Termination of pregnancy
A termination of pregnancy (also abortion and induced abortion ; Latin interruptio , abruptio graviditatis ) is the premature termination of a pregnancy by removing the abortion . As a rule, the human embryo or fetus intentionally does not survive the procedure. This is to be distinguished from the overarching medical term abortion ; this also includes a natural spontaneous abortion ( miscarriage ).
The admissibility of abortions has been hotly contested since late antiquity. Religious and ethical ideas , social claims, the woman's right to self-determination and the right to life of the human embryo or fetus are in conflict . This results in very different ethical assessments and legal regulations; they range from extensive freedom of choice for pregnant women to total prohibitions with harsh punishments.
Biologically, pregnancy begins with the fertilization of an egg and ends with birth. In Germany, pregnancy is criminally protected once the fertilized human egg cell has implanted in the uterus ( (1) sentence 2 StGB). Implantation begins around the sixth day after fertilization and is completed on the 10th to 14th day, i.e. around four weeks after the first day of the last menstrual period. The end of a pregnancy is legally determined, at least with regard to the regulations relevant for abortions, with the onset of the expulsion labor.
The times for pregnancies and the regulation of legal deadlines have different reference points:
- In medicine, the duration of pregnancy is calculated from the first day of the last menstrual period (p. M., Post menstruationem).
- In some legislations, for example in Germany, deadlines for an abortion refer to the time of fertilization (p. C., Post conceptionem). Since conception is only possible immediately after the follicle rupture (ovulation) about 14 days after the last menstrual period, two weeks are to be added to the assumed date of fertilization (p. C.) In order to calculate the pregnancy weeks ( wks) that are customary in medicine (p. M.) ) get.
Unless otherwise stated, the information in this article refers to the medical (p. M.) Census. When doctors talk about months of pregnancy, they do not mean calendar months, but four weeks of pregnancy. Therefore, there are different times with apparent deviations.
Termination of pregnancy
The term termination of pregnancy is defined differently.
The Federal Court of Justice defines it as “any action on the pregnant woman or the fruit that causes the still living fruit to die in the womb or the loss of the fruit in a non-viable state”.
Interventions before completion of nidation (implantation of the blastocyst in the lining of the uterus ) are not considered discontinuation. Implantation begins about a week after fertilization and thus about three weeks after the first day of the last menstrual period. Implantation is completed about a week after it begins.
There is no uniform medical or legal definition of the term late termination.
On the one hand, if you cancel after the 12th or 14th week of pregnancy, p. m. (or after the statutory period according to the time limit regulation ) is spoken of a late termination. On the other hand, in the public discussion, an abortion is often only referred to as a late termination after the 24th week of gestation (22nd week from fertilization), because from this time the child is potentially able to survive outside the womb.
Methods of termination of pregnancy
Suction method / aspiration
At around 62 percent (as of 2016), the suction method is the most frequently used method of termination of pregnancy in Germany. It can be from the 6th to around the 14th week of pregnancy p. m. be applied. The procedure is almost always carried out on an outpatient basis, it is easy for experienced doctors and can be carried out in a few minutes.
The pain is eliminated either locally with local anesthesia or with a brief general anesthetic . Sometimes (in Switzerland) regional anesthesia is also used. In many countries the procedure under local anesthesia is standard (England, Netherlands, USA); in others it is usually performed under general anesthesia (e.g. Germany, Switzerland). Local anesthesia is the safest method of eliminating pain during termination of pregnancy in the first trimester of pregnancy and is therefore recommended by the WHO, British and French guidelines.
The cervix is often given a small dose of a prostaglandin such as a prostaglandin before the procedure. B. Misoprostol (Cytotec) or Gemeprost (Cergem) softened, which facilitates the expansion. The cervix is held in place with gynecological ball forceps and the opening of the cervix is stretched with fine metal pins (dilators, e.g. Hegar pins ). Then the fruit sac with the embryo and the mucous membrane of the uterus are sucked off with a blunt tube (suction curette; 6 to 12 mm diameter, depending on the duration of the pregnancy) ( menstrual extraction ). In the 10th week of pregnancy, the human embryo is no longer than 25 mm long.
Ultrasound is used to check whether any tissue remains that can be removed with a second suction or a blunt curette . In most cases, a follow-up examination beyond this is not necessary.
The termination with the suction method is associated with a very low complication rate under good medical conditions. Occasionally, spasms of the uterus occur afterwards, which are mostly comparable to menstrual cramps and can be treated accordingly with antispasmodic medication .
The standard procedure is a combination of mifepristone and the prostaglandin misoprostol . The so-called "abortion pill" blocks the effect of the corpus luteum hormone ( progesterone ) and leads to the opening of the cervix. About two days later, the prostaglandin is ingested, which causes the uterus to contract and expel the uterine lining along with the fruit sac and embryo. The process is comparable to a spontaneous abortion or a heavy menstrual period. The drugs are mostly taken on an outpatient basis, but under medical supervision. Increasingly, women are also offered the option of taking prostaglandin at home. A follow-up examination is required after one to two weeks.
Mifepristone is approved in the European Union for early drug termination up to the 9th week (63rd day after the start of the last menstrual period) and for late termination in the second trimester. In the Scandinavian countries, the method is increasingly used between the 9th and 14th week of pregnancy. In Germany, 25 percent of the abortions were carried out with medication in 2019, in Switzerland 70 percent and in Sweden 80 percent. The lower proportion in Germany is due, among other things, to the delay due to the obligation to provide advice and the time to think about it, as well as to resistance from the medical profession (spatial requirements, insufficient reimbursement of costs). In Germany and Switzerland - in contrast to other countries - late abortions are almost always carried out with medication.
Termination after the 14th week of pregnancy is usually carried out in hospitals because of possible complications. In advanced pregnancies, the same drug combination is administered as standard, but in a higher dose. From about the 22nd week of pregnancy, it is possible for fetuses to survive an abortion. To prevent a live birth , if the fetus is possibly viable, the blood supply to the umbilical cord is cut off or potassium chloride is injected, which triggers cardiac arrest (" fetocide ").
Medical abortion causes temporary vaginal bleeding, cramps, and the shedding of the embryo and placenta. Complications are more common when misoprostol is given alone, especially incomplete termination, which is why the WHO recommends the use of both drugs. Under medical supervision, severe complications with combination therapy requiring hospitalization, blood transfusion, or surgery are rare at 0.3%. The mortality (in the USA) is about 0.65 deaths for 100,000 drug abortion attempts, which is 13 times lower than the birth-related mortality.
In countries where abortions are prohibited and drug abortions take place without medical supervision, studies also show a high success rate and a low rate of complications.
In the curettage (also curettage), after the expansion of the cervix of the fetal sac carefully scraped off with the embryo and the endometrium with a curette (a spoon-like instrument). This previously common method of termination of pregnancy has mainly been replaced by suction and is rarely used as the sole method of termination of pregnancy. Today, curettages are performed when, after an abortion, other methods still need to be removed from the embryo or other tissue remains from the uterus.
In rare cases - in Germany there were only 5 cases in 2016 - a pregnancy is also terminated by the surgical removal of the uterus ( hysterectomy ). The reason for the intervention is usually not the termination of pregnancy, but a threatening disease of the uterus, e.g. B. a cancer that does not allow a continuation of the pregnancy.
Complications of the procedure
Legal abortions, performed under good clinical conditions in industrialized countries , are among the safest medical interventions. In the United States, the maternal mortality rate after abortion was approximately 0.6 per 100,000 procedures in 1998-2005, making abortion approximately 14 times safer than childbirth (8.8 deaths per 100,000 live births). Mortality increases with the length of pregnancy.
Serious early complications (such as perforations, severe infections, severe blood loss) occur in less than 1 percent of cases of abortions up to the 14th week of pregnancy.
In countries and cultures in which abortions are illegal, the complication rate is significantly higher, as the abortions are often carried out under unsanitary conditions and with questionable methods by mostly unqualified people - sometimes called Engelmacher in colloquial language - or the women concerned themselves ( self-abortion ). Terminations are also often only made in the 2nd trimester . According to the WHO, illegal abortions are a major contributor to the high mortality rate among women of childbearing age in countries where abortion is prohibited.
The main complications of medically supervised and self-induced abortions are:
- Incomplete breaks with remaining tissue, which require surgical intervention to aspirate and remove the remaining parts, and above all increase the risk of infection.
- Infections , especially endometritis , account for 0.5% of all surgical abortions and 0.01% - 0.2% of all drug abortions. Typically, there are several germs, especially the intestinal and vaginal flora , as well as Neisseria gonorrhoeae and Chlamydia trachomatis . Most infections are mild and treatable with antibiotics on an outpatient basis . If there are severe signs of infection, broad-spectrum parenteral antibiosis is necessary, then there is also the risk of sometimes rapidly progressing sepsis and acute lung failure . Infection can be caused by remaining placenta residues, and with self-induced demolition, non-sterile tools and overlooked intestinal perforations.
- Persistent bleeding can be the result of uterine atony , remaining placenta remnants or placentation disorders (e.g. placenta accreta ), as well as bleeding disorders or arteriovenous malformations, but also from injuries to the uterus with perforations in neighboring organs (bladder, intestine, etc.). Heavy bleeding can lead to hemorrhagic shock and disseminated intravascular coagulation (DIG). Therefore, emergency therapy to stop bleeding is important, with uterine medication, uterine aspiration, balloon tamponade, aggressive infusion therapy and, if necessary, massive blood transfusions , as well as arterial embolization . In an extreme emergency, a hysterectomy is necessary. Bleeding within the uterus ( hematomaetra ) leads to severe cramps, but is usually not threatening and can be treated well with uterotoid means and, if necessary, ambulatory aspiration.
- Mechanical injuries can occur especially with self-induced abortion, in which lateral injuries to the uterus and cervix are particularly dangerous because large arterial branches run there. These injuries can also lead to internal bleeding that is not directly recognized, into the pelvis or the retroperitoneal space . In addition, perforations can occur in neighboring organs, especially in the bladder and intestines, with the rare formation of fistulas and an increased risk of infection.
- Uterine rupture : Very rare, very serious complications, especially after previous caesarean delivery
Long-term physical consequences
Fertility: An uncomplicated termination does not affect fertility. The next ovulation usually occurs after about two to three weeks; the woman can become pregnant again. To avoid another pregnancy, an effective method of contraception must therefore be started immediately after the termination .
Breast cancer risk: Opponents of abortion claim that abortions increase the risk of breast cancer . Medical associations like the World Health Organization , the American Congress of Obstetricians and Gynecologists , the National Cancer Institute , the American Cancer Society, and the Royal College of Obstetricians and Gynecologists deny that abortions cause breast cancer. According to the German Cancer Research Center , abortions do not pose a cancer risk. Scientific studies would have ruled out a connection between abortion and breast cancer with relative certainty. In addition, a meta-analysis in 2004 could not find any significant association.
In 2008, two systematic reviews of the more recent scientific studies (after 1989) were carried out on the psychological well-being of women after an abortion. One comes from a group of experts at the American Psychological Association (APA), the other from a team of researchers at Johns Hopkins University in Baltimore. Both independently came to the conclusion that the qualitatively best studies refute the thesis that an abortion causes psychological problems. An adult woman with a single termination in the first trimester for non-therapeutic reasons does not have more mental problems than the average woman. According to the APA report, which was updated in 2009, risk factors for developing mental disorders after an abortion are not the procedure itself, but the perceived stigma, need to keep the abortion a secret, low social support for decision-making, low self-esteem, denial and avoidant coping strategies and especially previous psychological problems. However, the APA report also identified a total of 17 risk factors that are associated with a higher number of mental disorders after an abortion.
In another systematic review in December 2011 , experts from the National Collaborating Center for Mental Health , a center belonging to the British National Health Service , also came to the conclusion that abortion does not increase the risk of developing mental disorders. According to other review articles, there is no causal relationship between abortion and mental disorders.
As a result of a long-term study, a New Zealand research group led by David M. Fergusson came to the conclusion in 2006 that the risk of mental disorders such as depression, anxiety disorders, suicide and the consumption of harmful substances is significantly higher, especially in young women who have had an abortion. Although the APA report comes to the conclusion that the study is unusable, the criticism is mainly based on the facts that on the one hand only the situation of young women is taken into account, on the other hand the social and legal framework for women in New Zealand is increasing different from the USA. Furthermore, the APA report names Fergusson's study as the most informative and strongest in their group, which may a. the long-term perspective and the correct use of medical diagnosis catalogs.
The psychologist Priscilla Coleman published a meta-analysis in the British Journal of Psychiatry in 2011 that included 877,181 patients, of whom 163,831 had had an abortion. As a result, women who have terminated pregnancies have an 81% increased risk of developing mental health problems.
In 2016 Donald Paul Sullins published the results of a long-term study over a period of 13 years for women in the USA, which found a moderately increased incidence of mental disorders and addictions after an abortion.
In the USA, anti- abortionists, among others, represent the existence of post-abortion syndrome (PAS). PAS is not a recognized medical syndrome and is not classified as a disorder in either the World Health Organization's International Statistical Classification of Diseases and Related Health Problems or the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders . In several literature reviews, scientists came to the conclusion that the PAS does not exist.
The decision to terminate an unwanted pregnancy is associated with conflicts of conscience of varying degrees for some women . However, most women report a sense of relief immediately after the termination. According to a review article, most women who have had an abortion do not regret their decision and would make that decision again in similar circumstances.
According to a systematic review from 1991, mothers who have been refused an abortion can suffer long-term consequences . It is reported that many women found it difficult to adapt to the unwanted role of mother and that the child was more of a burden. The children of the affected mothers achieve poorer school results on average, show more behavioral problems such as delinquency and require more psychiatric treatment.
The Tanach (Old Testament) deals with the problem of abortion only marginally, and there is no uniform understanding of this in Judaism. Ancient Judaism rejected abortions unless the mother's life was endangered by the pregnancy. For example, Philo of Alexandria (1st century) condemned non-Jews for the widespread abortion and infanticide practices. Beyond the general consensus that abortion is strictly prohibited if the mother's life is not in danger, there is controversial debate.
A starting point is that the question of whether the unborn child is already a human is answered not according to scientific, but according to internal religious standards. So life in the Tanakh is often equated with breathing; see Ruach ( breath of life) and breath soul . In the Talmud there is the statement that the fertilized egg cell is “just water”, “mayim b'alma” up to the 40th day. The fact that the termination of pregnancy is still not released at will is due, among other things, to the Torah's proclamation. According to Talmudic law, the fetus is not regarded as an independent life, but as part of the mother (“The fetus is the mother's loin”) and the property of the husband.
Another passage does not refer to abortion, but to obstetrics : the fetus may be killed at birth in order to preserve the mother's life: “If the woman has difficulties giving birth, cut up the fetus inside her and pull it part by part, because her life is more important than his. When the greater part [others translate: the head ] is born, do not touch it, because one life must not be eliminated for another life. ”From this point on, killing is forbidden in any case. Maimonides believes that the fetus may have to be viewed as a “persecutor”, someone trying to take the life of a woman who has problems with pregnancy and childbirth. According to the law, however, anyone who persecutes another person with the intention of killing himself may be killed himself. In doing so, he justified the termination of pregnancy only if the mother was at risk. The Ashkenazi chief rabbi of Israel Isser Jehuda Unterman (1886–1976) compared abortion with murder if the mother was not at risk. He also counted the psychological pressure that could drive the mother into suicide as such a danger. The Sephardic Chief Rabbi Ben Zion Chai Usiel (1880–1953) approved the termination of pregnancy even in the case of minor need for the woman. In doing so, he relied on the Talmudic passage, which speaks of humiliation: “In any case, it is very clear that they only allowed the fetus to be killed in an emergency, but also when the emergency is not serious, such as for Example of a possible humiliation of the mother. But in the absence of an emergency it is certainly forbidden, because it is about annihilation and the prevention of a life chance for a nefesh in Israel. ”So Usiel allowed the termination even for less serious reasons, but prohibited it if there were no justifying reasons.
In Christianity, termination of pregnancy is mostly viewed as a sin . According to the Catechism of the Catholic Church, human life must be absolutely respected and protected from the moment of conception. From the very first moment of its existence, human rights are to be recognized, including the inviolable right of every innocent being to life. Accordingly, an abortion is to be equated with the killing of a person, the direct participation a serious offense. Individual Catholic theologians such as Andrea Arz de Falco, Alberto Bondolfi , Hans Halter, Stephan Pfürtner question the Church's doctrine on abortion.
Within Protestantism, some theologians are of the opinion that breaking off is indeed a violation of the biblical prohibition of killing, but could possibly be ethically justifiable as the lesser evil in an insoluble dilemma; the self-responsible conscientious decision of the woman concerned in her distress is to be respected.
Ancient and Middle Ages
The New Testament does not deal with the subject. However, early Christian sources already reject abortion, often in deliberate opposition to the views of the pagan majority society . The Didache , one of the earliest non-biblical texts, says in Chapter 2: "You shouldn't kill, [...] you shouldn't abort a child, you shouldn't kill a newborn." At the same time, Clemens of Rome and later rejected them Church fathers ( Basil of Caesarea , Augustine of Hippo , John Chrysostom ) unanimously approve of abortion. The Christian Barnabas letter from the first or second century demands, for example: “Do not kill the child by abortion, nor kill the newborn!” Tertullian agrees : “We are also not allowed to have a person who is before birth to kill as someone who has already been born ”and“ We, on the other hand, are not allowed to destroy even the embryo in the womb [...] after we are forbidden to kill a person once and for all. Preventing childbirth is anticipated murder; it does not matter whether a person is robbed of life after birth or whether it is destroyed in the developing state. A person is already what a person should become - every fruit is already contained in its seed. " Minucius Felix writes in his Dialogue Octavius, 30th chapter, in the first half of the third century:" not with us, [ ...] but with you I see the newborn children being abandoned; that some women destroy the germ of future life by ingesting medicines and commit child murder. ”In the Synod of Elvira around 306, abortions were condemned for the first time in a council. After the Constantinian Revolution , Emperor Constantine put the death penalty by the sword on abortions; this was a big change in Roman law which previously provided no punishment for it at all. Ephraem the Syrian , † 373, writes in the tenth chapter of his speech about Judgment Day: “who destroys the fruit of her womb, [...] who miscarries her child, it will be miscarried by this child himself on Judgment Day and withdraw it their life and light of the life beyond. […] This is the retribution for those who take their children’s lives. ” In 374, Basil of Caesarea condemned abortion in his letter to Amphilochius of Iconium :“ A woman who deliberately aborted the womb is guilty of murder . There is no subtle distinction between the womb before and after birth. [...] The woman endangers herself, and then there is the destruction of the embryo, the second, intended murder. [...] Church penance should not be extended to death. "The Church Doctor and Archbishop of Ravenna Petrus Chrysologus , † 450, emphasized in a sermon the relationship of man to God before birth:" You lucky ones, [...] even before yours Mother sees, Heavenly Father accepted you as children of God in a unique and lasting kinship. "
In theology, the doctrine of successive ensouling, also called epigenism, prevailed for a long time; accordingly the animation takes place gradually and progressively ( Augustine , Hieronymus , Thomas von Aquin , Alfons von Liguori ). This doctrine goes back to Aristotle , who believed that an embryo or fetus first had a plant soul (anima vegetativa or vegetalis), on the basis of which it lived at all, then a sentient animal soul (anima sensitiva or animalis) and only 40 days (at a male fetus) or 90 days (for a female fetus) after conception a rational human soul (anima intellectiva or rationalis or humana). The Scholastic defines a human as a being with a rational soul. In his Summa theologica Thomas Aquinas writes: “in generatione hominis prius est vivum, deinde animal, ultimo autem homo” (“in the development of man there is first a living being, then an animal, but finally a man”). Based on the teaching of Aristotle, for Thomas the soul is the form of the body and its entelechy , and a soul requires certain organic requirements. According to Aristotle, Augustine had already claimed that a human soul could only exist in a body that had a human form. Albertus Magnus , an opponent of successive ensouling and Thomas's teacher, did not deny this requirement and justified his view that an embryo had a rational soul from the start with the conviction that it looked like a tiny child from the start. In comparison, Aristotle and Thomas had an astonishingly correct idea of embryogenesis for the time , in that they believed that the form (today one would call it the phenotype ) of an embryo first goes through lower, plant-like and then animal-like stages of development before it becomes one adult humans could become. The embryology and developmental biology emerged as a science until the 19th century, see. Karl Ernst von Baer's rule from 1828 and Ernst Haeckel's basic biogenetic rule from 1866. The Aristotelian and medieval demarcation of the embryonic stages of development was certainly somewhat arbitrary and fluctuated. In the Christian tradition, according to Aristotle, the 90 days until the assumed animation of a female embryo was often changed to 80, following the biblical purity laws after a birth: Mary was unclean for 40 days after the birth of Jesus (Luke 2.22) and was not allowed to enter the temple; if a daughter had been born she would have been unclean for 80 days ( Leviticus 12). Dante Alighieri described the three phases of soul development in the Divine Comedy without specifying the time and without differentiating between the sexes : After the body of the fetus has formed and finally its brain has emerged, God breathes the rational soul into it as the culmination of his work.
Although successive ensouling was theologically controversial in scholasticism, Catholic canon law from the Decretum Gratiani around 1140 to 1869, according to this doctrine, made a distinction between the fetus inanimatus or informatus and the fetus animatus or formatus , the inanimate or unformed and the ensouled or formed fetus. An abortion was from a Catholic perspective always considered sin and was with months to years of penance occupied, but he was appointed as only one animated fetus murder considered with excommunication , sometimes punishable by death penalty. In the medieval Corpus Iuris Canonici it was said: “He is not a murderer who carries out an abortion before the soul has been poured into the body.” Since it was not yet possible to determine the gender, an abortion was not excommunicated until at least 80 days after conception. Before that, the fetus was considered the “mother's body part” (pars viscerum matris). The view of the later animation of women thus resulted in a deadline solution of almost three months as far as the penalty of excommunication in the event of an abortion is concerned. An example: Pope Innocent III. († 1216) decided in the case of the lover of a Carthusian monk, who had aborted at the monk's insistence, that the monk was not guilty of killing if the embryo was not yet animated according to Aristotelian biology.
Roman Catholic Church
In the bull Effraenatam Perditissimorum , Pope Sixtus V also placed the abortion of the embryo, which was regarded as inanimate, subject to excommunication and the death penalty, but this was reversed in 1591 by his successor Gregory XIV . Under the blessed Pope Innocent XI. In 1679 the Holy Office finally decided in favor of the idea of simultaneous inspiration. However, this was not incorporated into canon law until almost two hundred years later .
Corresponding to these moral concepts, according to secular law, for example the court order of Emperor Charles V of 1532, which was authoritative for centuries , only the abortion of the three-month-old ensouled womb was punishable by the sword. The General Land Law for the Prussian States of 1794 abolished the death penalty on the one hand and granted "the general rights of humanity [...] even to unborn children from the time of their conception on the other hand," but adhered to the naturalized differentiation of punishment for abortions the age of the unborn child. Anglo-Saxon law up until the beginning of the 20th century only punished abortion as murder if child movements ( quickening ) had already been felt.
The distinction between the inanimate and the animated fetus was made by Pope Pius IX. Repealed in the Bull Apostolicae Sedis in 1869 . Since then, canon law speaks only of the fetus; In the German version, fetus is translated as “child” (Canon 871 CIC 1983.) The child receives its soul at the time of conception (simultaneous soul-giving). The dogma of the Immaculate Conception of Mary , declared by the same Pope in 1854, played a role in this change . Pius IX relied on the personal physician of Pope Innocent X , Paul Zacchias, who said as early as 1661 that the soul endowed with reason ( anima rationalis ) is poured into the human being at the moment of conception, because otherwise the feast of the Immaculate Conception of Mary would celebrate a senseless matter, which, however, is "inappropriate" to the Blessed Virgin. Nonetheless, in the 20th century the important neo - scholastic Jesuit Karl Rahner tended to continue animating successively: “Even from dogmatic definitions of the church it cannot be inferred that it would be against faith to assume that the leap into the spirit person only occurs in the The development of the embryo happens. No theologian will claim to be able to prove that the termination of pregnancy is in every case a human murder. "Regarding the use of human germ material for research he wrote:" It would be conceivable that [...] reasons speak for an experiment, which, in a reasonable assessment, are stronger than the uncertain right to a person's existence subject to doubt. ”Contemporary opponents of successive ensouling, in turn, criticize the misuse of Thomas Aquinas's position in bioethics as an anachronism and object that Thomas was not yet known at the time It has been the case that the existence of an organism with a species- and individual-specific genotype begins as soon as the zygote is created, i.e. a new, unique human being.
In the “Pastoral Constitution on the Church in the Modern World”, Gaudium et Spes of 1965, the Second Vatican Council stated: “God, the Lord of life, has given people the great task of preserving life, which is must be met in a decent manner. Life is therefore to be protected with the greatest care from conception. Abortion and the killing of the child are heinous crimes ”(Article 51). The Congregation for the Doctrine of the Faith has: a. in her teaching instruction Donum Vitae from 1987, justified again in more detail: “From the moment the egg cell is fertilized, a new life begins, which is neither that of the father nor that of the mother, but that of a new human being, the develops independently. It would never become human if it had not already been from that moment on. "The Church's teaching sees itself confirmed here in the" research results of human biology , which recognizes that the zygote resulting from fertilization is the biological identity of a new one has already constituted the human individual. ”Pope John Paul II reproduced the teaching of the Catholic Church on this issue in the encyclical Evangelium Vitae (No. 62) of 1995, which also rejects the death penalty, in the following words:
“With the authority that Christ conferred on Peter and his successors, I therefore declare, in communion with the bishops - who have condemned abortion several times and, although they are scattered around the world, unanimously agreed to this doctrine at the aforementioned consultation - that direct abortion, i.e. abortion willed as an end or means, always represents a serious moral offense, namely the willful killing of an innocent person. "
This is justified by natural law and therefore claims to apply as the norm for all people, not just for Christians. According to can. 1398 of the CIC of 1983, just as before according to can. 2350 of the CIC from 1917, who performs an abortion, the penalty of excommunication . The pregnant woman, the doctor who performs the abortion and all those involved in the crime who are essential and indispensable for the abortion to occur are affected by the crime. Ecclesiastical criminal capacity and criminal responsibility are required. Incidentally, the principles of criminally relevant error of prohibition, known from secular criminal law (error about the prohibition as such, not about the type of punishment), as well as the usual grounds for exclusion and mitigation of guilt , also apply here.
The question of the use of the so-called “ morning-after pill ” was discussed in a more complicated and controversial manner. If this prevents the already fertilized egg cell from implanting, this constitutes a prohibited abortion. The situation is different in the case of rape for contraceptives which already prevent the fertilization of an egg cell. In early 2013 it was reported that a raped woman had not been treated in two Catholic hospitals because doctors were unable to prescribe the morning-after pill. The responsible Archbishop of Cologne, Joachim Cardinal Meisner , then made it clear: “If, after a rape, a preparation whose principle of action is to prevent conception is used with the intention of preventing fertilization, then in my opinion this is justifiable. If a preparation, whose active principle is the nidation inhibition, is used with the intention of preventing the implantation of the already fertilized egg cell, this is still not justifiable, because the fertilized egg cell, which protects human dignity , is actively deprived of its livelihood will. "With regard to the assessment of the central active principles of the individual preparations, he added:" The Church can only explain the moral principles. The individual doctor in a Catholic institution must then conscientiously familiarize himself with these principles and thus come to a responsible decision. ”Then the general assembly of the German Bishops' Conference confirmed “ that in Catholic hospitals women who have been victims of rape are of course human , medical, psychological and pastoral help. This may include the administration of a morning-after pill, provided that it has a preventive rather than an abortive effect. Medical-pharmaceutical methods that cause the death of an embryo must still not be used. The German bishops trust that in Catholic institutions the practical treatment decision will be made on the basis of these moral theological guidelines. In any case, the woman concerned, the decision must be respected. "The president of the competent Pontifical Academy for Life has this line then publicly supported by pointing out that Catholic hospitals contraceptives administered for 50 years, ever since it during the Congo crisis to massive Rape came. Genuine abortion drugs such as mifepristone (RU-486), however, remain absolutely forbidden from the point of view of the Catholic Church.
In certain cases, an “intervention is permitted that is not intended to result in an abortion, but which can result in the death of the child as a side effect”: B. the saving of the life of the future mother, regardless of her state of pregnancy, would urgently require surgical intervention or other therapeutic treatment, which, as by no means wanted or intended, but inevitable, would result in the death of the budding life do not call such an encroachment a direct attack on innocent life. Under such conditions, the operation can be permitted like other comparable medical interventions, always provided that a valuable good such as life is at stake, that the operation cannot be postponed until after the birth of the child and no other more effective The way out is feasible ”( Pius XII , address to the participants in the congress of the“ Front of the Family ”and the Federation of Large Families, November 27, 1951).
In 2015, Pope Francis granted all priests the power to “absolve those who undertook it and who repentedly ask for forgiveness for it” during the Holy Year of Mercy from the sin of abortion. ”With the apostolic letter Misericordia et misera , at the end of the Holy Year In November 2016, the time limit of this regulation was lifted.
The reformers do not deviate from the church tradition. Luther describes the conception of a child as “worship” and therefore advocates the protection of the begotten. Calvin refers to Exodus 21:22 and condemns abortion.
Since the beginning of the 20th century, Protestant social ethics developed a nuanced attitude in dealing with the encyclical Casti connubii of 1930. But there is no official doctrine in Protestantism. The question of the ethical assessment of abortion was and is therefore controversial within the Protestant churches.
In principle, termination of pregnancy is assessed as a violation of the ban on killing. On the one hand, there is the radical rejection of abortion, as with Dietrich Bonhoeffer . On the other hand, however, ethical argumentation was increasingly no longer based solely on the abstract justifiability of an action, but asked about its possible effects. Karl Barth is often quoted as saying that he spoke of "secret and open mass murder" in relation to abortion. But he also wrote in his Church Dogmatics : “From where should the absolute thesis be justified that God never and under no circumstances want anything other than the preservation of a germinating human life and could demand it from mother, father, doctor and the other participants? [...] Human life and so that of the still unborn human being is not an absolute value. [...] It does not claim to be preserved under all and any circumstances. [...] Let us put it out in the open: there are situations in which the killing of germinating life is not murder, but imperative. ”Barth goes so far as to provide a socio-medical indication -“ that is, in connection with the present threat the physical and spiritual life of the mother taking into account economic and environmental conditions ”- not condemned in principle and generally as a violation of God's commandment. In a bound and just as free conscience, a conscientious weighing, but also a resolute venture, must take place.
After Protestant ethics had initially recognized the medical and, in the course of the 1960s, also the ethical (criminological) indication by a majority and increasingly included contextual references in the formation of judgments, a comprehensive reform of the criminal abortion law was hardly questioned in the German Protestant Church in the early 1970s . The majority of the evangelical voices advocated an extended solution of the indications, taking into account socio-medical aspects. A deadline regulation was rejected, however, the unborn child's right to life takes precedence over the pregnant woman's right to self-determination.
In 1973 the Federation of Swiss Protestant Churches (SEK) also called for a socio-medical indication in a statement on three legislative drafts: “Although we have to pay full attention to the social situation of the expectant mother due to an evangelical attitude, we cannot agree with the solution of indications with social indication, because that The clarification process proposed is too lengthy and requires a complex organization. We could therefore only agree to the indication solution without a social indication. However, the draft cannot fully do justice to the emotional and social distress that often arises due to an unwanted pregnancy and should therefore also take social aspects into account to a greater extent. We have to reject the deadline solution. "
One of the first to put the pregnant woman's right to life and self-determination above that of the unborn was the Basel theology professor Hendrik van Oyen . He did not look at the problem of abortion under the maxim of the prohibition of killing, as usual, but made the New Testament commandment to love the starting point of his considerations. Social policy measures were brought to the fore in order to avoid abortions as much as possible. In August 1971 a group of four theology professors from Tübingen took the view that a new regulation should promote the responsibility and willingness of those affected. The best protection of human life is the socio-political averting of possible threats to human life.
The Basel theology professor Gyula Barczay was particularly in favor of the deadline regulation. If the primary interest is the unconditional protection of unborn life, Christian responsibility is narrowed and the perspective of ethical thinking is falsified. The biblical message does not recognize any isolated responsibility for the merely biological being of human life. In the New Testament, the fifth commandment is radically reinterpreted through the word and behavior of Jesus. The bid will be personalized. Responsibility for human life does not apply to the abstract “human life”, but to the concrete fellow human being with his own past, present and future expectation. It is about the physical-social-spiritual-spiritual well-being of the fellow human being. The incarnation is not selective, but a process from gamete fusion or nidation to birth. The point in time at which developing life begins to exist as an individual is not only undecidable, but also immaterial. The well-being of the concrete fellow human being is essential. Desirability is a fundamental condition of the human quality of human life. An ethically correct decision on this question is only conceivable as a responsible decision by those directly involved in the matter. It “must be seen that there are situations in which an unwanted child simply cannot be understood as a gift. In such cases, the pregnancy may not be forced to term by law. "
The SEK adopted this line of argument in its statement of May 15, 1997: “Human life in the biblical sense is not just biological life. Human life is more: it is a physical, spiritual, emotional and social unit. […] We regard the period of pregnancy as a situation in transition. […] The further the development of developing life has progressed, the greater weight must be given to its protection. ”In its statement of October 30, 2001, the SEK supported the time limit regulation. From an evangelical-theological point of view, it is primarily about Christian freedom, self-responsible action and the dignity of women. Moral subjects are free people who show solidarity. The pregnant woman should be given full decision-making ability, taking into account that the person lives, suffers and makes decisions under social and economic conditions. The conscience decisions of others are to be respected.
A little less clearly, but ultimately in favor of women’s right to make decisions, the EKD expressed itself in its declaration “The role of women in the EKD” on September 10, 2004 before the Equal Opportunities Committee of the Council of Europe “Women and Religion”. Unborn life is worth protecting. However, women could find themselves in such a hopeless conflict situation that they could see no other way than to terminate the pregnancy. Such conflicts could “e.g. B. from the age of the woman, the financial situation, fear of responsibility and the future, an expected disability of the child, relationship problems, the professional situation, pressure from the social environment or a lack of desire to have children ”. Ultimately, the woman's decision must be respected. "The life of the unborn child can only be protected with the pregnant woman and not against her."
The demand that a woman bear an unwanted child against her will and then take care of the child for decades is rejected; This interferes irrevocably with the mother's life. The dilemma between the woman's right to shape her own life and the protection of the future child's life cannot be resolved, and a compromise is not possible. Feminist theology focuses on autonomy and personal responsibility as an expression of human dignity regardless of the decision for or against the termination of pregnancy.
There are different attitudes towards the subject of termination of pregnancy in Islam and depending on the length of the pregnancy, its premature termination is assessed differently. The basis for this is the Koranic description of embryogenesis , according to which development in the womb is divided into three phases (cf. Sura 23 : 12-14). In Hadith it is mentioned that each of these three phases will take 40 days. After that, on the 120th day of pregnancy, the “lump of flesh” receives the soul, which is breathed into it by an angel. According to another interpretation, people are animated after 40 days. In the opinion of many scholars, pregnancy may therefore be terminated in its early phase if the pregnant woman is physically or mentally suffering. In 1990 a pathological PND finding, i.e. H. if the embryo is expected to be disabled, the decision to terminate the pregnancy is left to the parents. Some Muslim scholars, however, still classify the early removal of the womb as a grave sin, since they regard the fruit as part of the female body that is entrusted by God and thus inviolable. The legal status of abortions after rape has been increasingly discussed since the 1990s. While there is a general tendency to protect the rape child, arguing that the child was not responsible for the crime, in 1999 the Mufti of Jerusalem Ikrima Sa'id Sabri allowed abortions after systematic rape in the Kosovo war . Termination of pregnancy after the 120th day is generally prohibited unless the birth definitely endangers the mother's life.
According to Buddhist belief, taking any form of life is associated with bad karma . In addition, Buddhist laypeople and monks are prohibited from killing life within the framework of the Five Silas . However, the negative effects of killing vary from case to case. Therefore, according to the Buddhist way of thinking, a fundamental rejection of the termination of pregnancy is just as problematic as a fundamental consent to it. A possible objection to be mentioned here is that a deliberate termination of pregnancy does not mean taking a life, since the embryo could not survive regardless of the womb anyway. However, it must be countered here that under normal circumstances (i.e. with a healthy embryo) without external obstacles (such as abortion) a new life would arise . Therefore, termination of pregnancy is at least an indirect violation of Buddhist commandments.
Abortions were and are common in almost all cultures. They are judged controversially. The catchphrase " Pro-Choice " comes from the USA for the requirement to generally allow abortions. Some opponents form there under the opposite slogan "Pro-Life" in so-called " life rights movements ". Controversial are u. a. the questions,
- which ethically relevant properties such as human dignity, personal rights, right to life or pain perception exist in the prenatal developmental stages, how these are related and under which circumstances they have what weight (see also SKIP arguments );
- whether there are relevant rights of women for the assessment, e.g. rights of disposal over their bodies, or rights of other affected persons or institutions and how such rights are to be weighted, i.e. which right is given priority in which type of conflict of rights;
- who may decide whether to terminate or continue the pregnancy, for example: the woman concerned, fathers, doctors or courts;
- what effect the criminal liability of the termination of pregnancy has on the number of terminations;
- how a legalization of the intervention affects the number of medical complications, whether it would reduce serious consequences such as infertility and deaths among women;
- which legal framework conditions should result from these empirical and moral questions.
In the moral evaluation is essentially a matter of whom are due to what rights. Insofar as certain protective rights or defense rights of the unborn child are linked to terms such as “person” or “humanity”, “sensitivity”, “self-confidence” or the like, it is still disputed from which phase of pregnancy these terms are applicable. For example, the following events and developmental steps have been suggested in order to ascribe certain rights to the fetus:
- the insemination , so the fusion of egg and sperm
- the preimplantation period , so the implantation of the fertilized egg in the uterine lining
- the onset of brain waves in analogy to the definition of brain death
- the sentience of the fetus
- certain weeks of pregnancy , such as B. in the time limit regulation
- the ability to survive outside the woman's body
- the birth of the child, for example in statutory provisions (e.g. inheritance law)
Against such criteria is u. a. objected that the physiological development proceeds continuously and therefore each (or at least some) of the above conditions are arbitrary, or that one has to assume an identity and therefore continuity of the later rights holder to all earlier stages anyway.
There are only a few testimonies from antiquity that deal with abortion. In the oriental tradition, only the consequence of the abortion of a blow against the woman is dealt with, for example in several regulations of the Codex Hammurapi with detailed gradations of the punishment depending on the social status of the woman. The same was true in Assyrian and Sumerian law and in the Bible (see section Judaism).
In ancient Greece, termination of pregnancy was a means used e.g. B. recommended for elderly parents or high population densities. In Attic law there is only one place related to demolition. There, a pregnant woman is prohibited from having an abortion if her husband dies during pregnancy. An inheritance should be able to be born to succeed the man. Assumptions that the Orphics had already stood up for the unborn child's right to life could not be proven. The classification of the termination of pregnancy as murder is clearly attested in an inscription on a private shrine in Lydian Philadelphia . A speech "περὶ τὴς ἀμβλώσεως", which is believed to be falsely ascribed to Lysias , investigates the question of whether the embryo is a person and whether the abortion is murder.
In the Corpus Hippocraticum the use of a pessary by the doctor is forbidden. The statements about the termination are difficult to interpret and a much-discussed point. In the version that is still known today, both surgical and oral abortion methods are not excluded. Another passage in the Corpus, in which a prostitute is advised to jump up and down and hit the buttocks with his heels until the fetus is rejected, speaks for the fact that abortions were neither prohibited nor frowned upon. However, after Cicero in Miletus, a woman was sentenced to death for abortion, which suggests that it was seen as murder.
Greek medicine also made a distinction between termination and contraception. Today there are problems with the interpretation of the terminology. It is possible that medical devices that were used contraceptively - for example to expel menstrual blood - were also used as abortion drugs, without the abortion being named as such. Also, laxatives , diuretics and emetics and the vaginal mucosa irritating agents are as an abortifacient in Corpus Hippocraticum mentioned. This is also no longer easy to interpret because the process of conception was interpreted differently than it is today and fertilization has not yet been interpreted as the beginning of pregnancy, but as part of a longer process. The triggering of a missed menstruation could also have been an abort, since an incipient pregnancy was not regarded as such.
The reason for the termination was also important for the Greek doctors. According to Soranos of Ephesus , there were two groups. The first interpreted the Hippocratic oath in such a way that abortions were prohibited. Other doctors often endorsed termination for therapeutic reasons. Abortions for social and cosmetic reasons were mostly rejected.
Terminations were allowed under Roman law of the republic and the early imperial era because the fetus was not viewed as an independent life, but as part of the mother owned by the father. Thus a womb had no legal status. The termination of pregnancy was therefore only a criminal offense if it was carried out by someone unauthorized under family law. Under Antoninus Pius and Septimius Severus , demolition was persecuted around 200 and punished with temporary exile if the woman carried out an abortion without her husband's permission. Termination was therefore socially and legally acceptable if the father (or husband) gave their consent and the woman survived the termination. If she did not, it was a criminal offense that fell back on the drinker. Therefore, only a married or divorced woman who was pregnant by her previous husband could be punished. The later rejection of the termination of pregnancy is probably due to the Pythagoreans , who developed strict moral standards.
The most common means of termination was the administration of a termination potion, which, however, could lead to stomach upset and headache. Soranos advised that physically strenuous exercises and strong massages should be used first. In addition there should be envelopes and baths. Finally the bloodletting and shaking followed. If nothing else helped, mild suppositories should be used. Pointed objects should not be used if possible because of the associated risk. However, there is written evidence of their use throughout the Roman Empire.
However, under Roman law, even born children were not yet necessarily worthy of protection. Therefore, another commonly used means of birth control has been to kill the child after birth. This was due to the fact that abortions at that time were associated with the considerable risk that the pregnant woman would die in the process or suffer permanent physical damage. As a result, children were often carried to term and then either left to their fate (suspension) or killed immediately after birth. The discovery of the remains of around 100 infants in a Roman bath in Ascalon is assigned to this method of birth control.
In many places, especially in the case of matrilineal peoples, the decision to terminate a pregnancy is the sole responsibility of the woman or her family and the fathers of the child have no say. In some primitive peoples who believe in transmigration of souls, termination of pregnancy is not viewed as killing, but rather as an offer to the child to return at a more convenient time. The aborigines of Australia and other nomadic peoples use (t) abortion specifically to regulate the birth rate.
For some indigenous peoples of South America , the use of abortion herbs was obviously problematic before they were evangelized:
“The Jesuit Gilli [ Filippo Salvatore Gilli (1721–1789)], who for fifteen years listened to the confession of the Indians at the Orinoco and who boasts of knowing i segreti delle donne maritate , expresses himself about it with astonishing naivete. 'In Europe,' he says, 'wives are afraid of having children because they do not know how to feed, dress and furnish them. The women on the Orinoco know nothing of any of these worries. They choose the time when they want to become mothers according to two precisely opposite systems, depending on whether they have this or that idea of the means of keeping themselves fresh and beautiful. Some maintain, and this opinion is prevalent, that it is better to start having children late so that you can devote yourself to work in the home and field without interruption for the first few years of the marriage. Others believe, on the contrary, that becoming a mother at a very young age strengthens one's health and helps to a happy old age. Depending on whether the Indians have one or the other system, the abortion drugs are used at different ages. ' If one sees here how selfishly the savage makes his calculations, one would like to wish the civilized peoples of Europe luck that Ecbolia , which apparently harm their health so little, have remained unknown to them until now. "
Philosophical positions of the present
The moral assessment of abortion is one of the most debated topics in practical philosophy. Correspondingly different arguments result from the multitude of moral theoretical framework theories. Additional prerequisites that are important for the assessment - such as ontological assumptions about the identity or non-identity of individuals over time and scenarios - also determine the ethical positions on abortion. While z. For example, some moral theories assume that moral judgments should focus on unconditional rights ( deontology ), many others assume that the concept of moral rights, insofar as it is meaningful at all, is relative to other conditions, such as subjective preferences ( utilitarianism ). In addition to the examples discussed below, u. a. Michael Tooley, David Boonin, Louis Pojman, Stephen D. Schwarz, John Gillespie, Harry J. Gensler and John Noonan also presented frequently scientifically discussed contributions.
One of the best-known philosophers who, in very many cases, consider abortion to be morally permissible, is the Australian ethicist Peter Singer . He was first known primarily for his animal ethics positions. According to him, a moral judgment is only to be made by weighing up the interests of all those concerned as equals ( preferential utilitarianism ). The extent to which these preferences are met or not met by the consequences of an action should be examined in each case ( consequentialism ).
Opinions about whether or from when a fetus can be called “human” are therefore irrelevant for the moral assessment of abortions. Morally relevant are properties associated with the development of preferences such as "rationality, self-confidence, consciousness, autonomy, sensations of pleasure and pain, and so on". Concerning the embryo or fetus, only consciousness and pain perception come into consideration here. If this is the case, "abortion should not be taken lightly (if a woman ever takes an abortion lightly)." However, even then, only an existence is ended that has no more moral value than more highly developed animals - the slaughter of which appears to most people morally harmless, "Just because we like their meat"; analogously, "even an abortion at a late stage of pregnancy for the most trivial reasons [...] can hardly be condemned"
As long as there is no sense of pain and awareness, however, “a termination of pregnancy ends an existence that has absolutely no value in itself .” Therefore, the interests of other affected persons, especially in the life of the future child, could at best be taken into account; In the case of an abortion, however, it is to be assumed "that those most affected - the potential parents or at least the potential mother - really want the abortion".
Many opponents of abortion argue that an abortion would not harm any pre-existing interests. However, the fetus is a potential human life and it is already wrong to kill it because of this potential. However, Singer considers such potential properties to be fundamentally morally irrelevant: there is no general reason to ascribe the same moral rights to a potential X as to a real X, and there are no other considerations here for ascribing further moral rights because of any potential properties than, if necessary, anyway are attributable on the basis of actually realized properties.
The American philosopher Don Marquis takes a non-religious position against abortion. In his well-known essay Why Abortion is Immoral , he found a stalemate for traditional argumentation patterns. In their arguments there would be an opposite characterization of the fetus (e.g. already human - not yet human), which would then necessarily lead to an equally opposite evaluation according to general moral principles. Both basic assumptions got into logical problems in certain borderline cases. In both approaches he even believes he can recognize a possible naturalistic fallacy .
Marquis claims to have found a more general approach to this question. Starting from the intuitively understandable assumption that it is wrong to kill himself , he develops that what makes killing fundamentally wrong is the effect on the victim, essentially by the fact that his future is stolen from him . He calls his approach "Valuable-future-like-ours" theory (for example: "Theory of the valuable future like ours"). With this argument, Marquis comes to the conclusion that, apart from rare exceptional cases ( prima facie ) , abortions are immoral. In his opinion, his approach also offers the advantage that it enables an insightful gradation of the protection of life where other approaches come into logical conflict.
Demolition has been an issue in the women's movement since the beginning of the 20th century. Opinions diverged among early feminists . Helene Stöcker was one of the first to demand the abolition of Paragraph 218 as chairwoman of the Federation for Maternity Protection and Sexual Reform from 1905 , whereby she mixed racist ideas of "high-breeding" and life unworthy of life with the demand for the right to abortion. In 1904 Gertrud von Bülow (1844–1927) published a work with the title: The right to eliminate germinating life , in which she marked § 218 as an “unworthy intervention in the most intimate private affair of a woman”. Many other pre-World War I reformers also used “racial” arguments for the right to abortion.
Left-wing politicians and doctors such as Friedrich Wolf (play Cyankali ), Else Kienle or, in Switzerland, Fritz Brupbacher (brochure Kindersegen, Fruchtverhütung, Fruchtabreibung , 1925) supported this demand for social reasons.
The opposite opinion was represented by the chairwoman of the bourgeois-dominated Federation of German Women's Associations (BDF) Gertrud Bäumer . In 1920, Hilde Adler wrote in the BDF magazine that allowing abortion would lead to a catastrophic decline in the birth rate and sexual wilderness.
From the 1960s onwards, the second wave of the women's movement demanded the approval of abortion, especially with the argument of “women’s self-determination” (“whether children or none, we alone”; “my belly belongs to me”). The women's movement campaigned politically for the impunity of abortion, and in some cases for a right to do so. In 1971, for example - following the French model - 374 women confessed themselves in the cover story We have had an abortion! the magazine Stern publicly about her abortion in order to protest against paragraph 218. This pushed the discussion forward. In the Federal Republic of Germany, in connection with the reunification with the GDR, there was a fierce fight for a new regulation on abortion until the 1990s.
In the United States , a group of feminists led by Lorraine Rothman had been promoting a practice they called menstrual extraction since 1971, which consisted of extracting menstrual blood from the menstrual blood using a speculum and a self-assembled device ("del em") Suction uterus directly. The background to this campaign, which also met with little response in the feminist environment, was not so much the introduction of a practical new method of monthly hygiene , but rather the creation of a legal gray area in which women had very early abortions under the pretext of "sucking out menstruation" without worry before law enforcement would even be able to perform.
Gender-selective abortions are those that are due to the fact that the child is not of the desired gender. Globally, this primarily affects female fetuses ( female fetocide or prenatal femicide ), which, particularly in China and India, are aborted millions of times due to their gender. In China, the one-child policy greatly increased the preference for sons; In India, due to the usually high dowry or dowry for girls, economic reasons play a notable role. Amartya Sen problematized prenatal gender selection in 1990 under the heading of missing women , whose number he put at 100 million.
“An estimated 113 to 200 million women are missing worldwide because female fetuses are specifically aborted, girls are killed as babies or cared for so poorly that they cannot survive. According to the latest estimates, one million female fetuses are aborted annually in India and China alone. "
Even Albania , Armenia , Azerbaijan and Georgia were due to a surplus of men to back shifted gender distribution reprimanded the neonatal 2011 from EUR Europe. In Germany, gender-selective terminations are prevented by the fact that the sex of the unborn child may only be communicated to the parents after the 12th week of pregnancy according to Art. 1 GenDG .
The socio-economic consequences of the surplus of men (increase in trafficking in women, prostitution and violence in families, unstable social system) are assessed as serious.
Legislation and other influencing factors
Restrictive abortion legislation does not correlate with a lower abortion rate. The rate in regions with relatively liberal legislation such as Europe or North America is lower or comparable to that in regions with restrictive legislation such as Latin America and Africa.
In contrast, there appears to be a direct correlation between the level of sex education in a population and the dropout rate. "The better countries educate about contraceptives, the more efforts they put into prevention, the lower the number of abortions," explains the gynecologist and long-time president of FIAPAC (Fédération internationale des associés professionnels de l'avortement et de la contraception), Christian Fiala. The Netherlands is an example of this: young people there are given comprehensive information through schools and the media, and access to contraceptives is easy. The country has one of the lowest dropout rates in the world.
Number and abandonment rates
According to estimates by the World Health Organization (2011), around 210 million women become pregnant and around 135 million children are born alive each year. The remaining 75 million pregnancies end in stillbirths, spontaneous abortions or termination of pregnancy. About 40 percent of all pregnancies are unplanned and about a fifth of all pregnant women decide to have an abortion. This corresponds to around 42 million abortions annually, of which around 20 million are legal and 22 million against the legal provisions at the place of execution.
The abortion rate is the number of abortions per 1000 women of childbearing age (usually 15 to 44 year olds) in one territorial unit per year. According to estimates, this rate was 28 worldwide in 2008, 27 in Europe (12 Western Europe, 43 Eastern Europe), 19 in North America, 32 in Latin America, 28 in Asia and 29. In 2008, Switzerland had the lowest dropout rate in Europe at 6.5.
The majority of illegal abortions are carried out by laypeople and therefore mostly under medically and hygienically precarious conditions, which often lead to life-threatening complications. According to estimates by the WHO for 2008, around 47,000 women die every year in illegal abortions. This estimate has been lowered from previous estimates (69,000 for 1990). The decline in deaths has occurred in South America in particular, after women there increasingly used drugs instead of more drastic abortions.
In Africa, 97 percent of abortions are unsafe (improperly performed), in Latin America 95 percent, in Asia between 40 and 65 percent, depending on the region. In East Asia, North America and Western Europe, on the other hand, the terminations are almost 100% safe, in Eastern Europe the uncertainty factor is 13%.
Situation by country
History before 1945
On July 2, 1920, 81 members of the Independent Social Democratic Party of Germany (USPD) introduced a motion to the Reichstag to repeal Sections 218, 219 and 220 of the Criminal Code. There was neither discussion nor voting in the Reichstag. The undersigned MPs included Rudolf Breitscheid and Georg Ledebour . With this motion, the USPD took up the demands of the radical women's movement and sex reformers. In § 218, a pregnant woman “who intentionally aborts her fruit or kills it in the womb” was threatened with “penitentiary for up to five years”. Third parties who committed the act with the consent of the pregnant woman were also punished. The minimum length of the penitentiary sentence, since it was not threatened higher, was one year (Section 14 (2)). The sentence ranged from six months to five years in prison in extenuating circumstances. Section 219 provided for up to ten years in prison for third parties who had received payment for the act. § 220 punished abortion without the consent of the pregnant woman with penitentiary from two to fifteen years; if the death of the pregnant woman was caused by the act, with ten to fifteen years or lifelong imprisonment.
On July 31, 1920, 55 SPD members of the Reichstag (including the later Reich Minister of Justice Gustav Radbruch ) submitted a motion to the Reichstag that abortion should be unpunished "if it was done by the pregnant woman or a state-approved (licensed) doctor within the first three months pregnancy "has been made. The application, which Radbruch was instrumental in initiating, was ultimately unsuccessful; it lagged significantly behind its time. Radbruch said in the Reichstag: “Our tendency is not to allow abortion within the limits of our proposal, but only to impunity. We do not want to confer a right, we want to abolish a penalty. Completely far from us is the individualistic justification of civil women's rights activists for the lifting of the abortion punishment, that everyone is absolutely free master of his body. "
On January 23, 1922, the Communist Party of Germany (KPD) submitted a bill to the Reichstag to repeal § 218 and 219.
On May 27, 1922, the KPD deputy Wilhelm Koenen attacked the “shameless abortion paragraph” in the 213rd session of the Reichstag and demanded the “removal of sections 218 to 222”, including “the reactionary Reich under the Social Democratic Minister Radbruch "Criticized because he did not want to give" relief "to" women who still suffer from the terrible abortion laws ".
On March 5, 1924, the KPD submitted a bill to the Reichstag to repeal Sections 218 and 219 and to amnesty those convicted under these sections. On May 7, 1926, an amendment to the law was passed in the Reichstag, according to which §§ 218, 219 and 220 were replaced by a new § 218. Instead of a prison sentence, it provided for a prison sentence without a minimum sentence, although the prison sentence was retained for offenders acting commercially or without the consent of the pregnant woman.
One of the first laws that the Nazi regime passed after it came to power in 1933 was the reintroduction of Sections 219 and 220 of the Criminal Code , which now publicly announce, advertise and display means, objects and procedures for abortion and publicly offer their own or third-party services to promote abortions are made a criminal offense, even if it did not lead to an abortion. Prior to 1933, abortions were mostly punishable by fines and prison terms of less than three months; under the Nazi regime, the proportion of higher prison sentences increased significantly. From July 26, 1935, there was an obligation to notify the health department of “termination of pregnancy, miscarriage and premature birth” before the 32nd week of pregnancy, which passed this on to the Reich Ministry of the Interior. On October 10, 1936, the Reich Central Office for Combating Homosexuality and Abortion was created by a secret decree .
In accordance with Article 6 (Paragraph 2) of the Fourth Ordinance for the Implementation of the Law for the Prevention of Hereditary Diseased Offspring of July 18, 1935 , guidelines for the termination of pregnancy and infertility for health reasons were issued by the Reich Medical Association in 1936 .
1935 founded Heinrich Himmler the Lebensborn e. V. , who set himself the task of "supporting the abundance of children in the SS, protecting and caring for every mother of good blood and looking after needy mothers and children of good blood". Lebensborn gave unmarried "valuable" women the material possibility to have their children and thus offered them an alternative to abortion.
At the same time, access to contraceptives was made more difficult. Women with “good blood” should neither prevent nor terminate pregnancies in the future. Children of Jewish women or other undesirable groups, on the other hand, were allowed to be aborted without giving a reason.
Motherhood was no longer a private matter, but was placed in the service of Nazi politics (e.g. population policy ). Its worth was underscored by a variety of public ceremonies. The Third Reich celebrated Mother's Day as a national festival with official honors for mothers who were happy to give birth. On Mother's Day 1939, the state awarded about three million women the “Cross of Honor of the German Mother”.
From 1943 onwards, the death penalty was applicable for abortion if “the vitality of the German people was continuously impaired”, for the other cases of abortion the prison sentence (up to fifteen years) was reintroduced, but against the pregnant woman it could only (not defined in the law ) Particularly severe cases are imposed; third parties can be sentenced to prison in less severe cases.
History after 1945
In 1950, the GDR passed the law on mother and child protection and women's rights , which, according to Section 11, permitted an abortion for medical or embryopathic and in exceptional cases from 1965 also for social indications. With the law on the interruption of pregnancy of 1972, the termination of pregnancy was legalized if it was carried out by a doctor within the first twelve weeks with prior advice and compliance with other legal provisions.
See in detail: Law on the interruption of pregnancy
The 1968 movement , the spread of the birth control pill , changed attitudes to sexual ethics and the declining influence of the Catholic Church in Germany changed the attitude of many women and men towards abortion. At the beginning of the 1970s, as part of a reform of the criminal law, the legal regulation of abortion was discussed in public. The cover of Stern magazine on June 6, 1971 - We drifted away! - was a high point in the debate and a milestone in the fight against Section 218 of the Criminal Code . While the Catholic Church in particular called for the fundamental protection of the fetus, parts of the women's movement advocated the complete deletion of paragraph 218. At the political level, there were two opposing models: The CDU / CSU parliamentary group in the Bundestag advocated an "indication regulation" that abortions only under certain medical conditions (e.g. when there is a risk to the mother's life) and ethical (e.g. in the case of a Rape ) conditions allowed. The SPD and FDP spoke out in favor of a " deadline regulation " according to which abortions should in principle be exempt from punishment up to the twelfth week of pregnancy. On April 26, 1974, the Bundestag passed the deadline regulation with a narrow majority. However, this was declared unconstitutional by the Federal Constitutional Court on February 25, 1975 after the CDU had sued. On May 6, 1976, the Bundestag passed a modified indication regulation as a compromise.
In Germany, termination of pregnancy is threatened with imprisonment according to Of the Criminal Code (StGB). However, the threat of punishment for doctors and pregnant women has numerous exceptions and limits.
Legally, pregnancy begins (only) with implantation . Previous measures to prevent implantation are therefore not considered an abortion.
The area of application of §§ birth , which is equated here with the onset of opening labor. Interventions after this point in time are prosecuted as homicides within the meaning of and StGB. This is justified in particular by the fact that the child needs stronger criminal protection from this point on.StGB ends, according to almost unanimous opinion, with the beginning of the
Deadline solution with obligation to advise and indications
Unofficial or justified exceptions that are not punishable are contained inStGB:
- Section 218a (1) (deadline solution with obligation to advise) : The pregnant woman demands the termination and can prove that she participated in pregnancy conflict counseling and then complied with a three-day reflection period. Here the termination of pregnancy is only exempt from punishment within the first twelve weeks after fertilization (i.e. 14 weeks from the first day of the last menstrual period ). For pregnant women, this exception applies in contrast to the doctor according to § 218a Paragraph 4 up to the 22nd week (24 weeks pm).
- Section 218a (2) (medical indication) : There is a danger to the life or physical or mental health of the pregnant woman, which can only be averted by terminating the pregnancy. Then there is impunity throughout the pregnancy. That reason was given for 3,785 abortions in 2016.
- Section 218a (3) (criminogenic or criminological indication) : There is reason to assume that the pregnancy is the result of rape or a comparable sexual offense. Here, too, termination of pregnancy is only permitted within the first twelve weeks. This reason was given in 17 abortions in 2019.
In any case, the termination may only be carried out with the consent of the pregnant woman and only by a doctor.
In exceptional cases 2 and 3, the termination is expressly not illegal. In the version of Section 218a of the Criminal Code of July 1992, the termination was not illegal in case 1 either; However, this was declared unconstitutional in 1993 by the Federal Constitutional Court . The Criminal Code was then amended in 1995 in such a way that in this case the termination is no longer expressly declared “not unlawful”, but the fact that the termination of pregnancy is deemed not to have been fulfilled. The timely deliberated termination is therefore not punishable for all parties involved . The exclusion of the offense does not clarify the question of illegality ; to what extent the question was left open by the regulation is controversial. The overriding view de facto equates the exclusion of the facts to a justification .
The law does not specifically regulate who is responsible for assessing the existence of these exceptional cases; however, according to(1), a medical or criminogenic indication must be by an independent doctor who does not carry out the termination himself.
With the "Law to amend the Pregnancy Conflicts Act", which came into force on January 1, 2010, the requirements for comprehensive information, care and support for pregnant women in the event of a possible medical indication, especially after the opening of a suspicious prenatal diagnosis, were newly regulated. The law now stipulates a three-day period between diagnosis and termination of pregnancy for abortions after the 14th week of pregnancy, which did not previously exist. The prospective parents should not make a decision in the first "shock" after the diagnosis. The change in law came into force on January 1, 2010.
In the event of a termination between the 14th and 24th week of pregnancy without a medical indication, the pregnant woman remains exempt from punishment if she can prove counseling. However, the doctor is criminally liable. In any case, the court can waive the penalty if it finds that the pregnant woman was in particular distress at the time of the intervention.
If, in the event of a late termination, the child survives the process, the doctor is obliged to initiate life-sustaining measures immediately after the birth.
Termination of pregnancy for embryopathic indication
With the new regulation from 1995, the so-called fetal (embryopathic) indication was deleted from the penal code. If a malformation is found during a prenatal examination, termination is permissible on the basis of medical indications if the physical or mental health of the pregnant woman, taking into account her current and future living conditions, would be unreasonably impaired by a disabled child.
In practice, it is not always possible to reliably identify a malformation at an early stage. This is why some women / couples decide to terminate, even if severe impairment is only likely. In addition, there are also misdiagnoses, so that on the one hand a proportion of late terminations not shown in the official statistics affects healthy fetuses, on the other hand severe disabilities that could justify an termination remain undetected.
Sometimes a malformation is a reason for a late termination for the affected woman / couple, but the doctors refuse the intervention, for example because they do not see the mental health of the pregnant woman at risk. If the woman still considers the termination to be imperative, she only has the option of having it carried out abroad, usually in the Netherlands up to the 22nd week of pregnancy .
Right of refusal
According to Law on Avoidance and Management of Pregnancy Conflicts (SchKG), nobody is obliged to participate in an abortion.the
This right is not only available to the performing doctor, but also to all other directly involved, such as anesthetists and nurses. Those not directly involved, such as administrative staff, are not affected by the regulation. Treatments before the decision to terminate the pregnancy and aftercare are excluded from the regulation; the doctor's freedom of contract may apply here. , however, stipulates an obligation to cooperate in cases in which the refusal would lead to serious damage to health or even death of the patient and this risk cannot be averted otherwise than through cooperation.
According to the Federal Constitutional Court , a doctor is obliged to refuse an abortion that he “does not consider responsible”. Medical pro-life organizations, such as European Pro-Life Doctors and the Association of Catholic Doctors in Germany , speak out against abortion in general (and therefore also against medical participation in general) . Strong regional, often religiously determined, differences in willingness to participate in abortion have been criticized, as this made it difficult to find a doctor for the operation. In addition, the use of the right under ) SchKG can de facto restrict the pregnant woman's freedom of choice.
Other special features
If the pregnant woman suffers severe brain damage and is treated in intensive care, as in the case of the baby from Erlangen , the question arises whether switching off the devices represents an abortion through failure after the diagnosis of brain death . The question is legally, medically and ethically controversial. D. Giesen et al. a. come to the conclusion that the Erlangen experiment is subject to strong legal concerns.
Costs and assumption of costs
The costs for the abortion itself amount to around 360 euros (medical termination) to 460 euros (vacuum aspiration) in the first three months.
The costs for preliminary and follow-up examinations as well as treatment of any complications are covered by all cost bearers ( health insurance , civil service allowance , " social welfare offices "). The costs for termination of pregnancies with a medical indication are also covered . Abortions with a criminological indication are also covered by the statutory payers, and in some cases also by private health insurances.
Abortions according to the counseling regulation must be paid for by yourself. Women with a low income of their own (up to 1,258 euros since July 2020) receive treatment free of charge if they do not have any short-term realizable assets at their disposal or if the use of the assets would mean undue hardship for them (regardless of their insurance), if they request this before the procedure. The income limit increases (since July 2020 by 298 euros each) for each child that the woman is dependent on, if the child is a minor and belongs to her household or if she is mainly responsible for it. If the cost of accommodation for the wife and children exceeds a certain amount (368 euros since July 2020), the income limit increases by the additional amount, but no more than the latter amount. The costs for these abortions are billed to the statutory health insurance companies and then reimbursed to the health insurance company of the respective federal state.
Legal development including legal history
- 507: In the Lex Salica it says: Anyone who has killed a child in the womb or before it has been given a name and whose name has been convicted will be fined 4,000 denarii, or 100 shillings.
- 1532: The term “abortion” appears for the first time in the Constitutio Criminalis Carolina or Embarrassing Court Regulations of Emperor Charles V (Art. 133). The punishment for the abortion of the at least three months old “ensouled” womb is death by the sword for men, death by drowning or another type of execution (left to the discretion) for women. The abortion of a body fruit that is not yet considered to be “animated” is punishable at discretion, although death and corporal punishments are excluded as they are not expressly threatened (Art. 104).
- 1794: The general land law for the Prussian states , which was enacted under the influence of enlightened ideas, represents a turning point in German legal history in several respects. It abolished the death penalty for abortion and improved the legal status of dependent, minors and unpaid persons in decisive areas Points. Among the explanations in the opening part there is also a provision that already subjects the earliest stages of human life to the protection of the state legal community: "The general rights of mankind also belong to unborn children from the time of their conception" (§ 10 I, 1 ) and consequently it says in "§ 11: Whoever is responsible for caring for children who have already been born has the same duties with regard to those who are still in the womb". In Sections 986 and 987, the differentiation of the sentence according to the age of the fetus appears again, but without providing for the death penalty.
- 1813: The Bavarian Penal Code provides for abortion to be punished for four to eight years in the workhouse (Art. 172 f.). If a third party has committed the act without the consent of the pregnant woman and thereby put her life in danger or caused permanent damage to her health, he is punished with sixteen to twenty years imprisonment , but if he caused the death of the pregnant woman as a result, with death ( Art. 173).
- January 1, 1871: The original version of Section 218 of the Criminal Code comes into force in the North German Confederation , in which a pregnant woman “who aborts her fruit or kills it in the body” is punished with penal servitude for up to five years. In "extenuating circumstances" the prison sentence could be commuted to a prison sentence of six months to five years. Third parties who committed the act with the consent of the pregnant woman were also punished. The minimum length of the penitentiary sentence, since it was not threatened higher, was one year (Section 14 (2)). Section 219 provided for up to ten years in prison for third parties who had received payment for the act. "The most important reason for the criminal prosecution is the demand of the government, business and the church for increased population growth." § 220 punished abortion without consent of the pregnant woman with prison from two to fifteen years; if the death of the pregnant woman was caused by the act, with ten to fifteen years or lifelong imprisonment.
- January 1, 1872: In the newly founded German Reich , the Reich Criminal Code comes into force, which takes over §§ 218 to 220 from the Criminal Code for the North German Confederation unchanged.
First half of the 20th century
- 1900: Through the introduction of Section 184 No. 3 of the Reich Criminal Code , the public display, announcement and promotion (but not the sale) of objects that are "intended for indecent use", including contraceptives, were punishable by imprisonment for up to one year or Punished fine. In 1927, by supplementing No. 3a, the application of the provision to agents used to prevent venereal diseases (e.g. condoms) was limited to cases that “violate morality and decency”.
- 1908: The women's rights activist Camilla Jellinek calls for the abolition of § 218 at the general assembly of the Federation of German Women's Associations . After an extremely heated debate, the majority of Jellinek's proposal does not follow.
- 1909: Several drafts from the Reichstag provide for an amendment to Section 218 with the aim of reducing the sentence.
- 1919: “After the First World War the number of abortions is said to have risen to 30, according to other estimates to 50 of 100 births. At the same time, the number of illegal abortions increases, so does the death toll. At the beginning and during the Weimar Republic, protests and initiatives against the existing abortion ban developed increasingly. The demands range from the deletion of § 218 to a time limit solution to an extended indication model and merely to mitigate punishment. Sex counseling centers are being established. "
- 1920: An application by the SPD in the Reichstag to leave the abortion unpunished for the first three months fails because of the majority in the Reichstag.
- 1926: The abortion is softened from a crime to an offense and only punished with prison. "At the request of the SPD, the sentence is reduced from prison to prison and the minimum sentence from six months to one day, although the prison sentence for offenders acting commercially or without the consent of the pregnant woman was retained."
- 1927: The Reichsgericht recognizes the medical indication of termination of pregnancy for the first time ( RGSt 61, 242). Argument: If the life of the mother is endangered by the embryo, then there is an above- legal justifying emergency , after which the termination is justified. In 1975 this construction was positive in the form of StGB, which is still valid today .
- 1928: At the 45th Doctors' Day it is determined that 10,000 women (= 1.25 percent) die in around 800,000 abortions and around 50,000 women (= 6.25 percent) suffer permanent damage to their health.
- 1929: The fight for § 218 comes to a head: artists and writers take a stand and take up the subject in literary terms. Alice Lex-Nerlinger , Käthe Kollwitz, Franz Krey, “Maria und der Paragraph”, Alfred Döblin, “Die Ehe”, Kurt Tucholsky, “Die Leibesfrucht”, Friedrich Wolf's play Cyankali , the film Kuhle Wampe or: Who Owns the World? . Doctors participate in the controversy, particularly the Association of Socialist Doctors .
- December 31, 1930: The encyclical Casti connubii of Pope Pius XI. will be published. She underlines the subordinate role of women and the ban on contraceptives.
- 1931: The doctor and writer Friedrich Wolf and the doctor Else Kienle are arrested on February 20, 1931 on charges of having carried out professional abortions. Both of them took a public position against § 218 before their arrest. Kienle led a free advice center of the Reich Association for Birth Control and Sexual Hygiene and gave lectures on these topics, and Wolf above all with his drama Cyankali . The arrest of the two doctors led to mass protests and events, led by the KPD, of which Wolf was a member. "Combat committees against § 218" were formed in almost all of the larger cities of the Weimar Republic. A committee for self-incriminations against § 218 , which goes back to a suggestion of the doctor Heinrich Dehmel (1891-1932) in the Weltbühne on May 13, 1930 and whose members or sympathizers include Thea von Harbou , Lion Feuchtwanger and Albert Einstein , demands “Women and doctors for mass self-accusation ”,“ in order to demonstrate the invalidity of this law. ”After the release of the two doctors, the movement slowly crumbles. The advocates of § 218 are increasingly speaking out and the National Socialists are doing counter-propaganda.
- 1933: In May, with the law amending criminal law provisions, Sections 219 and 220 were reintroduced to Section 218, which also prohibited the provision of abortion products, methods and services.
- 1935: The law amending the law for the prevention of genetically ill offspring introduces an option, motivated by the National Socialist attitude towards eugenics and sterilization , to terminate the pregnancy for a person to be sterilized (six-month period rule). The formal condition for a punishable termination was, among other things, the “consent of the pregnant woman”; in practice, however, the wishes and reservations of women defined as “inferior” are likely to have been disregarded.
- 1936: In October the establishment of the Reichszentrale for combating homosexuality and abortion is ordered, which is supposed to collect the reports of the health and criminal authorities centrally.
- 1943: Introduction of the death penalty in the event that “the vitality of the German people” continues to be impaired. For the other cases, the prison sentence (up to fifteen years) was reintroduced, but it could only be imposed on the pregnant woman in particularly serious cases (not defined in the law), and imprisonment was possible against third parties in less serious cases. On the other hand, an abortion remained unpunished if it prevented the reproduction of “inferior ethnic groups”. In the final phase of the war, this also allowed a legal termination for German women who had been victims of mass rape by Soviet soldiers. A rape by Western Allied soldiers was no reason for a legal termination (see the decree of the Reich Ministry of the Interior of March 14, 1945 with the number “B b 1067 / 18.8, II”).
Second half of the 20th century
- 1947–1948: In the countries of the Soviet zone of occupation, different indication models are introduced, the sentences for pregnant women are lifted and the sentences for other perpetrators are significantly reduced.
- In 1950 (analogous to a regulation in the Soviet Union ) - in the GDR with the law on mother and child protection and women's rights, a restrictive model of indications for the conditional approval of abortion for medical and eugenic reasons is introduced (it remains in force until 1972 ). With the eugenic indication , which goes well beyond the Federal Republic's parallel right to cancel, the GDR is picking up on the Weimar tradition of the labor movement .
- August 4, 1953: Abolition of the death penalty for abortion in the wording of the StGB in the Federal Republic (in fact the death penalty for abortion was abolished by the Military Government Act No. 1 (Art. IV No. 8) 1945 and any death penalty with the entry into force of the Basic Law in 1949).
- 1960s : The beginning movement of the liberalization of the demolition law is accompanied by sharp debates and protests. The demolition finds many opponents among Christians, Jews and Muslims, with the Roman Catholic and Orthodox Churches as well as many Evangelical Christians standing out. The emerging women's movement and the wave of emancipation demand in many demonstrations (“My stomach belongs to me”) the abolition of § 218 StGB. The 1968 movement calls for numerous social changes.
There are several drafts for reform of the criminal law in the Bundestag. The grand coalition reduces the maximum sentence to five years imprisonment, for particularly serious cases (which are not defined in more detail, but are not used for the punishment of pregnant women) to ten years. In autumn 1969 the SPD appointed the Federal Chancellor for the first time; Willy Brandt leads the first SPD-FDP coalition. The majority is scarce; after the federal election in November 1972 it is larger. From 1972 the draft reforms are discussed in the Bundestag.
- March 9, 1972: In the GDR, the law on the interruption of pregnancy is passed . It contains a deadline solution in the case of an abortion, after which the termination is permitted within the first three months. Members of the CDU (East) parliamentary group are voting against for religious reasons - this was the first and, until 1989, the only case of dissenting votes in the People's Chamber controlled by the SED .
- June 18, 1974: Deadline solution in the Federal Republic. The Fifth Act to Reform the Criminal Law (5th StrRG) inserts Section 218a into the Criminal Code, which leaves the termination of a pregnancy unpunished in the first twelve weeks.
- June 21, 1974: At the request of the government of the state of Baden-Württemberg, the Federal Constitutional Court issues an interim order that Section 218a of the Criminal Code does not come into force for the time being, but that medically, eugenically or ethically indicated termination of pregnancy within the first twelve weeks after conception is free from punishment remains (BVerfGE 37, 324; BGBl. 1974 I p. 1309).
- February 25, 1975: Judgment of the Federal Constitutional Court that the time limit solution of § 218a StGB did not do justice to the constitutional obligation to protect developing life to the required extent. “The life that develops in the womb stands as an independent legal asset under the protection of the constitution (Article 2, Paragraph 2, Clause 1, Article 1, Paragraph 1 of the Basic Law). [...] The protection of life of the womb generally has priority over the pregnant woman's right to self-determination for the entire duration of the pregnancy and must not be questioned for a specific period. The legislature can express the constitutionally required legal disapproval of the termination of pregnancy in other ways than through the threat of punishment. [...] A continuation of the pregnancy is unreasonable if the termination is necessary in order to prevent the pregnant woman from endangering her life or the danger of serious impairment of her health. In addition, the legislature is free to regard other extraordinary burdens for the pregnant woman, which weigh similarly heavy, as unreasonable and in these cases to leave the termination of pregnancy unpunished. "
- May 18, 1976: New version of Section 218 of the Criminal Code comes into force and provides for a prison sentence of up to three years or a fine for those who terminate a pregnancy. In particularly serious cases, a prison sentence of up to five years is possible. If the pregnant woman commits the act, she will be punished with a fine or imprisonment of up to one year. In four cases (indications), however, an abortion remains unpunished: medical, criminological , eugenic and emergency indication .
- 1988–1989: Memming trial against a gynecologist who carried out abortions and thereby determined the plight of the patients himself instead of insisting on the prescribed advice from a counseling center. In the first instance, Memmingen Regional Court, two and a half years imprisonment and professional ban; the doctor's revision was successful (no professional ban; suspended sentence).
After the turn
In the 1990s - towards the end of the 16-year term of office of Federal Chancellor Helmut Kohl and with the entry into force of the period regulation in 1995 - the polarization subsided; With the red-green coalition (1998–2005) the climate of opinion changed further. New debates are easing around the revision of the medical indication, which came into force on January 1, 2010.
- October 3, 1990: old federal states: indication regulation, new federal states: time limit regulation (previous GDR termination right).
- June 26, 1992: Bundestag passes the law on the protection of prenatal / expectant life, the promotion of a more child-friendly society, assistance in pregnancy conflicts and the regulation of abortion (Pregnancy and Family Assistance Act, Federal Law Gazette 1992 I p. 1398): regulation of deadlines with obligation to advise.
- August 4, 1992: Provisional order by the Federal Constitutional Court.
- August 5, 1992: Pregnancy and Family Assistance Act partially comes into force. The following do not come into force: Art. 13 No. 1 (amendment of the Criminal Code) and Art. 16 (repeal of the regulations that continued to apply in the territory of the former GDR).
- May 28, 1993: Judgment of the Federal Constitutional Court: transitional regulation for the entire federal territory from June 16, 1993.
- August 25, 1995: Publication of the Pregnancy and Family Aid Amendment Act . Most of it comes into force on October 1, 1995.
- January 1, 2010: The change in the medical indication (introduction of mandatory advice) comes into force.
|Live births||796 013||734 475||672 724||662 685||673 544||682 069||714 927||737 575||792 141||784 901||787 500|
|Total aborts||130 899||134 964||119 710||108 867||106 815||102 802||99 715||99 237||98 721||101 209||100 986||100 893|
|Terminations per 1000 births (living)||164.4||183.8||177.9||164.3||158.6||150.7||139.5||134.5||124.6||128.9||128.2|
|Terminations per 1000 women||6.6||6.8||6.1||5.9||5.9||5.7||5.6||5.6||5.6||5.8||5.8||5.8|
|according to legal justification:|
|Advisory regulation||126 025||131 340||116 636||105 357||103 462||99 079||96 080||95 338||94 908||97 278||97 151||97 001|
|Medical indication||4 818||3,575||3 046||3 485||3 326||3 703||3,594||3 879||3 785||3 911||3 815||3 875|
|after time #:|
|up to and including 13th week *||128 791 *||132 883 *||117 390 *||105 976||104 069||100 002||96 935||96 442||95 892||98 496||98 168|
|14th to 23rd week inclusive *||1 949 *||1 904 *||2 137 *||2 411||2 299||2 238||2 196||2 161||2 199||2,059||2 163|
|from 24 weeks *||159 *||177 *||183 *||480||447||562||548||634||630||654||655|
|after previous live births:|
|none||47 809||53 352||48 760||43 937||42 616||40 506||39 261||38 793||38 506||39 627||40 417||40 537|
|at least 1||80 090||81 342||70 950||65 070||64 199||62 296||60 454||60 444||60 215||61 582||60 569||60 356|
|before 1||32 709||34 413||31 055||28 126||27 914||26 718||25 316||24 869||24 259||24 036||23 051||22 510|
|before 2||34 677||32 277||27 726||24 724||24 387||23 711||23 159||23 111||22 863||24 069||24 005||24 124|
|before that 3||11 287||10 705||8 776||8 508||8 355||8 260||8 310||8 533||8 895||8 995||9 023||9 229|
|before that 4||3 052||2,883||2,344||2,437||2 409||2 431||2,509||2 597||2,724||2 906||2 955||2,929|
|before that 5 and more||1 365||1 334||1 049||1 135||1 134||1 176||1 160||1 334||1 474||1 576||1 535||1 564|
Status: December 31, 2019.
# Since the statistical data refer to the duration of pregnancy from fertilization (pc), the information has been converted to the medical information of the weeks of pregnancy (pm) used in this article.
* As of 2010, the limits of the periods from 14th to 24th week have been changed to 13th to 23rd week, which means that the series are no longer directly comparable.
The table shows statistical data on abortions in Germany since the counseling regulation came into force in 1996 with the number of live births as a reference value. For a better overview, the data before 2011 are given in five-year intervals.
From 1996 to 2000, the Federal Statistical Office itself issued a warning every year against considering the figures it published as reliable. The number of unreported abortions not recorded in the statistics is unclear; Manfred Spieker only sees half of the abortions recorded. This estimate is based on (late) abortions carried out abroad, multiple reductions after in-vitro fertilization, higher numbers of abortions accounted for by health insurers and the incomplete, uncontrollable reporting practice of gynecologists.
The breakdown of the terminations according to the reason and the time of termination shows that the vast majority (97 percent) of terminations are made according to the counseling regulation and over 97 percent up to and including the 14th week pm However, the number of so-called " Late terminations ”beyond the 14th week of pregnancy did not decrease in line with the general decline. Medical reasons (see above) are therefore used relatively more often to justify a later termination. The number of abortions for criminological indication falls officially of little consequence, however, is underreporting of such crimes generally high and often pregnancies are aborted using the counseling regulation without specifying the reason that they incurred as a result of a crime. Statistical surveys on the age distribution of women who have an abortion show, according to the data from 2011, that only 10 percent of women who have an abortion are under 20 years old. Abortions are not primarily a phenomenon of very young women. The focus of the terminations is distributed relatively evenly across the age groups from 20 to 40 years of age, with a downward trend as the women get older. Around 60 percent of women already have one or more children.
Furthermore, a total of unrecorded number of German women had abortions abroad. For the Netherlands alone, around 1,100 abortions per year among women living in Germany have been reported since 2005. Most of it took place after the 14th week of pregnancy. The Dutch statistics do not record which indications existed and to what extent these were cases in which German doctors had refused to terminate the study.
In 2016, 98,721 abortions were recorded in Germany, the lowest number of abortions since the statistics began in 1996, while the number of births rose again slightly. 94 908 terminations were made according to the counseling regulation and 28 according to criminological indication up to the 14th week of pregnancy. 3,785 abortions occurred according to medical indication, 2,829 of them from the 14th week of pregnancy.
Abortion has been regulated in Austria since 1975 in Sections , and the Austrian Criminal Code. As in Germany, the living womb is protected from nidation . Pregnancy ends with childbirth (beginning of labor, caesarean section). Each subsequent killing is to be assessed according to the homicides (e.g. StGB, killing of a child at birth). Deliberate termination of pregnancy is generally punishable.
Section 96 Termination of Pregnancy
- Section 96 (1): If the pregnant woman agrees to the termination of the pregnancy and if the perpetrator is a doctor, he is to be punished with imprisonment for up to one year, in the case of commercial activity up to three years.
- Section 96 (2): If the offender is not a doctor, the act is punishable by imprisonment for up to three years. If the act is committed commercially, or if it results in the death of the pregnant woman, she is punishable by imprisonment from six months to five years.
- Section 96 (3): In all cases, the pregnant woman herself is only to be punished with imprisonment for up to one year. It does not matter whether she carries out the termination herself or has it carried out. Even if the perpetrator is not a doctor, the sentence is no higher.
Section 97 Impunity for the termination of pregnancy
Here, those exceptions are standardized under which termination of pregnancy remains unpunished. The dogmatic classification is difficult and not undisputed. According to the prevailing opinion in doctrine and jurisprudence, these are grounds for justification , i.e. H. the act is neither punishable nor unlawful . One inferior opinion sees grounds for exclusion from the offense , another just grounds for exclusion from punishment . The abortion must be carried out by a doctor, unless medical help cannot be obtained in good time in the event of an immediate mortal danger that cannot otherwise be averted for the pregnant woman, Section 97 (1) no.3.
- Section 97, Paragraph 1, Item 1 (time limit solution) : A termination of pregnancy is possible within the first three months without giving reasons, provided that medical advice has been given beforehand. However, this period is handled differently: in practice, it is often assumed that 12 weeks from the first day of the last menstruation . According to the law, however, the completed implantation can be accepted as the beginning of pregnancy . This corresponds to a period of up to 16 weeks from the first day of the last menstruation or 14 weeks from fertilization.
- Section 97 (1) 2 & 3: A later termination of pregnancy is only exempt from punishment if the pregnancy poses an immediate mortal danger to the pregnant woman or the serious risk of serious damage to her physical or mental health (medical indication) if the pregnant woman is at the time of her pregnancy was not yet 14 years old, or if there is a serious risk that the child would be born severely disabled (eugenic indication: is nowadays preferably referred to as an “embryopathic indication”) .
- Section 97, Paragraphs 2 & 3: Nobody can be obliged to carry out an abortion or to participate in it, except in the case of mortal danger to the pregnant woman. Nobody may be disadvantaged because of their participation or refusal to participate in an unpunished abortion.
Section 98 Termination of pregnancy without the consent of the pregnant woman
- Section 98 (1): This section applies if consent is absent or has been obtained by fraud or enforced. The perpetrator is punished for up to three years, but the act results in the death of the pregnant woman, with imprisonment from six months to five years. It does not matter whether a doctor carries out the termination of the pregnancy.
- Section 98, Paragraph 2: The perpetrator is not to be punished under Paragraph 1 if the termination of pregnancy is undertaken to save the pregnant woman from an immediate, otherwise unavoidable danger to life under circumstances in which the consent of the pregnant woman cannot be obtained in good time.
- 1768: Empress Maria Theresa signs the Constitutio Criminalis Theresiana . Punishment for breaking off: execution by the sword. In the period that followed, whipping of single women who had had an abortion was also widespread.
- Efforts to reform led to new penal legislation in 1803, which was revised in 1852. Abortion was strictly forbidden and was punished with severe imprisonment for up to five years.
- In 1922 the Supreme Court ruled that the abortion of the pregnancy would go unpunished for the doctor if it was undertaken to avert danger to the life of the pregnant woman.
- 1937: The amendment to the penal law "does not punish anyone who has committed the act to rescue the pregnant woman from an immediate, otherwise unavoidable mortal danger ..."
- In 1939 the St. Pölten doctor Otto Wolken was sentenced to six years in hard prison for “fruit abortion” and “attempted rape” (rape).
- In 1954 a commission was set up to draw up a new draft criminal law. To regulate the termination of pregnancy, three different variants for an indication solution were worked out.
- It was not until the SPÖ had won the elections in 1970 that the government submitted a draft to parliament in 1971, which provided that the termination of a pregnancy should be punishable if there were “reasons worthy of special consideration”. In the same year, the young generation in the SPÖ applied to the party congress to make abortion exempt from punishment.
- In 1972 the Action Committee was formed to abolish § 144 and demanded the deletion of § 144 without replacement, but at least a time limit. The demand was taken up by the Socialist Federal Women's Conference and, according to their request, the party congress in April stood behind the deadline regulation.
- The motion was deposited in parliament on May 8, 1973 and approved in the National Council on November 29 with 93 votes in favor against 88 against. The regional chamber rejected the bill in December.
- On January 23, 1974, the National Council passed a persistent resolution. The Salzburg state government then lodged a complaint with the Constitutional Court. The latter decided on October 11, 1974 that the time limit regulation was not unconstitutional and did not violate Article 2 of the ECHR , which did not stipulate the point in time from which life is protected.
- Aktion Leben , founded in 1971 , then initiated a referendum to create a federal law for the protection of human life from conception. The request was able to collect almost 900,000 signatures, but was rejected in 1977 in the National Council.
- On January 1, 1975, the deadline regulation that still applies today came into force.
Austria does not keep any official statistics on abortions. The estimates vary widely and often seem ideologically motivated. Anti-abortion organizations estimate up to 100,000 abortions. The head of the Gynmed Outpatient Clinic for Abortion and Family Planning (a clinic specializing in abortions) assumes that Austria is one of the frontrunners in Europe with 30,000 to 40,000 abortions annually. The political and social scientist Irene Tazi-Preve estimates 19-25,000.
In Switzerland, abortion is regulated in Articles 118–120 of the Criminal Code. It is in principle punishable (Article 118 StGB). Termination of pregnancy within 12 weeks of the last period is exempt from punishment if the woman asserts in writing that she is in an emergency situation and the termination is carried out by a doctor after a detailed consultation (Article 119, Paragraph 2 StGB). The decision about termination rests with the woman within this period.
After the 12th week, an abortion is only permitted if, according to a doctor's judgment, it is necessary to avert a serious risk to the physical or mental health of the woman. This indication also includes the psychological stress of the pregnant woman due to the discovery of a severe malformation of the fetus. The more advanced the pregnancy, the greater the risk (Article 119, Paragraph 1 of the Criminal Code). After the 24th week, an abortion is only carried out in the practice in very rare cases, if the life of the pregnant woman is at risk or if the child is so severely damaged that it would not be viable after the birth.
For Switzerland, if intensive medical treatment is discontinued for pregnant women with severe brain damage, the criminal liability is denied.
Parents' consent to an abortion is not required for minors of good judgment. A visit to a counseling center is compulsory for young people under the age of 16 (Article 120, Item 1, Letter c of the Criminal Code). In Switzerland, the costs for the termination of pregnancy are covered by the health insurance companies.
Due to the new regulation, there has been an obligation to notify abortions throughout Switzerland since 2002.
In 1942 the Swiss penal code came into force. Until then, criminal law was the responsibility of the individual cantons. Termination of pregnancy was only exempt from punishment if there was a medical indication. A different practice quickly developed depending on the canton. Although several attempts to liberalize the law failed, more and more cantons were handling the medical indication in an increasingly liberal manner until, in the 1990s, a deadline regulation was practically applied in the majority of cantons. The legal opinion of a second doctor became a mere consultation.
In 1993 a parliamentary initiative by National Councilor Barbara Haering (SP) called for the revision of the penal code to include a time limit. In 2001, a corresponding proposal was approved by parliament and in a referendum on June 2, 2002, the electorate approved it with 72.2 percent yes votes. The time limit came into force on October 1, 2002.
For the history of deadlines in Switzerland, see the chronology on the website of the Swiss Association for Impunity in Abortion .
The number of abortions in Switzerland has been recorded annually since 2004 by the Federal Statistical Office. Since the type of survey was different in the individual cantons up until 2002 and only estimates existed for the most populous canton of Zurich due to the lack of reporting requirements, the figures before and after the new regulation came into force cannot be fully compared.
In 2011, 11,079 terminations were reported, of which 634 (around 6 percent of terminations) were to women residing abroad. Among women living in Switzerland, the drop-out rate was 6.8 per 1,000 women between the ages of 15 and 44, which corresponds to 13.2 drop-outs per 100 births. This means that Switzerland has one of the lowest dropout rates in an international comparison. The number and rate of abortions have remained more or less stable since 2003, but a decrease compared to previous years has been observed. Around 70 percent of the terminations were made within the first eight weeks of pregnancy and 87 percent within the first ten weeks. Around 4 percent of the abortions occurred after the twelfth week. 70 percent of the terminations were carried out with the drug method.
Termination of pregnancy is only permitted if it is necessary to avert serious danger to life or serious damage to the health of the pregnant woman that cannot be averted otherwise, or if the pregnant woman was under the age of 14 at the time of conception or if the pregnant woman was involved rape (section 200), sexual coercion (section 201) or sexual abuse of a defenseless or mentally impaired person (section 204) has been committed and the pregnancy is based on such an act (sections 96–98a of the Criminal Code ).
Up until June 30, 2015, the termination of pregnancy was only permitted if it was necessary to avert a serious danger to life or serious damage to the health of the pregnant woman that could not be averted otherwise, or if the pregnant woman was under the age of 14 at the time of conception and was not married to the father; the termination of pregnancy carried out on a Liechtenstein woman without these requirements could according to Section 64 No. 8 of the Criminal Code can also be punished in Liechtenstein if it was committed abroad.
Rest of Central and Eastern Europe
In Poland , termination was permitted from 1943 to 1945 and from 1956 to 1993; today it is only legal if there is a medical or criminological indication (currently also if it is embryopathic, see below).
The law on family planning, the protection of the human fetus and the conditions for the permissibility of an abortion of January 7, 1993 (also known as the so-called abortion compromise) limited the legal abortion to three cases. It was only permitted in the event of danger to the life or health of the mother (medical indication), disability of the fetus (embryopathic indication) or pregnancy as a result of a criminal act (criminological indication). For the medical indication, the legislature has not provided any time limit for the implementation of the termination of pregnancy. In cases of embryopathic indication, the termination was allowed to take place up to the point in time at which the unborn child was able to live independently outside the womb. Taking into account all the possibilities of modern medicine, the limit was, in the majority opinion, 22–24 weeks. In the event of criminological indication, the termination of pregnancy is permitted up to the twelfth week. The Polish penal code does not provide for a criminal liability of pregnant women before the birth phase - even in contrast to countries with more liberal abortion rules.
In 1996, under the government then headed by the Federation of Democratic Left , the law was amended to include the exception of social emergency. On May 27, 1997, the Constitutional Court declared this amendment unconstitutional. According to the judgment, the new regulation was not justified by any other constitutional value and therefore violated the constitutionally guaranteed protection of life.
In April 2000, an abortion was refused in a Polish hospital despite medical indications. The woman concerned therefore sued the European Court of Human Rights . On March 20, 2007, the latter ruled that the Polish state had violated its duty to protect the complainant's private life under ECHR . a. 25,000 euros in compensation for pain and suffering.
In March 2008 (at that time the Tusk I cabinet ruled ) a gynecologist was sentenced in front of the court in Płock to two years in prison (suspended as a four-year suspended sentence) and the payment of a fee (around 1000 złoty, i.e. 260 euros per procedure) because she had 26 illegal procedures Had abortions. She had tried to persuade all patients to carry the child to term and to give it up for adoption and warned of possible complications. The gynecologist described her actions as "medical and social help". The women in whom she terminated the pregnancy were each single mothers with two to three children. F. had to pay 64,000 zloty (approx. 18,000 euros) together with court costs.
On September 23, 2016 (when the Szydło cabinet ruled ), a majority of MPs (267 votes) in the Sejm , the lower house of the Polish Parliament, voted in first reading for a further tightening of abortion law. If the proposal had been implemented into current law, an abortion would only be permitted if the life of the pregnant woman was in danger. Women and doctors who violate the ban on abortion face several years in prison. The planned tightening of abortion law has been criticized by human rights activists and women's movements. At the beginning of October 2016, according to cautious estimates by the police, around 100,000 people across the country demonstrated at the Czarny Protest (German: "Black Protest") against a complete ban on abortion. In a session called on October 6, 2016, the Polish parliament rejected the draft law of the citizens' movement “Stop Aborcji” (English: “Stop abortions”) by a large majority after a second reading. 352 MPs voted against the initiative, 58 were in favor, 18 abstained. The vote is considered the first major defeat of the ruling PiS party.
On October 22, 2020, the Constitutional Court lifted the abortion of pregnancy with embryopathic indication as a violation of human dignity, after an application by a group of 119 conservative MPs, mostly from the ruling party PiS, had been submitted. In 2019, 98 percent of the 1,100 legal abortions were carried out on the basis of the exemptions received. The Constitutional Court's decision led to days of nationwide protests . President Andrzej Duda surprisingly expressed “understanding for the anger and fears of the protesters”; his wife Agata expressed her incomprehension about the decision of the Constitutional Court, which she said “forces women to be heroic”. So far, the government has not formally published the ruling by the Constitutional Court. Therefore it has not yet come into force. As a compromise, Duda suggested that abortion should remain legal in the future if the child is so severely disabled that it has no chance of survival.
From 1957 onwards, termination of pregnancy was unpunished in Romania at the woman's request. In 1966, for reasons of population policy, the legislation was massively restricted by Decree 770 and tightened again in 1972 and 1985 under the dictator Nicolae Ceaușescu . The goal was to increase the birth rate. The import of contraceptives was banned and women were subjected to monthly gynecological checks. But the women soon found ways of having an abortion illegally, albeit under the most difficult conditions, as the film shows for 4 months, 3 weeks and 2 days . The number of births therefore rose only temporarily and after a while fell back almost to the previous level. However, the number of deaths from illegal abortion has increased sharply.
After the fall of the Ceaușescu regime in 1989, one of the first official acts of the new government was to introduce a time limit. The number of deaths after abortion fell suddenly in 1990 to a third of the previous year (from 142 to less than 50). The number of legal abortions rose sharply in the short term and even reached a rate of 3 abortions for 1 birth (1990). However, it has fallen sharply again since family planning began to take hold in Romania and abortion is no longer the most common method of birth control.
Abortion rate per 1000 women aged 15 to 44 years
- 1965: 252
- 1967: 46
- 1988: 15
- 1990: 182
- 2006: 31
Opponents of the new constitution that came into force on January 1, 2012 see the provisions on the protection of life as a de facto ban on abortion.
Russia (1922 to 1991 Soviet Union)
With a law of November 16, 1920, abortions were legalized and offered free of charge in hospitals, whereby the law aimed above all at the state control of the abortion, perceived by the legislature as a social evil. Only licensed doctors were allowed to carry out an abortion; all other doctors or non-doctors made themselves liable to prosecution. Slightly Restricted In 1924 (through the introduction of fees), the law published on July 27, 1936 generally prohibited abortions except in the case of mortal danger or eugenic indication. For the next twenty years, the authorities waged an unsuccessful battle against the widespread illegal abortion, the consequences of which placed a great strain on the health system. Mainly because of this, on November 23, 1955, the abortion law was abolished. Temporary attempts to replace abortion as the most important means of family planning with contraceptives failed because of a pronatalistic policy that restricted access to effective contraceptives (hormonal V.) or at least did not promote access and acceptance. The official drop-out rate was around 100 per 1000 women of childbearing age (1970–1989), one of the highest in the world.
Since then, according to Eurostat, the dropout rate in Russia has fallen to 45/1000 (2003). In most of the other former member states of the USSR and in other Eastern European countries, too, the quota has fallen massively after modern contraceptives gradually became more widespread in this region too.
Western and Southern Europe
In Belgium , after decades of struggle, the parliament approved a time limit in March 1990. But she could only enter into force when King Baudouin , who refused to sign the law, for two days "because of government incompetence abdicated" to keep Parliament could put the law into its own authority in force, to which the king through parliament again was used.
The law allows the termination of pregnancy in the first 12 weeks after conception (14 weeks pm) at the request of the woman if she is in an unspecified emergency situation. The decision rests with the woman. The procedure may only be carried out in authorized clinics, which must offer the woman advice and help. A 6-day reflection period must be observed before the procedure. After the deadline, termination for medical reasons or if the fetus is damaged is permitted.
This regulation was transferred from the Criminal Code (Belgium) to a separate law by a notice dated September 17, 2020 . The articles that punish the termination of pregnancy without the consent of the pregnant woman remained in the penal code.
The Netherlands has had very liberal abortion legislation since 1981 (in force since November 1, 1984). The practice has been very liberal since the early 1970s. At that time, abortion clinics emerged , which quickly became contact points for women from countries with more restrictive laws.
The current legislation allows an abortion until the child is viable outside the womb, usually up to the 22nd week of pregnancy pm The doctor has to conduct a consultation with the mother to convince herself that she is in an emergency and that she is Made a careful decision. The intervention may only be carried out after a 5-day reflection period (except for abortions in the first 6 weeks of pregnancy, in so-called overtime treatment) and only in approved clinics.
At the beginning of the 1980s, around half of all abortions in the Netherlands were carried out on German women alone, and around 14 percent of abortions are still carried out on foreign women today. In relation to women of childbearing age living in the Netherlands, however, the drop-out rate was at times the lowest in the world; in 1990, only 5.2 out of 1,000 women had an abortion. In 2007, the rate was 8.6 out of 1000. For the under-24 age group, it was assumed in 2004 that this was due, among other things, to the fact that the Dutch health insurances no longer pay young women the birth control pill and many of them have since become less reliable methods of contraception practice. The increase between 1993 and 2000 was also attributed to high levels of immigration. More than half of all abortions involve first- and second-generation immigrants, who have a much higher rate of abandonment than native Dutch women.
There are two abortion laws in the UK, one for Great Britain and one for Northern Ireland.
In Great Britain the British House of Commons decided on October 27, 1967 for Great Britain a broad social medical indication regulation ( Abortion Act ; long title: An Act to amend and clarify the law relating to termination of pregnancy by registered medical practitioners ); the law came into force six months later. In 1990 an amendment (“Human Fertilization and Embryology Act”) was passed; Since then, termination after the 24th week of pregnancy is no longer legal, unless the pregnant woman is in serious danger (“grave risk of physical or mental injury to the woman”) or there is evidence of “extreme fetal abnormality”. Two doctors have to confirm this diagnosis.
Since the risk of an abortion is generally lower than that of childbirth, a liberal practice that came close to a deadline regulation quickly developed. Abortion clinics sprang up, attracting large numbers of mainland women who wanted abortion. This abortion tourism soon ebbed when other countries introduced deadline regulations. Today the Abortion Act is one of the more restrictive laws of its kind in Europe because - at least on paper - it does not allow women to decide for themselves about the abortion. An attempt at liberalization in parliament was blocked in October 2008 by the Brown Labor government for formal reasons.
In Northern Ireland , until 2020, abortions were only legal if there was a medical indication, now a time limit applies.
There was an absolute ban on abortion in Ireland for more than 100 years. The Offences Against the Person Act of 1861 provided life imprisonment for abortion; the law is still in force today. In 1983 this ban was confirmed in a referendum vote by 53.7 percent of the vote; as a result, the "right to the life of the unborn" was enshrined in the constitution and the state obliged to protect this right as far as possible, taking into account "the equal right to the life of the mother".
In February 1992, the Supreme Court ruled that a 14-year-old girl who had become pregnant through rape and was threatened with suicide could travel to England with her parents to terminate the pregnancy. That is, danger to life (including suicide) was recognized as a reason for an abortion. In October, the Open Door Counseling and Dublin Well Woman Center advice centers won the European Court of Human Rights for the right to provide information about the possibility of an abortion abroad. In November 1992, this right to information and the right to travel abroad to abort was adopted in a referendum.
In a further referendum in 2002, a constitutional amendment that wanted to exclude suicide risk as a reason for a legal abortion was narrowly rejected.
In July 2009 the European Court of Human Rights accepted the complaints of three Irish women as admissible. They argued that the abortion ban violated their right to life and private and family life, as well as the prohibition of inhuman treatment and all discrimination (Articles 2, 3, 8 and 14 of the European Convention on Human Rights ). The negotiations in cases A, B and C against Ireland took place in December 2009. In December 2010 the Court ruled that C had violated Article 8 of the Convention on Human Rights because Ireland had failed to implement existing constitutional law that allows abortion when a woman's life is in jeopardy. The government is therefore obliged to enact a law that clarifies the situation.
The public debate on Irish abortion law intensified after 31-year-old Savita Halappanavar passed away on October 28, 2012 at Galway University Hospital . Halappanavar was denied an abortion despite health problems and despite the doctors 'assessment that the fetus was not viable and that it was an incipient miscarriage because the fetus' heartbeat was still noticeable. "This is a Catholic country" was said to the husband of the pregnant woman, who was herself a Hindu. After the fetus's heart stopped beating, it was removed. Halappanavar died of blood poisoning shortly afterwards . On November 14, 2000 people demonstrated in front of the Irish Parliament for reform of the abortion laws.
In 2013 the Irish Parliament passed the Protection of Life During Pregnancy Act . The law came into force on January 1, 2014. As a result, abortions can now be legally performed in the Republic of Ireland if the pregnant woman's life is in danger, for example even if experts determine that the mother is suicidal.
On May 25, 2018, in a referendum on the abolition of the abortion ban in Ireland in 2018, the majority of Irish voted to remove the abortion ban from the constitution. On December 13, 2018, the Irish Parliament passed a bill allowing abortion up to 12 weeks of pregnancy and beyond for certain medical reasons.
In France , the self-accusation campaign of prominent women on April 5, 1971 finally led to the adoption of the time limit (Loi Veil ) by parliament. It came into force in January 1975. In May 2001 the law was subjected to a major revision.
The Criminal Code now only contains the offense of termination of pregnancy without the consent of the pregnant woman (Article 223-10). Everything else is regulated in the Health Act ( Code de la santé publique , Art. L2211-1 ff). During the first 14 weeks, the woman who is in an emergency can ask a doctor to terminate her pregnancy. The doctor has to inform her about the methods and the risks of the procedure as well as about the counseling services and give her an information brochure. “Not emancipated” minors must go to a counseling center and must be accompanied by a person of their choice if the parents are not to be informed. The intervention can be carried out after a reflection period of 7 days at the earliest. After the deadline, a pregnancy can be terminated for medical reasons (health risk for the pregnant woman or severe fetal damage). In this case, two doctors must agree to the procedure. The costs of an abortion are covered by social insurance.
In 1978 a time limit came into force in Italy (Law 194/1978), according to which a woman can have her pregnancy terminated in the first 90 days. It was by referendum (1981 referendum confirmed). The pregnant woman must seek advice from her doctor or a recognized counseling center and observe a reflection period of 7 days. After the period of 90 days, termination is only permitted for medical reasons, the indication must be made by a doctor. Abortions may only be carried out in public or specially authorized clinics.
The general opinion is that the deadline regulation has largely made the previously numerous illegal abortions disappear. The number of legal abortions in 2008 was 121,000, a decrease of 48 percent compared to the maximum in 1982. In 2007, 70 percent of gynecologists refused abortions for reasons of conscience , which often leads to long waiting times in hospitals. Many pregnant women are afraid of missing the deadline for a legal abortion, some have the procedure carried out at their own expense in other European countries (e.g. in the Netherlands).
For years there was a dispute in Italy about the approval of the abortion pill Mifegyne (RU 486), which has been in use in most European countries since 1999. In July 2009 the Italian drug approval authority Aifa basically gave the go-ahead; on December 9, 2009, RU 486 was finally approved for sale.
The competence for the health sector lies with the Italian regions ; the central government can only formulate guidelines. In April 2010 only six regions had decided how the pill RU 486 should be accessible. The “Implementation Regulations” are still controversial (as of February 2013).
In a referendum in Portugal on February 11, 2007 , the majority (59.3 percent) voted in favor of legalizing abortions within the first 10 weeks of pregnancy. Prime Minister José Sócrates implemented the result of the vote in parliament. Up until then, Portugal was one of the countries with the strictest demolition laws in the EU, along with Poland , Ireland and Malta . In a referendum in 1998 , the majority voted in favor of maintaining criminal liability. The new abortion law has been in effect since July 15, 2007, although conservative forces have announced resistance to the new regulation.
In 1937, during the Spanish Civil War, the Republican government passed a law on the first woman to serve as Minister of Health, Federica Montseny , which gave women the right to decide on an abortion for themselves. After the victory of the nationalists under General Franco, a strict abortion ban was reintroduced in 1939, which remained in force until 1985.
After the end of the Franco dictatorship and the first democratic elections, the then central government began reforming the penal code. The preliminary draft from 1979 provided for a strict regulation of indications for abortion. After the election victory of the PSOE (Socialist Party) and against the background of several court judgments for illegal abortions, a time limit was also discussed in the early 1980s. After heated debates, Parliament finally passed an indication regulation in 1985. Reasons for an unpunished termination were a risk to the physical and mental health of the pregnant woman (without time limit), rape (up to the 12th week of pregnancy) and a malformation of the fetus (up to the 22nd week of pregnancy). As a result, numerous clinics specializing in abortion emerged, in which the great majority of abortions are still carried out today, and the handling of the law was quickly liberalized. The number of Spanish women who went abroad for a demolition fell rapidly. In 1985, 6344 Spanish women were treated in Dutch clinics, compared to only 313 in 1990. Conversely, “abortion tourism” from other European countries to Spain developed, especially for very late abortions that were offered in some private clinics.
The discussions about the legal regulation of the termination of pregnancy continued until a new law came into force in mid-2010. While left-wing parties and feminists called for the deletion of the criminal paragraphs or a time limit regulation, conservative circles sought a return to a more restrictive law and criticized the broad interpretation of the current regulation. On various occasions there were reports against liberal doctors which, for example, led to the arrest of the head of a clinic and its closure in 2007. This was one of the reasons that the Zapatero government began revising the legislation in 2008. In October 2009 the Spanish government ( Zapatero II cabinet ) passed a draft law to liberalize abortion. The debate was conducted with great severity. The new law was passed by the Senate on February 24, 2010 (132: 126). It came into force on July 1, 2010. With the introduction of a deadline solution, termination of pregnancy up to the 14th week (exceptions: up to the 22nd week) is exempt from punishment.
In the parliamentary elections in November 2011 , the conservative PP won an absolute majority of the seats in the Chamber of Deputies. There was a change of government: Mariano Rajoy formed the Rajoy I cabinet . The PP won the election, among other things, by announcing a tightening of the abortion law. Justice Minister Alberto Ruiz-Gallardón presented a draft law in December 2013 that would only have permitted an abortion after reported rapes or if there were proven health risks for the pregnant woman. A malformation of the fetus, on the other hand, would no longer have been a reason for an abortion. Prime Minister Rajoy finally decided after long debates to defuse the draft law; On this occasion, the Minister of Justice resigned on September 23, 2014.
Any abortion is a criminal offense in six countries on the American continent, namely in Haiti , the Dominican Republic , Suriname , Honduras , El Salvador and Nicaragua . Those who have an abortion and women who have an abortion are liable to prosecution.
In the United States , abortion has been a thing of the past since the Roe v. Wade of the Supreme Court in 1973 basically allowed until the child was viable. However, the individual federal states have the competence to establish their own legal regulations, as long as they do not represent an undue burden (undue burden) for women. A number of states have introduced restrictive regulations, such as mandatory counseling, cooling off periods, regulations for clinics or parental consent for minors. With the ruling of the Supreme Court in 2007 in the case of the Partial-Birth Abortion Ban Act , it became clear that the court partially supports these efforts. In a ruling of February 19, 1997, the Supreme Court also ruled that it is permissible to define so-called bubble zones (restricted areas for anti-abortion demonstrators) around abortion clinics .
On May 15, 2019, the Senate of the Republican-dominated state of Alabama passed the most restrictive law against abortion to date. On April 30, 2019, the House of Representatives approved the bill with a large majority. After the vote, the bill was signed by Alabama Governor Kay Ivey , taking effect 6 months later. Thereafter, termination is illegal in almost all cases and only permitted if there is a serious health risk for the expectant mother. No exceptions were made for pregnancies resulting from incest or rape. Anyone who performs an abortion should, according to the law, be punished with 10 to 99 years or life imprisonment. Attempting to do one is to be punished with imprisonment from one to ten years. Pregnant women who have an abortion are not penalized under the law.
Leading proponents of the law openly declared that they are aware of the legal challenge of this new, more stringent law strove to achieve that ultimately the question in principle before the Supreme Court (Supreme Court) is decided. Since the Supreme Court has an increasingly conservative majority as a result of the new appointments under Donald Trump's presidency , there is the prospect that Roe v. Wade is lifted nationwide. Critics of this tightened law noted, among other things, that in the vote in Alabama only men voted for the bill. The four female members of the Senate had voted against.
Some opponents of the current abortion regime criticized the law in Alabama as too radical. Even the majority of anti-abortion opponents in the United States believed that exceptions should be made in the event of rape or incest. In addition, the lawmakers in Alabama have given no explanation as to why they wanted to repeal Roe . Precisely because of its radical nature, the law is vulnerable and it will probably fail in the federal appeals courts and not reach the Supreme Court .
In Canada , abortion had been allowed since 1969 if the life or health of the pregnant woman was at risk. The procedure could only be performed in public hospitals, where a commission of three medical professionals had to give their consent. This led to great differences in the practice of hospitals. When the doctor Henry Morgentaler opened a private abortion clinic on a non-profit basis contrary to the law, he was arrested and convicted. The case was taken to the Supreme Court, which finally in 1988 declared the legal regulation unconstitutional because it violated the constitutional rights to life, liberty and security of the person. Since then, attempts in parliament to regulate abortion again have failed. Canada is thus one of the very few countries that does not have a law on termination.
In early 2012, Argentina changed its abortion law. Since then, abortions have been explicitly allowed even after rape. Until then, abortion was only allowed if the mother's life or health (physical or mental) was at risk. Otherwise, abortion women could face up to four years in prison.
In June 2018, after months of public debate , the Chamber of Deputies passed a law that allowed abortion in the first 14 weeks of pregnancy with 129: 125 votes. On August 9, 2018, the Senate rejected this law by 38:31 votes (with 3 abstentions).
On December 30, 2020, the Senate decided (38:29; 1 abstention) to allow abortion up to the 14th week of pregnancy, after the Chamber of Deputies had spoken out in favor of it more clearly than in 2018 (131: 117). Argentina was the first large country in Latin America to take this step. This time the law was introduced by President Alberto Ángel Fernández himself. The proponents had protested in public in green clothes for legalization, which is why they were also referred to as the "green tide" (marea verde) . Pope Francis , who is from Argentina, spoke out against the law shortly before the decisive vote on Twitter .
In Bolivia, abortions are only allowed to protect the health of pregnant women. At the beginning of 2014, the country's constitutional court rejected an application submitted by women's rights groups to decriminalize abortion.
In Brazil, abortions are prohibited, but under certain conditions they remain unpunished: if the mother's life is at risk, rape or her health is endangered.
Chile has had one of the most restrictive abortion bans in the world since the tightening of abortion law in the late 1980s in the final phase of the military dictatorship . Abortion is strictly prohibited and both doctors and women can be punished with several years in prison. Since August 2017 there have been three exceptions to this ban, namely if the mother's life is at risk, if the pregnancy results from rape or if the fetus is not predicted to have a chance of survival.
In Colombia , termination of pregnancy has been permitted in a few exceptional cases since May 2006. After the first abortion made possible by a decision of the Colombian supreme court in an eleven-year-old who became pregnant after being raped by her stepfather, the Catholic Church pronounced the excommunication of all those involved in the abortion (but not of the rapist, since rape is not threatened with excommunication is, but abortion already); the girl was not affected by the excommunication because of her age.
In Cuba , abortion has been possible in the first 12 weeks at the request of the woman since 1965. After the first trimester, the approval of a commission of experts is required. With the exception of Cuba, in Latin America it is only possible for women in Guyana (since 1995), Uruguay (since 2012) and more recently in Mexico City to decide about an abortion themselves. All other states in Central and South America have very restrictive regulations.
Most Mexican states prohibit abortion unless the mother is in danger, rape, or her health is endangered. A first exception to this rule was created in the federal district of Mexico City , since a time limit has been in effect there since April 2007. A constitutional suit against this ruling was dismissed by the Supreme Court in August 2008. Since then, conservative circles in several states have tried to prevent any attempt at liberalization by inscribing the right to life from conception in the constitutions.
In September 2019, the southern state of Oaxaca legalized abortions up to 12 weeks of gestation with no restrictions or reasons.
Abortion is generally prohibited in Nicaragua and both doctors and women can be punished with several years in prison. In October 2006, the legal aborto terapéutico (aborto terapéutico), which has been legal since 1893, was banned, so that neither women whose lives are at risk due to pregnancy complications nor women who are pregnant through rape are allowed to have an abortion. As a result, the number of fatal pregnancy complications has increased. Studies indicate that life-saving treatments are increasingly being used for complications that are not covered by the law, e.g. B. fallopian or ectopic pregnancies as well as treatments that do not lead to an abortion will be refused.
Uruguay liberalized its abortion law in autumn 2012. In Uruguay, abortions within the first 12 weeks after a counseling session are not punishable.
In the People's Republic of China , termination of pregnancy is permitted and desirable after the second child (until 2015 after the first child ). There were numerous exceptions before 2016. The regulations in rural regions or in regions populated by minorities allowed more than one child; Likewise, couples in which both partners came from one-child families were excluded from the rule. As in many other Asian countries, there is a preference for male offspring, which in the past led to increased abortions in female fetuses. An attempt to counter this problem in China has been through a law that has banned sex determination by ultrasound or other examinations since 2002 .
In Pakistan, abortions are only allowed if medically indicated. Family planning is seen as a sin in Pakistan.
On April 11, 2019, the Constitutional Court of South Korea lifted the far-reaching ban on abortion by a two-thirds majority that had been in force in 1953 as unconstitutional. The government must now pass a law to facilitate abortion by December 31, 2020. Otherwise the current regulation would be completely repealed.
In Turkey , abortions have been permitted up to the 10th week at the request of the mother since 1983, after this period only for medical reasons. However, underage pregnant women require the consent of their legal representative, married women that of their husbands. 27 percent of married women have had at least one termination of pregnancy.
In May 2012, Turkish Prime Minister Erdogan surprisingly announced that he considered abortion to be murder and that he would soon only allow abortions to be exempt from punishment for the first four or five weeks. This would de facto be a ban on abortion, because pregnancies are usually only discovered afterwards.
“Erdogan's concern is not only that abortions are 'against the will of God', but above all that they endanger the existence of the Turkish people and their economic dynamism. For a long time he has recommended at least three, preferably five children to every Turkish woman. It seems that the prime minister now feels strong enough to make his population policy ideas the maxim of state action. That is why he also railed against caesarean births . Both interventions are part of a "secret foreign plot to sweep Turkey off the global stage" "
After massive protests by women's rights organizations, the ruling AKP party withdrew its plan on June 21, 2012.
Most African countries have inherited restrictive regulations from the colonial powers that do not allow abortion at all or only for medical reasons. A deadline regulation applies in Cape Verde (since 1986) and in South Africa (since 1996).
Since May 2005, the abortion laws in Ethiopia have been less restrictive. Four reasons for legal abortion were allowed in order to lower the death rate of women during pregnancy, including from illegal abortions. Rape and incest, including fatal congenital diseases, are recognized as grounds for permissible termination, and physical and mental health risks are recognized as grounds.
In Tunisia, abortion has been permitted in the first three months without any further conditions since 1973; after the third month of pregnancy it is permitted if the mental or physical balance is at risk or serious damage to the embryo is to be feared.
There are some cases of people around the world who have survived attempting their own abortion. These include u. a. the American singer and life rights activist Gianna Jessen, born in 1977, and the German boy Tim, who became known as the Oldenburg Baby in 1997, was born in 1997.
- Luc Boltanski : Sociology of Abortion, on the state of fetal life . Suhrkamp, Frankfurt am Main 2007, ISBN 978-3-518-58475-0 (German translation).
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