheitszentrum (Feminist Women’s Health Centre), which is still active today (Feministische Projekte in Berlin 1974-78, 2019b). The organisation also offered a weekly advice hour on the medical aspect of abortion, in collaboration with Brot und Rosen and led by doctors since 1974 (Szemkus, 2019). Other significant contributions to the women’s movement came from Homosexuellen Aktion Westberlin and the anti-capitalist organisation Sozialistische Frauenbund Westberlin, which may have come under influence from the DDR (Schwarzer, 2011; Berlin Goes Feminist, 2016). 

Civil society’s efforts encouraged the Bundestag (Parliament) to pass the Fristenlösung that year but it failed to come into force, following a constitutional complaint from the CDU/CSU (Hanisch, 2019; Notz, 2006). In 1976, lawmakers instated the Indikationslösung. Abortion remained illegal but would not be punished under certain conditions, such as under “a “medical”, “criminological”, “embryopathic”, or “social” indication. Pro-abortion women’s groups continued to protest for more lenient legislation, making abortion a key issue on their agenda. The 1980s saw the CDU/CSU advocating in favour of pro-life counselling centres and doctors were to inform the Federal Office of Statistics to enable the termination to be covered by health insurance providers (Hanisch, 2019). The trial of the gynaecologist Horst Theissen in Memmingen, Bavaria, attempted to prosecute him and the women he treated. It was the largest abortion trial in the country’s history, characterised as a “witch hunt” (Hanisch, 2019). In the 1990s, the discussion on abortion receded into the background, as the women’s movement devoted more attention to the issue of having children (Hanisch, 2019). 

East Berlin women’s movements for abortion

In East Germany, the country’s constitution and its provision for gender equality meant that Paragraph 218 never applied. A law in 1950 allowed abortion under limited circumstances. In 1965, abortion for social circumstances became legal and in 1972, the procedure was legalised until the 12th week. Following that time, terminations would be permitted if the pregnancy posed a risk to the mother’s life (Hanisch, 2019). This may have been to avoid West German protests arriving in the DDR (Hanisch, 2019). Until the reunification, every third pregnancy in East Germany ended in abortion (mdr.de, 2023). However, this right became obsolete as the BRD’s law came into force for the entire country (Hanisch, 2019). In 1990, East Germans marched in front of the DDR parliament in an effort to reclaim their rights. The Independent Women’s Association submitted a petition with over 17,000 signatures, with the Minister for Women receiving over 26,000 postcards. That year, East and West Germans protested against Paragraph 218 at the Brandenburger Tor (mdr.de, 2022). 

The unification treaty ensured that existing abortion provisions in the East and West would remain in place until the end of 1992 (Schröter, 2016). That year, the Bundestag voted for legal abortion during the first 12 weeks of pregnancy, with the provision of compulsory counselling (Hanisch, 2019). A complaint lodged by the Bavarian government in 1993 saw the law termed unconstitutional. Abortion under certain circumstances was to be “illegal but exempt from punishment” (Hanisch, 2019). This came into force in 1995, under the Schwangeren- und Familienhilfeänderungsgesetz (Pregnancy and Family Assistance Amendment Act), dubbed the Schwangerschaftskonfliktgesetz (Pregnancy Conflict Act) and was criticised for its ambivalence (Schröter, 2016; Stitz, 2021). 

Abortion access in the 21st century

In the 21st century, minor amendments were made to the law regarding the medical grounds for abortion (pro familia Bundesverband, 2017).

In 2017, Dr Kristina Hänel received a 6,000 euro fine for providing abortion services to patients (Connolly, 2022). In 2019, doctors and hospitals were allowed to state on their websites that they offer abortion services, but could not provide medical details. Information was only available from the Federal Centre for Health Education (Deutsche Welle, 2019).

Today, abortion is permitted until the 12th week of pregnancy, if there is a risk to the mother’s health or if the pregnancy was caused by rape (Heidelberg Institute for Geoinformation Technology, 2022). After this time period, people may undergo pregnancy terminations “[…] to avert a danger to life or the danger of a serious impairment of the physical or mental state of health of the pregnant woman”. Up to one in three people who opt for abortions in Germany still decide to undergo the procedure in the Netherlands (Heidelberg Institute for Geoinformation Technology, 2022). One reason may be the lack of abortion service providers in Germany. Many are retiring and medical schools rarely feature abortion in their curriculums (​​Whittle, 2023). Additionally, hospitals that are affiliated with the Catholic Church do not offer abortions. Campaigning from the women’s movement led to the abolition of  Paragraph 219a in 2022, which had prevented doctors from advertising abortion services. This law had been introduced by the Nazis in 1933 and campaigning for its abolition began in the 1990s (Connolly, 2022).

Across Germany, there were 99,948 abortions in 2020, with the procedure costing at least 360 euros. The state covers costs for women with no or low income (Rød et al, 2023). Practitioners can voluntarily register their services on a list compiled by the German Medical Association. As of June 2022, 369 locations are available for pregnancy terminations (Heidelberg Institute for Geoinformation Technology, 2022). 

A 2023 study found that the Covid-19 pandemic exacerbated existing barriers to abortion access and presented new ones. Abortion provider Women on Web (WoW) has been operating in Germany since April 2019. From March 2020 to March 2021, the federal government imposed three lockdowns to curb the spread of the coronavirus. The study conducted by Women on Web found that, during this time, counselling centres could continue providing compulsory counselling services online or via phone to those seeking abortions. However, this service was not yet available during the first lockdown. Furthermore, some centres never made telecounseling services available to patients. Practitioners revealed that abortion services decreased, due to the risk of spreading coronavirus. The closure of schools and kindergartens also presented additional care responsibilities to parents, which prevented people from accessing abortions if they were unable to find childcare support from members of their households. A further issue was hospitals refusing to provide abortions, as they were not classified as emergencies. The pandemic also caused delays in the application process for the government to cover abortion costs (Rød et al, 2023).

Practitioners also stated that the pandemic enabled the provision of telecounseling for the first time. Patients saw the privacy afforded by this option as highly beneficial, as it reduced the need to travel and afforded them the comfort of their own homes. However, it could also pose difficulties for patients who could not access the internet or phone services. Groups especially affected were those who already face disadvantages, such as disabled people, non-native German speakers and foreigners aiming to access German abortion services from abroad. 36% of study respondents stated that financial issues impeded their access to pregnancy terminations. Respondents also indicated that privacy was a huge concern, especially for those experiencing domestic violence. On the whole, people who tested positive for Covid-19 faced delayed abortion treatments, which means their pregnancy could exceed the legal limits for termination. Moreover, telemedicine abortion was never formally authorised by the federal German government (Rød et al, 2023).

As of March 2023, the German Family Minister, Lisa Paus, had proposed legislation to prevent anti-abortion activists from blocking access to services during lent. This would see an extension of the Pregnancy Conflict Act (Deutsche Welle, 2023). Moreover, the government is set to establish a commission on abortion regulation outside of the German Criminal Code (Whittle, 2023).

Today, pro-abortion campaigners establish counter-protests to Berlin’s annual Marsch für das Leben (March for Life), where anti-abortion activists gather in front of the Brandenburger Tor (EWTN, 2022). Protesters from the EuroProLife organisation have campaigned outside abortion services in Frankfurt, at demonstrations held by US group 40 Days for Life. Journalist Ulli Jentsch has highlighted how anti-abortion protesters in Germany have been influenced by those in the US since the 1990s. He has indicated that this influence manifests in the forms of American anti-abortion activists speaking at the Marsch für das Leben, as well as providing legal and financial support for cases in European courts. Lawyers from the US Alliance Defending Freedom (ADF) have helped Pavica Vojnovic, organiser of the “40 Days for Life” protest in Pforzheim, to win her case against the municipal government’s ban on anti-abortion protests outside a clinic (Whittle, 2023).

There appear to be few pro-abortion civil society organisations in the capital, which includes the local branch of Doctors for Choice Germany. The off-shoot Medical Students for Choice Berlin advocates for improved training on abortion methods. Their papaya workshops, organised with Doctors for Choice, aim to amend this, with students practising on the fruit (Msfc-Berlin). Moreover, members of Berlin’s Family Planning Center BALANCE work with Doctors for Choice Germany to facilitate abortion access (World Health Organization, 2022). The Bündnis für sexuelle Selbstbestimmung works across Germany for women’s reproductive and sexual autonomy, including organising against the Marsch für das Leben in Berlin (Bündnis für sexuelle Selbstbestimmung, n.d.).

On the whole, campaigning for abortion was not limited to Berlin by any means. In West Germany, the pro-abortion movement succeeded in gaining popular support but struggled to translate this into political support and legislation. In the DDR, abortion laws were more lenient, so there was no need to campaign as in the West. However, people in the DDR generally had more limited freedom to express political dissatisfaction. Success was further stunted by the post-reunification imposition of Paragraph 218. 

Today, there appear to be few organisations in Berlin that solely work on abortion. The main issue faced by Medical Students for Choice Berlin is universities’ reluctance to offer more teaching on abortion. Via email correspondence with the organisation, it was revealed that it receives funding from its Fachschaft (student association) and prize money, with no legal restrictions, thanks to the overturning of Paragraph 219a. They rarely face harassment from anti-abortion activists. 

Overall, movements have succeeded in overturning Paragraph 219a and continue to fight for the abolition of Paragraph 218. 

Policy recommendations

The federal German government should first and foremost recognise “abortion as an essential health service and eliminate all other discriminatory abortion laws and policies, including the requirement for pre-abortion counselling” (Rød et al, 2023). Placing a  counselling requirement forces people to discuss and justify their private medical decisions. Legalising the provision of telemedicine would facilitate access to abortion for those with childcare responsibilities, but service providers should also ensure access to surgical abortions. They should also be legally required to register the fact that they provide abortions on the German Medical Association’s list. 

There should be state funding for Medical Students for Choice Berlin and its sister organisations in other German states. This would ensure that medical students have the necessary knowledge to perform abortions and raise awareness of pregnancy terminations. Finally, making pregnancy termination a compulsory part of the curriculum for all medical students would facilitate access to abortions for future patients. 

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