Abortion: 100 kilometers to the nearest doctor’s office

Status: 06/24/2022 05:24 am

The Bundestag is debating Paragraph 219a – the advertising ban for abortions should be abolished. However, this does not change the fact that women in many regions cannot find doctors who perform abortions.

“It is unacceptable that women in such an existential situation are left alone here in our city,” criticizes Claudia Heltemes, head of the pro familia counseling center in Trier. The psychologist regularly advises women who are unsure whether they want to continue their pregnancy or terminate it because of their personal circumstances.

If, after extensive consultation, they decide to abort, Claudia Heltemes has to send the women to neighboring Saarland, about 100 kilometers away. There are two practices in which abortions are performed. In Trier, on the other hand, there is not a single practice that does this.

“The supply situation has gotten worse nationwide in the last 20 years,” reports Heltemes. “The Trier region is one of the poorest in Germany, because there were no abortions here before.”

There is no clinic in Trier that would conclude a so-called supply contract with a doctor for emergency care after an abortion – a requirement in order for a doctor to be licensed for abortions in his own practice. This is also due to the fact that the clinics with gynecological departments are run by Catholics.

Fewer and fewer doctors for abortions

Nationwide, the number of doctors who perform abortions has been falling for years. According to the Federal Statistical Office, 20 years ago there were still around 2,000 medical practices, surgical centers and clinics that performed the procedure. By 2018, that number had almost halved. Currently, 1089 medical facilities in Germany perform abortions.

Heltemes doesn’t want to accept that. For years she has been campaigning for women who want to terminate their pregnancy to be free to choose where they do so. Having to drive a hundred kilometers is an impertinence, she thinks. An operation under general anesthesia can only be carried out if the woman has someone accompanying her, but: “Women who want to have an abortion cannot or do not always want to confide in someone else,” says Heltemes.

In society, the subject of abortion is still taboo, and women are suggested that they are doing “something disreputable or illegal”. The psychologist suspects that this is probably why many doctors are reluctant to offer the procedure. Especially in Catholic regions like Trier.

hostilities against the medical profession

In fact, doctors who perform abortions are repeatedly exposed to hostilities. Opponents of abortion hold vigils in front of practices or organize prayer meetings in front of counseling centers.

Klaus Doubek, President of the Professional Association of Gynecologists (BVF) therefore finds that the repeal of Paragraph 219a is not sufficient. The professional association sees “the urgent need for the legislature to create framework conditions that do not allow any scope for hostility and harassment – neither among women nor among doctors.”

Abolition of paragraph 219a is only the first step

The professional association sees the repeal of paragraph 219a as the right first step. Gynecologists must be able to provide medical and factual information about the process and methods of an abortion. For the women seeking help, it is “unacceptable to make it difficult for them to have direct access to this information,” says Doubek.

Basically, from a medical point of view, the Federal Association considers it necessary to provide women in the situation of an unwanted pregnancy “at a high medical and humane level”.

Adequate care required

An abortion entails great physical and psychological risks if it is not carried out by specialists in a professional medical environment: “Safe abortions must be regarded as an elementary part of health care,” says Klaus Doubek. The risk of developing psychological problems after an abortion is “related to women’s experiences of being taboo and stigmatized,” explains the doctor.

Around 350 pregnant women seek advice and help every year at the pro familia counseling center in Trier. Their stories are as different as the women themselves, says psychologist Heltemes. The 16-year-old sits with her in counseling, who feels too young to have a child, or the mother of three, who lives on the subsistence level and could not afford another child financially. Every woman must have the right to make a free decision about her life.

And also a right to get medical care where you need it. Claudia Heltemes wants to keep fighting for this. Only recently she tried to talk to the chief physician of a clinic in Trier – so far without success.

But the consultant knows that time is of the essence. Because one of the two addresses in Saarland that offer abortions could soon be eliminated for reasons of age. If no one is found by then, the women have to travel further away for the procedure – to Koblenz, Kaiserslautern or Mainz.

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