Current study by the University of Kassel on abortions in hospitals published in the Zi-Versorgeatlas

23.03.2023 17:15

In 2019, around 101,000 abortions were carried out in doctors' practices and hospitals in Germany. Of these, 21,135 were attributable to the clinics. According to the advisory regulation, there were 18,023 cases, of which 17,623 (97.8 percent) were outpatients. This corresponds to a nationwide rate of 10.4 abortions per 10,000 women of childbearing age (15 to under 50 years) that were carried out on an outpatient basis in clinics.

Strong regional differences within Germany are noticeable. The highest abortion rates were observed in East Germany, including among women under 18 years of age. Brandenburg, Mecklenburg-Western Pomerania, Saxony-Anhalt, Thuringia and Saxony were at the top (51.8, 40.4, 38.5, 37.1 and 30.6 abortions per 10,000 women, respectively). In contrast, Baden-Württemberg, Berlin, Saarland and Bavaria ranked significantly lower (4.6, 3.6, 2.1 and 1.9 abortions per 10,000 women, respectively). Overall, almost half (46.3 percent) of outpatient abortions in hospitals occurred among women between the ages of 25 and 35. Almost two thirds (61.1 percent) of the women who decided to have an abortion in Germany in 2019 were single and just over a third (35.2 percent) were married.

Strong east-west divide

These are the central results of a care atlas study by the University of Kassel on “Regional differences in care when performing outpatient or inpatient abortions in hospitals in Germany,” which the Central Institute for Statutory Health Care (Zi) published on March 23rd. “The regional differences in abortions according to the consultation regulation have not yet been sufficiently investigated. Striking differences between the old and the new federal states could be primarily due to the regulations in the GDR at the time, the distribution of hospital sponsors and the different religious traditions,” said the Zi board chairman, Dr. Dominik von Stillfried.

Relevant national and international mobility

The mobility of patients between federal states and internationally in border regions also plays an important role in abortion care, von Stillfried continued: “Almost a third of the women who had an outpatient abortion in the hospital sector in Bremen in 2019 came from Lower Saxony. Our study also shows relevant international mobility. In Brandenburg, a third of the women who had an outpatient abortion at the hospital in 2019 were registered as living abroad. What is striking is the high proportion of patients with foreign residence in Brandenburg. One explanation for this would be cross-border mobility of women from Poland, where restrictive abortion laws apply.”

According to Section 218 of the Criminal Code, abortion is a criminal offense in Germany. If a woman in Germany wants to voluntarily terminate her pregnancy, she can only have it terminated by a doctor after consultation in the first twelve weeks. In the past, doctors were not allowed to advertise abortions. Advertising within the meaning of Section 219a StGB is defined as publicly disseminating detailed information about possible methods of abortion and the corresponding risks. On June 24, 2022, the German Bundestag decided to lift the advertising ban for abortions.

Special evaluation of pregnancy statistics

In order to identify regional differences in the provision of voluntary abortion in hospitals, a special evaluation of pregnancy statistics from 2019 was analyzed. The special evaluation was carried out by the Federal Statistical Office in support of the University of Kassel for the project “Medical care situation for carrying out an abortion in the hospital sector in Germany”. With this study, these statistics on abortion are evaluated and presented in more detail for the first time.

Original post

Escamilla Loredo MI, Hollederer A.: Regional differences in care when performing outpatient or inpatient abortions in hospitals in Germany. Central Institute for Statutory Health Insurance in Germany (Zi). Supply Atlas Report No. 23/02. Berlin 2023. URL: doi.org/10.20364/VA-23.02