The risks that fewer and fewer doctors know how to perform an abortion in Germany | The NY Journal
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Lack of training makes abortion difficult in Germany, but a group of students is trying to fix it
The woman at the family planning center looks sternly at Teresa Bauer and her friend. “And what are you studying?” She asks the friend, who has just discovered that she is pregnant and wants to have an abortion.
“Cultural Studies,” she replies.
“Ahhh, So you lead a colorful lifestyle?“, The woman says sarcastically.
Bauer remains seated, holding back her rage.
Stressed after learning about her accidental pregnancy, her friend has asked Bauer to get her an appointment necessary to agree to the termination of the pregnancy.
The first thing was to attend an orientation session designed, according to German law, to “protect the life of the unborn,” which sometimes may discourage some women from going ahead. Some of the clinics that deal with this service are run by churches. Bauer has taken care not to bring her friend to one of them, fearful that she would be judged.
So he had to go after a doctor who could prescribe the necessary pills. Since 2019 the law allows doctors to publicly report that they perform abortions, but they cannot indicate what kind of services they offer, so Bauer had to call consultations one by one.
“Berlin it is a liberal citySo I thought it would be easier than it has been, ”he says.
“Even when we were going to buy the pill, the doctor’s assistant kept asking, ‘Are you really sure?’ Seeing what my friend was going through and how they treated her made me so angry that i decided i had to do something about it“.
At the time, Bauer was a third-year medical student and a few days later she emailed a student association at her university called Students for Choice telling them that she wanted to volunteer.
Now she works with them and campaigns to improve the training on abortion that future doctors receive, as well as to raise awareness in society of the obstacles that women who seek abortions still encounter.
Restrictive laws
Although Germany is often considered a liberal country, its laws on reproduction are surprisingly restrictive. In reality, abortion is not legal, but it is not punished in the first 12 weeks of pregnancy as long as the woman has attended one of these counseling sessions and has waited three days before terminating the pregnancy.
For this reason, medical schools do not teach their students about abortion, and there are few doctors capable of performing this procedure.
In some areas of Germany women have to make long trips to get to an abortion clinic.
In 2018, more than 1,000 went to the Netherlands, where the process is simpler and the limit is at 22 weeks. In some cities in northwestern Germany, such as Bremen and Münster, some doctors cross the border into Belgium and the Netherlands to perform abortions there.
The German Penal Code
- Section 218 makes abortion illegal.
- The 218th establishes the “exemption from liability for abortions performed in the first trimester, or later in cases of medical necessity”, provided that the mandatory orientation and the three days of waiting are passed.
- The 219th prohibits the advertising of pregnancy termination services, although since 2109 doctors can advertise that they perform abortions, as long as they do not give details.
Students for Choice is attempting to address the obstacles still faced by women seeking abortions by carrying out what they call “Papaya workshops”, in which the intervention of the interruption of pregnancy with one of these tropical fruits is tried.
Its size makes it ideal for replicating the human uterus and extracting the seeds can recreate what is done with a human fetus in one of these surgical procedures. The idea is that students become familiar with the subject and encourage them to seek specialized training when they complete their studies.
This association of students arose in 2015 at the initiative of Alicia Baier, who says that she discovered by chance the problems with abortion during a conference at the time she was studying.
“It’s a taboo subject and nobody talks about it, so most of them do not know the problems that there are to access abortion until they need one themselves, “he says.
Then he discovered that the majority of doctors who perform abortions in Germany are professionals over 60 years they are close to retiring.
“They are a generation that lived through the struggles of the past for women’s rights,” she says. “They became politicized. But the younger generations never knew about it. “
Baier came into contact with a group of students from the United States who explained to him that could be practiced with papayas. A professor later connected her with some gynecologists who could run the workshops.
“They told me, ‘We’ve been waiting for students like you for a long time.’
No doctors
In Lower Bavaria, a region with a population of 1.2 million on the border with Austria and the Czech Republic, the last gynecologist who performed abortions came out of retirement 5 years ago, since no doctor in an area with 80% Catholic believers had wanted to take over.
But Dr. Michael Spandau had to quit again last March. At 72 years old, he can no longer expose himself to the risk of contracting COVID-19.
“Women have to travel to Munich or Regensburg, 130 kilometers away,” says Thoralf Fricke, from the local branch of the NGO Pro Familia, located in the center of the picturesque city of Passau.
“If you don’t have a car, you have to go by train. That’s expensive. If you live in a rural area, it is three hours one way and another three hours back. And it is a risk to your health. This operation is not like having a tooth removed. You can have complications like blood pressure problems ”.
In the region there is also a large population of refugee women, those who often lodge in rural houses in which they wait for their asylum claim to be resolved. They tend to lack support networks to help them find someone to take them or accommodation ”.
Rose, who is from Nigeria and lives 40 minutes by bus from Passau, needed an abortion last December. “My daughter is 6 months old and I told my boyfriend that I couldn’t face another child so soon,” he explains.
Fortunately, she was able to spend the night at the home of a women’s choice activist named Lea. “I was very groggy afterward,” she recalls. “I was lucky that I was with Lea because she held me while I was walking. If I had to go back to the bus I would have passed out ”.
The German Association of Gynecologists told the BBC that “in Germany it is the responsibility of the federal states to give women in critical situations sufficient guidance and assistance. The law states that no one is required to participate in an abortion. The only exception are cases in which the life of the mother is threatened ”.
“Gynecologists and medical personnel are free to decide according to their ethics and religion if they want to perform abortions. No one can be compelled. In regions where Catholicism predominates, it is more difficult to find doctors and nurses. So women must cover greater distances ”.
Passau Hospital noted that the City Council had decided in 2007 that abortions would only be carried out there in an emergency.
Threats and intimidation
The history of abortion in Germany is long and complex. In Nazi times, the abortion of a white woman was a serious crime, unless the fetus was malformed.
Instead, women from other ethnic groups were encouraged to abort. In the last years of communist East Germany more permissive laws were passed but when reunification occurred in 1990, the vision of the west, more conservative, ended up imposing itself.
The legal prohibition of advertising abortion services, established in Nazi times, it has recently been used by pro-life groups to initiate legal action against doctors across the country.
Thoralf Fricke claims that in the last two years he has started receiving more hate messages in his email, including death threats. Before the pandemic broke out, groups of activists had begun demonstrating in front of the Pro Familia clinic where they counsel women who want to have an abortion.
“A lot of women didn’t show up for their appointments,” he says. “We think they were intimidated.”
But the movement for women to choose is growing stronger. As a result of the campaign that Students for Election carried out at the Charité university hospital in Berlin last year, he first introduced abortion to his resume, as did the University of Münster.
If social distancing allows, the group is planning a training weekend in Berlin for students from across the country this fall.
“We are going to have big problems”
Alicia Baier has already finished her studies and is preparing as a trainee to be able to offer abortions. Now you can see firsthand the impact of lack of access to them on women.
“A doctor made a woman wait for a week unnecessarily, which led her to exceed the deadline to be able to interrupt the pregnancy only with pills,” he explains. After 9 weeks, the only option is a surgical intervention based on the voiding technique.
Baier also met a 19-year-old girl caught in an abuse situation who attempted a home abortion due to lack of information about where she could access a safe one. Finally, they had to remove her uterus.
Although there are now more students learning the procedure, Baier assures that their age It will cause a lack of services to remain for the foreseeable future.
“It will take a few years until we can work on our own and sooner, as current doctors retire, we are going to have big problems.”
M Römer, A Kolandt YN Kutsche They took the photos of the workshop with the papayas.
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