How painful is an abortion

Abortion: You Should Know That

Not every pregnancy is planned; the prospect of motherhood often poses major problems for women. Serious life changes threaten, especially when women are left with the situation alone.

But simply turning back the time or pressing the reset button is not possible, as much as some women who are unintentionally pregnant wish that. It's a very difficult decision to make. We can't take that from you. But we can support you with factual information on how and where you can be helped.

Why do women get pregnant unintentionally?

First of all: In the last 10 years, the number of abortions in Germany has fallen by more than 10 percent. According to the Federal Statistical Office, around 100,000 terminations were reported in 2020, compared to 110,400 in 2010. But if the dropout rate has dropped in recent years - the number will probably never drop to zero. "It can happen that a woman becomes pregnant completely unintentionally," says Dr. Ines Thonke from Pro Familia. "Sexuality is not rational." The mind turns itself off, and not only when alcohol is involved.

In addition, even the safest contraceptives can fail: out of 1,000 women who have an IUD, one becomes pregnant every year. In the case of the pill, the rate can skyrocket to 8 out of 100 if a gastrointestinal infection makes the rounds. "It is important to know that an unwanted pregnancy does not always have to do with your own negligence," said the expert. This is how the morning-after pill works.

Not least because of the still high numbers, it is important that there is information and education about the topic of abortion, even if some radical opponents of abortion would like to have this prohibited and have therefore even sued doctors. So, let's just assume that it happens to you or a friend at some point that you are faced with this decision. Here's what you need to know.

Until when is an abortion possible or allowed?

The law says: Until the end of the 12th week after conception, termination of pregnancy is exempt from punishment in Germany. What can women do who do not find out they are pregnant until the 13th week but do not want to have the baby? This happens again and again, especially when the cycle is irregular or the person concerned does not think pregnancy is possible - for example because the pill is still taken. In other European countries, in contrast to Germany, it is also possible to cancel later, for example in Holland up to the 22nd week. Around 1000 German women are patients in the clinics there every year.

"In Germany there is a medical indication," said Thonke. "An example: If a woman is credibly at risk of suicide, an abortion would be exempt from punishment regardless of the week of pregnancy." Patients can also refer to this regulation if the unborn child is seriously ill or disabled. Because that too can be a situation with which the mother is so overwhelmed that it seriously endangers her physical or mental health. Almost 4 percent of abortions in Germany happen after a medical indication.

What should I do if I decide to have an abortion?

Above all: consult your doctor. However, just making an appointment for tomorrow is not possible, even if you are quite sure or want to get out of the situation as soon as possible.

You first have to prove that you have received advice by submitting a so-called advice certificate. You can get it from numerous state-recognized municipal or independent organizations such as pro familia, who offer pregnancy conflict counseling free of charge. According to the law, counseling must be "open-ended" and can be of great help in sorting out one's own feelings. At the time of cancellation, the certificate must be at least 3 days old.

By the way: some certified doctors also do the consultations. The doctor advising you is then not also allowed to carry out the abortion.

How exactly does an abortion work?

There are two common methods of termination of pregnancy:

Termination by surgery

Here the cervix is ​​widened a little first. Metal pins are used for this: first a very thin one, then a slightly thicker one, until the entrance to the uterus is about 5 millimeters open. This is easier if it has been softened beforehand with a vaginal tablet.

Today, an abortion is no longer done with a curette, which the doctor uses to scrape the uterus, but with a kind of straw through which the embryo is sucked off. The whole thing only takes a few minutes and is done under anesthesia. The procedure can be carried out under local anesthesia without any problems, but the vast majority of abortions take place under general anesthesia.

Some women experience slight pain afterwards because the uterus contracts. In addition, complications such as an injury to the uterus are very rare.

Abortion by tablet

Here the pregnant woman in a doctor's office or clinic swallows a drug that switches off the pregnancy hormone progestin. 1.5 to 2 days later, a second tablet follows with an active ingredient that contracts the uterus, which, like a heavy menstrual period, can be quite painful. This tablet cannot be bought over the counter and you cannot get it in the pharmacy, but only in the doctor's office or clinic.

After ingestion, patients remain in the clinic or practice for about 3 hours. During this period there is usually a bleeding with which the embryo is expelled.

Which Abortion Method Is Better?

Beyond the 9th week you do not have to ask yourself this question: Medical abortion is then not permitted in this country. Otherwise, it is a matter of type and cost. Many women think it is good that they do not notice the surgical procedure themselves and that it is done as soon as they leave the clinic.

A drug termination takes at least 2 days and is consciously perceived. One advantage, however, is that there is no need for anesthesia, which is still not 100 percent risk-free. "In addition, drug abortion offers more privacy, which is important for some women," says Thonke. "In Sweden, Austria and Switzerland it takes place mostly at home."

What does an abortion cost?

The medical termination with the Mifegyne pill costs 200 to 400 euros, the surgical one costs between 200 and 600 euros, depending on which method and form of anesthesia you choose. You have to pay for an abortion according to the counseling regulation yourself.

If your income is below € 1,001 per month and you have no savings, or if you have been raped, the state will pay for it - but only if you apply for it from a statutory health insurance company before the procedure (even if you have private health insurance or no health insurance at all ).

Will an abortion affect my fertility?

No. The rumor persists because the old abortions led to more complications than the suction used today - not to mention the illegal abortions on the kitchen table or in the bathroom, which have been the norm for centuries. Every woman should know this about her fertility.

What physical mark does an abortion leave?

A gynecologist cannot tell your body whether you have had an abortion or not. "You can assume that usually no traces are left behind," says Dr. Thonke.

Even if you are one of the very few women whose uterus was injured or infected during the procedure, it cannot be assigned to an abortion later. There are many other possible reasons for this.

What are the aftereffects of an abortion?

A woman usually recovers quickly from an abortion. After an operation, you can expect mild to moderate pain and bleeding for 1 to 2 days, with most women coping with a few painkillers during this time.

After 14 days she can bathe, use tampons and have sex again. When the drug is stopped, the heavy bleeding usually lasts for half a day to a full day, and light spotting is normal for 14 days afterwards. Pain occurs in the first few days.

When did I recover mentally from an abortion?

It is very different. "Most women just feel relieved after the abortion," says Dr. Thonke. In contrast to the portrayal of anti-abortionists, these women did not make the decision easy for themselves and went through a very stressful time. When can an abortion be healthier than carrying to term.

The so-called "post-abortion syndrome", after which an abortion is accompanied by depression, grief, guilt and shame, is nonsense. Experts consider it to be the invention of anti-abortionists. According to Thonke, however, there are 2 constellations that significantly increase the risk of difficulties in dealing with what has happened. The first is an ambivalent attitude in advance: Those who were not sure about the decision until the end, also quarrel more often afterwards. It also affects women who had psychological problems before the unwanted pregnancy.

When can I start the pill again after the procedure?

Right away. You can take your first pill on the same day. You should discuss how you want to use contraception before the termination, otherwise it is possible that you will become pregnant again in 14 days. Inquire about hormone-free birth control methods.

If you want the IUD, have it inserted immediately after you break it off. The rate of emissions is then only increased very minimally, according to Dr. Thonke. Talk to your gynecologist about it, even if it's right before the procedure. Because she is obliged to take the time to talk again.

Is there anyone in my region who does abortions?

That is still not the case everywhere. Not every gynecologist makes abortions. "In some regions in the Allgäu, women still have to drive over 100 kilometers even today," said Thonke. For a mother of 3 or someone with little money, this can be a real problem. You will find out exactly where abortions are possible in your area during the consultation.

Where can I get more information?

There is very good information on the subject of abortion at Familienplanung.de. The website is also linked to the advice center database of the Federal Center for Health Education, which, with more than 1,600 entries, includes almost all German pregnancy advice centers. Via postcode you will receive a selection of offers in your area, from which you can choose the one that best suits you. Expectant fathers can also take advantage of free advice.

Detailed information on the subject is also available from profamilia.de, where you can download the brochure "Abortion", and from abtrieb.at. The simple website abtreibung-web.de was launched by a person affected. Although some information is out of date, the website answers many very specific questions.

So you see: an abortion is a relatively uncomplicated medical intervention, but it is preceded by a serious decision. The more you inform yourself in advance and exchange ideas with experts, the better you are in a position to make this decision. Our information will help.

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