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Any day now, the Supreme Court of the United States will almost certainly overturn the landmark ruling known as Roe v. Wade. That will make it harder – if not impossible – for women to get abortions in dozens of states. But in Germany, the new government is headed in the opposite direction, trying (to a point) to ease access for women to abortion services. Host Soraya Sarhaddi Nelson talks about these impending, monumental changes and how they are linked with guests:
Constance Chucholowski, a public affairs expert who chairs the Berlin chapter of Democrats Abroad;
Dr. Caroline Scherf, a German gynecologist in Wales who in 2021 worked in a Bremen clinic run by ProFamilia, a government-funded NGO for reproductive rights;
Alexandra Linder, head of the Bundesverband Lebensrecht, a Berlin-based association of German groups opposing abortion and which organizes the annual March for Life in Berlin.
We also hear from Green Party activist Laura Sophie Dornheim about her struggle to get an abortion in Berlin.
This show was produced by Abigail Megginson and Dina Elsayed.
Host Soraya Sarhaddi Nelson brings together prominent voices from all walks of life to tackle questions on vital and fascinating topics to increase public awareness and understanding.
Welcome to Common Ground Berlin, a talk show encouraging debate and a deeper understanding of hot button topics in the German capital and beyond. I'm your host Soraya Serhidy Nelson. Should abortion be an unassailable right or should it be a crime? These days it's a burning question in Germany and the United States as senior producer Dina El Sayed reports.
Speaker 2:People must decide their faith, not the church, not the state.
Speaker 3:There were demonstrations at the US Supreme Court last month after the draft of a planned ruling on abortions was leaked. Written by justice Samuel Alito, it would overturn a landmark ruling that for 49 years has guaranteed women across the United States the right to terminate their pregnancies. If the draft decision becomes law, it's expected at least half of the states will ban or limit abortions.
Speaker 2:Women must decide their faith. Not the church. Not the state. Women must
Speaker 3:Alito's attack on Roe v Wade as the landmark ruling is called sounded alarm bells in Germany too.
Speaker 4:So when I when I first heard about that leaked draft, my first reaction was, goosebumps and terror because it's my basic understanding of of solidarity that I'm worried about all the people in the states that are, badly affected by this.
Speaker 3:That's Laura Sophie Donheim, a green party activist and feminist who works in tech. The 38 year old mother of 2 recently joined Americans protesting the draft decision outside of the US embassy in Berlin.
Speaker 4:It was always a topic for me but when I was in the situation myself, it really hit me that the very basics of our German constitution that, says that, like, human dignity is is untouchable and cannot be violated. That right was just taken away from me because all of a sudden I was in a situation where the state did not grant me any dignity, did not grant me the right to make my own decisions, but forced me to jump through hoops and, like, undergo various bureaucratic and emotional obstacles to be able to to have an abortion when I felt it was not the time for me to have a child.
Speaker 3:Donhaime says she was 32 then. In a new relationship and in between jobs. It was her first pregnancy, and she found out during a routine visit to the gynecologist.
Speaker 4:And then just afterwards, she asked, for urine sample, and then I was waiting and waiting. And then she asked me in again and told me I'm pregnant. I was like, what? It was literally like in one of these really bad nightmares where you think like I have no clue what just happened.
Speaker 3:Her nightmare didn't end there. Technically, abortions are illegal in Germany. That means women here who decide to terminate their pregnancies have to run forced
Speaker 2:consultation, my
Speaker 4:decision was already, made. Forced consultation, my decision was already, made. And that waiting period just felt like like a punishment or like a burden. Like, you're you're doing this and, we, the the man who made this law, think it's wrong. So, we wanna make it as unpleasant for you as possible.
Speaker 3:Finding someone to perform an abortion isn't easy as doctors can be fined or even jailed for advertising such services. Dornheim says she got in touch with the government funded reproductive rights group, Pro Familia.
Speaker 4:They gave me a hand copied list with, doctors in Berlin, which I then tried calling a few and some were, definitely less welcoming, I'd say, or like more. Yeah. I I did not feel like they really want to give me the care I need. The the whole shame thing, like, well, it shouldn't be the situation and like, yeah, we're doing this, but we're not, like, happily doing it. So, of course, that's not the place where I'd wanted to go.
Speaker 3:Ultimately, she found a doctor she was comfortable with.
Speaker 4:For me, it was really, really important to have an abortion pills because I already felt like my life is so out of my hands. Like, there's so many laws and people who feel like they are ruling over me now. The thought of, like, having anesthesia and have someone perform surgery on me made me feel very uncomfortable. So, yeah, I asked this doctor, about this this option. And in Germany, it's still most abortion are performed by a surgery for various reasons.
Speaker 4:But yeah, after talking with her and after, explaining her that I'm very confident with my own body and like I don't get easily scared of bleeding. So something she made that possible for me.
Speaker 3:Donheim says she feels luckier than many women in Germany who try to terminate their pregnancies. She had strong support from her family and friends and lives in a city where those services are available. Even so, she says abortions must be decriminalized.
Speaker 4:The law is in the same chapter as murder or armed robbery. Right? And that is just absolutely not the place to regulate this procedure that so many women need. So I want to to 18, which is the paragraph that says that abortions are crime. I want that to be raised.
Speaker 1:That isn't likely, at least for now. That was senior producer Dina El Sayed. Joining me online to discuss abortion and whether there is a need for reform are doctor Carolina Sherff, a German gynecologist in Wales who spent part of last year at a Bremen Clinic run by Profamilia, a government funded NGO for reproductive rights. And Alexandra Linde who heads Bundesferband Lebensrecht, a Berlin based association of German groups opposing abortion and which organizes the annual march for life in Berlin. Welcome to you both.
Speaker 5:Thank you for the invitation. Welcome, Soraya.
Speaker 2:Thanks for letting me be on the show.
Speaker 1:Joining us in the studio is Constance Khokolovsky, a public affairs expert who also chairs the Berlin chapter of Democrats abroad. Welcome, Constance.
Speaker 6:Thank you. Thanks for having me. Constance, what's the latest on the expected Supreme Court ruling in the United States? Are many states gearing up to act once the decision is dropped? Absolutely.
Speaker 6:So the latest is that, we are expecting any day now a decision, a final decision by the Supreme Court. And given the draft decision by the majority that we saw, we should expect that the Supreme Court with a majority overturns Roe v Wade. Of course, Democrats abroad and certainly Democrats in the United States, especially women and people living in Republican states, are incredibly fearful of this decision. Because what we're expecting is that the states that already, in large part, oppose abortion, and we know that either because they have enacted trigger laws. That means that they have enacted laws that would essentially immediately ban abortions in their states the second that Roe v Wade, which provides the constitutional right at a federal level, is overturned.
Speaker 6:And then there are other states, we could go into tons of detail, that have, over the last few years, enacted laws that essentially limit abortion to an extent that it would be illegal. And many of these states are certainly access, restricted. That's the big fear.
Speaker 1:Do you think prosecutors in the states that are preparing bans or or restrictions massive restrictions over what they have now, are they gonna go after women who seek abortions?
Speaker 6:I believe so. Yes. I think we've seen already in states that have put laws into place that hadn't, in an interim period, been challenged by the Supreme Court, that women are being punished for having an abortion. And that is the huge, fear that we as Democrats have, that this is something that will affect especially minority women, especially poor women, and people who can get pregnant, when they need an abortion. They will be trying to travel thousands of miles in order to seek an abortion because they're fearful that prosecutors will go after women in these states.
Speaker 6:They're mostly conservative states and largely southern states.
Speaker 1:It's interesting because in Germany, impending changes have been going in a somewhat different direction. The Bundestag where the majority is a coalition of central left social democrats, the Green Party, and the Liberal Federal Democrats appears ready to strike down paragraph 219 a that was enacted during Nazi times to ban the, quote, promotion of abortion. Carolina, why is striking down this rule important?
Speaker 2:It is important because with this rule in place, women have found it very difficult to find information about how to access care when they need it. So when a woman needs an abortion, when the woman needs anything doing by gynecologist, she would look online, and she would search through different gynecological practices to see, for instance, service for colposcopy, like when you have an abnormal smear, or services for infertility, or services specifically at cancer treatment. And all of that is outlined on the websites of each gynecologist. So if a woman looks for abortion care, which is just one part of gynecology, in fact, it's the most common treatment in gynecology, then she can't find that information in Germany at the moment. That's not because anyone in particular has a problem with the information being there apart from a specific very small group of anti abortion campaigners who will then go through great lengths to, start criminal cases against these colleagues.
Speaker 2:They're just informing the women what treatment they have, whether they can treat with medical methods or with surgical methods, and to what gestational age they can provide this, and how that all works. They're not advertising it like the way you would advertise certain brand of cigarettes, which is what was meant to be discouraged. This is just informing about the treatments on offer.
Speaker 1:But that can get you in trouble if you're a doctor in Germany, and we've seen doctors be punished here for announcing that they offer abortions. And, of course, the most famous example is doctor Christina Henel, a general practitioner from a small city near Frankfurt, who was fined €6,000. So, Carolina, do the laws in Germany cut down on the willingness of doctors here to perform abortions?
Speaker 2:I believe they do. As long as abortion services any part of abortion services is enshrined in criminal law, doctors will have a very major disincentive to engage in providing it. That then creates the problem with service provision. And that in turn has resulted in problems in Germany, and specifically, that women in certain parts of Germany have to travel a very, very long way if they can access care at all.
Speaker 1:Well, Alexandra, this plan for paragraph 219 a is certainly a concern to your group. On your website, you have a statement from Doctors For Life that says this lack of information which is, quote, postulated like a prayer wheel is purely fictitious. What do you think is going to happen in Germany if 2 19 a is stricken?
Speaker 5:Well, there are many things to say. First, the law says, that you're not allowed to put such information on your website for your pecuniary advantage. That's what the law says. So the difference is every gynecologist can launch every day 6 information websites on abortion. He's just not allowed to put on there the information that he or she, him or herself, offers abortion and earns money by that.
Speaker 5:This is what the law says. The second point is there is no lack of information in Germany. There are many, many serious information on abortion. But if you compare the serious information and, for example, the things Mrs. Henle publishes, Mrs.
Speaker 5:Henle is no doctor. Mrs. Henle is no gynecologist, and she only performs abortions. And she says, concerning abortion in her advertisement folder that she removes pregnancy tissue, the content of the uterus, and an amniotic sac. And this is misinformation because it just tells half of the truth.
Speaker 5:So the fact in Germany is we need this law because we have got a law concerning abortion, which says that abortion is no normal health service because, for example, pregnancy is no illness. So you must not have a treatment which heals you or which saves your life just because you are pregnant. And if you have long ways to travel, this is quite normal in Germany. If you, for example, want to have a certain cardiac operation or certain treatment for your knees, you always have to travel long distances. And if you want to have a birth in Germany, it's even worse.
Speaker 5:You have to go long ways because many, many birth stations in clinics are closing. There were only very, very few cases, where people like Froheen had to pay something, but she acted against a law. So it's her fault and not the fault of the 2 or 3 persons in Germany, who inform about, this problem. I do not agree to those people, and we do not act this way. So the serious pro life movement does not act in this way.
Speaker 1:Caroline, is there anything you wanna say in response? Because my understanding is that, Frau Henel is in fact a general practitioner. I don't maybe I mean, as far as I know, she's a doctor. I don't know her personally. But I'm curious, if you have the answer to that and also if there's just anything else you wanted to respond to.
Speaker 2:I do have the answer to that and to many other questions, I think. I do not wish to discuss whether or not that 2019 is a good idea. I think my profession is very clear, as is the WHO, as is even the German, Association of as are the UK gynecologists and the European, Society of contraception. All of them want to decriminalize abortion altogether, not just the 2019. So I'm not going to argue about the principle because that's a medical fact.
Speaker 2:Making abortion accessible means that providing normal basic gynecological health care for women when they need it. It's no more, no less. It doesn't make abortion more frequent or anything like that. I don't even want to go there because it's completely futile, and we can read that out somewhere else. Christina Henle is, of course, a perfectly 100% qualified doctor.
Speaker 2:It's a linguistic issue here. In English, the word arst and doctor is the same word. In German, it is arst or arst in this case. The Germans have a different term doctor, which they describe someone who has an MD. So if someone has an MD in the UK, for instance, you're a doctor because you're in Arts or in Aston, but you then have an MD that goes at the end of your name.
Speaker 2:So for instance, I am doctor Carolina Sheff, m d f r COG, GI blah blah blah, lots of other letters behind my name. It's a different way of having the title. She's a perfectly acceptable general practitioner with all the qualifications she needs. She's the most highly qualified abortion doctor in that part of the country, and she has taken up all the work from a lot of other gynecologists in that area. So I think she deserves a lot of praise.
Speaker 2:Luckily, she's got that praise from the great majority of people who, know her work, and she has all that praise from the patients who she looked after. And I really think that's who we need to think about. We need to think about women who need to access abortion care. That's who is at the center of this attention. It's not lawmakers.
Speaker 2:It's not people who don't like having an abortion. They don't need to have it when they need it or when they have an unplanned pregnancy. It is about women who are pregnant and cannot be pregnant at the moment, and they need an abortion. Anything that criminalizes or puts it into law makes it more difficult to access. And I can go into a lot of detail, but actually, it doesn't help.
Speaker 2:It's the general criminal law that will actually be off putting for care provider.
Speaker 1:Well, as you point out, I mean, there and and as I said at the beginning, there are very strong opinions obviously on both sides and I don't think any of us are gonna necessarily convince the other today to change their opinion. But what I'm hoping for is a constructive and nuanced conversation that will hopefully inform people about how the process works. What are some of the changes that, you all would see. So, I I thank you again for being here and for keeping this hopefully a positive conversation. And and, you know, we we will move on.
Speaker 1:Alexandra, I wanted to ask you about, something that Laura Donheim says that she believes the supreme court overturning Roe v Wade will energize anti abortion forces in Germany. Do you agree?
Speaker 5:It's a good question. Well, the in the US USA, they are always some years further than in Germany. And in the USA, we can see the consequences, the negative consequences of decades of free abortion. For example, concerning the, Afro American women, Afro Americans have got a percentage in the population of, about 15%. But among the abortions, more than 30% are Afro American babies who are aborted.
Speaker 5:I'm a little bit astonished that doctor Scharf never talks about the children. In this case, it's very important to talk about all persons and all human beings who are involved in abortion. The second thesis is we see that in all countries where abortion is legal and in the USA, it was possible until about the 24th week when the baby can live, outside the womb of the mother. Now we have pregnancies of 18 weeks where the children can live outside the womb of a mother. So it's very useful and very important to consider this real medical progress and to reconsider such laws and such judgments.
Speaker 5:If you go to Wales and England, where abortion is free. And you see the numbers, which are horribly high, you have, 210 1,000 abortions in 20,020 in England and Wales with the population of 49,000,000 inhabitants. So the rate among 10,000 women in fertility age is 182. This is horribly high. And in Germany, with the actual law, when no woman who seeks an abortion gets an abortion denied, we have a rate of 56.
Speaker 5:So it might be that a real help for women is not to take the humanity from their children and not to say this is just tissue or amniotic sex, but to consider that women are not stupid. And we can only be honest to the women when we say, okay, we try to combine the right to life of the child, and your real problems, and your right to self determination. This is, from our point of view, the only possibility and the only real goal we should have. We all want to help women, but we also have to consider the consequences for women and the children in such cases. And, of course, the judgment of the supreme court will have consequences in Germany.
Speaker 5:There are many, many people, also politicians, who have a look at abroad in other countries where it's legal. And they have to take one decision. Do we want to have more abortion than legalize it? Do you want to have less abortion than find a better way?
Speaker 1:Constance, you've heard Carolina and Alexandra. Does any of what they say resonate with you in terms of what you hear in the United States?
Speaker 6:Yes. Much of what Alexandra mentioned are arguments that are also being made by those who oppose abortion in the United States and, to be honest, by the far right. So they're arguing that we are dealing with a child and not an embryo. And scientists and doctors have proven essentially that that is not the case. Right?
Speaker 6:We are not dealing with a child. We are dealing with a fetus, and the decision to have an abortion is to say, I might not be able to carry this child or I don't want to carry this child. And I think one thing, Aleksandra mentioned, in her last argument, is that disproportionately, African American women or people of color in the United States have abortions. And there are so many arguments out of the United States and and research out of the United States about why that is the case. And that's the case because there are inequalities that exist in the United States that result in, women of color, whether it's them living in poverty or not having access to birth control, for instance, that then puts them in a situation where they might be more likely to have an abortion.
Speaker 6:And so I think that is elemental that we discuss those policy issues, and discuss how we need to be better on those policy issues and and discrimination that occurs in the United States. And vital is because there's such a huge discrepancy, it really shows that this issue in the United States is also a racial issue. And denying abortion to, women, especially people of color would increase, those racist policies.
Speaker 1:We're gonna take a short break and when we return, we'll talk more about changing abortion laws in the United States and Germany. Stay tuned.
Speaker 7:Hello. This is Abby, presenter and cocreator of Berlin Briefing. Do you find yourself having trouble understanding the news of the Hauptstadt, usually presented in German? If so, Berlin Briefing can help. We curate local top stories and present them in an 8 to 10 minute podcast in English every Monday through Friday.
Speaker 7:You can find us at berlin briefing.de or wherever you get your podcasts.
Speaker 8:I'm Verena Hutter, host of The Big Ponder, the Goethe Institute's transatlantic podcast bringing abstract concepts to life through personal radio essays. Every other week, our producers turn broad topics into captivating stories told from a US and German perspective. You can find all episodes of The Big Ponder on our website goethe.de as well as on your favorite podcast apps and discover the stories behind The Big Ponder on our radio show, Sounding the Big Ponder. It is broadcast each Monday at 1 PM EST on WPFW 89.3 FM in Washington, DC. We do look forward to connecting with you.
Speaker 1:Welcome back to Common Ground Berlin. I'm Soraya Sarhadi Nelson, and we are talking about the future of abortions in Germany and the United States given some monumental changes that are expected in both countries. My guests are Constance Khokolovsky of Democrats Abroad in Berlin, doctor Carolina Scharf, a German gynecologist based in Wales who worked last year in Bremen at a Pro Pro Familia clinic, and Alexandra Linde who heads Bundesferband Lebensrecht, an association of German groups opposing abortion that organizes the annual march for life in Berlin. We've talked about the end to paragraph 219 a, which will make it legal for doctors to offer information on pregnancy terminations on the internet in Germany. Germany's ruling coalition is also exploring whether to get rid of paragraph 218, a law that for a 150 years has criminalized abortions here.
Speaker 1:Carolina, do you expect that to happen? Is there an appetite to regulate abortion outside of the framework of the criminal code?
Speaker 2:Yeah. I think there is a big appetite to regulate abortion outside of criminal law with anyone who's involved in it. As I said before, there are plenty of examples in other countries where that's the case, and it worked very well. The state of criminalization of abortion has no reference in relation to the actual abortion rate. There are some very variable countries who've managed to decriminalize abortion, such as the Republic of Ireland with that famous vote in 2018.
Speaker 2:Canada has decriminalized it in back in the eighties. India and South Africa had, no criminal law and is regulated there, and abortion is accessible, that does not mean anywhere that women come along and have an abortion just because it's such good fun. They hate it. They hate every minute of it, and they would rather not. And it is a last resort.
Speaker 2:So me as a doctor, my work will be a lot easier if I don't have to explain the woman that it's okay. Although, the law givers in Germany are are basically telling me as a doctor that I'm committing a crime. Because the way the law is written, the 218 is basically makes abortion a crime in whatever circumstances. The only difference is that if a woman has a compulsory conversation and then a compulsory waiting time of 3 days, the crime of committing the abortion is and that in English means it's not gonna be punished. But in actual fact, I've committed, several 100 crimes during my few months in Germany last year just by providing abortion care, which is mind boggling because what I was doing is I was helping the woman who were in front of me.
Speaker 2:I was doing my job as a doctor because the person that I'm interested in is the person in front of me. And that's who I'm helping with very, very safe treatment in an usually, of course, very early situation. Because the Germans are efficient, they diagnose their pregnancy early. So they have their abortion treatment before there is anything even vaguely visible. And even they feel so guilty because of all this crime business and because of gynecologist sending him away.
Speaker 2:And it's just really, really sad.
Speaker 1:Alexandra, what about you? Do you think that paragraph 218 could be stricken and that abortions could be handled under the health code like other medical procedures are?
Speaker 5:Having been proved for decades by a very fantastic new science called embryology, scientific branch proving that a human being is from the very first day of conception until end of life, a human being and the person. It's not possible just to say, oh, I declare a pregnancy being an illness and abortion being a normal treatment. That does not mean that the women are criminalized, but the person who earn money by that are criminalized if they do not respect the law. And this is quite normal in all other cases dealing with the lives of people. And the problem in Germany is not that doctors are afraid of pro life people like me, but they say, I want to be a doctor because I want to heal.
Speaker 5:I want to help. I do not want to kill people. And so I do not perform procedures like abortion, euthanasia, assisted suicide, or things like that. This is a conscientious objection of doctors who do not want to kill people. And everybody, who sees an under logical, book on page 1 knows that we are dealing with at least 2 people during an abortion, and we cannot deny that.
Speaker 5:This is very important to keep that in mind.
Speaker 2:And
Speaker 5:now I've forgotten your question. Well, no. The forgotten your quest
Speaker 1:Well, no. The question I think because you're saying, that it's a person no matter what from the word go, and so, therefore, therefore, it can't be a medical procedure. It can't be handled by the health code because it is a crime in your estimation.
Speaker 5:I do not say it the the end of the abortion, the result of an abortion is a dead human being. And so if there was the best law all over the world, we would have it all. It's a conflict. Sometimes it's a dilemma. It's a very hard situation for women.
Speaker 5:We know that because we deal with those women every day and help them every day. But you cannot say it's a quite normal health care procedure. This is the wrong way. Perhaps it's also the wrong way to say, it's a crime or to call it a crime, but it's a procedure with at least 1 dead person in the end. And so, you must find a regulation all persons can live with or all persons can deal with.
Speaker 5:It's very hard to find 1, but you you never must forget the end is the death of a person. And you cannot say, oh, well, these are no persons, these are no humans. It's just embryos of fetus. A fetus is just a scientific word for a baby before birth.
Speaker 1:No. I think it's illegal. At least, it's a legal, designation in the US. It is not a person for example, if you kill a pregnant mother and the baby is not viable, I think some states will say 8 months, some will say 6 months. It's not like you've murdered 2 people.
Speaker 1:That's not how the law looks at it. I'm assuming and and and I can be corrected if I mean, I'm not an expert on German law. But it seems that there will be a similar provision here. So I understand that that's your belief and I respect your belief. But I'm just saying legally, it's not a dead person.
Speaker 1:It's not like, Carolina has killed 100 of people because she's working
Speaker 5:in Soraya. Mhmm. In Germany, you can when when your mother dies before your birth, you are included and registered person who get the money from your mother. So you are registered as a person before birth if, for example, your parents die. This is law in Germany.
Speaker 1:Okay. Constance, I wanna talk a little bit about abortion costs, which are generally not covered by public health insurance in Germany. Is that the case in the US nowadays? Because I clearly remember it being covered by some American insurance plans back in the eighties.
Speaker 6:Yeah. I will admit, Sarai, I don't know depending on either insurance plan and state. I do believe that most of the time, abortion costs are out of pocket. And that is why so many women and people who can be pregnant in the United States depend on services like Planned Parenthood, where they know that they can get an abortion even outside of, sort of, their insurance. So we know that costs will go up, if Roe v Wade is overturned alone through the fact that women will need to travel to other states.
Speaker 6:If they are living in Mississippi, if they're living in Texas, if they're living in Oklahoma, many other states. There are 26, sort of states on the books, essentially, that have, either trigger laws or abortion laws in place, ahead of the 1973 Roe v Wade decision that will then likely be in effect if, Dobbs v Jackson overturns Roe v Wade. And that means alone, you know, the cost to get somewhere else and to find out where you can access care will certainly increase.
Speaker 1:Carolina, we've talked a lot about patients accessing abortions, but I want to explore this from the doctor's vantage point a bit. Are abortions taught in medical schools or in residences in Germany? And by that, I mean both those induced by pills or those performed surgically. I mean, is there training? Or again, is this something that medical schools are loathed to teach because of the inherent controversy around it?
Speaker 2:Yeah. Thank you for bringing that up. That's an ongoing discussion, and there is a little bit of disagreement last time I looked in Germany. So some of the German colleagues in the gynecology circles believe there is training and there is enough teaching on it. And many medical students and other junior doctors have said, well, there isn't because I still don't know how to do it, and I'm learning how to become a gynecologist.
Speaker 2:I believe I have to hold my hand up here because I'm not directly involved in training German doctors. I'm very much involved in doing the same thing in the UK, so I can talk about that. But you're not really interested.
Speaker 1:No. You can tell me about how it is done in the UK. I mean, after all, we're one giant European, family here. Right?
Speaker 2:It it is. I mean, in the UK, it's the same situation as Germany because it is criminal law here. It is still a crime to commit an abortion, but you it's not a crime if you fulfill certain criteria, which involve 2 doctors' signatures and all that. But the training has also been massively discouraged and has kind of, you know, died a death about 10, 15 years ago. We realized that there just weren't enough doctors because everybody was retiring, and there weren't enough doctors to provide treatment.
Speaker 2:And then different treatments came about, and it all became a little bit simpler, and the training was incorporated. So the 2 big colleges here, which is the RTOG, the, Royal College of Obstetricians and Gynecologists, and the faculty of sexual and reproductive health, they oversee the basic specialist training. We've got a specialist ops and gyne doctor and also a specialist sexual health doctor. Both of those specialties have very firmly embedded in their training modules on abortion care. So they will learn, how that works.
Speaker 2:They can have we talked briefly. I mean, Alexander was talking about contentious objection. Contentious objection, just like it is with other difficult areas of medicine, is also a thing in abortion care. And some doctors will make this clear and will say, well, yes. I do want to learn how abortion care works because I need to look after the woman maybe afterwards, but I do not wish to perform it.
Speaker 2:And every doctor is free to say that. So, you know, nobody's been coerced into performing an abortion if they feel that that's not within their conscience. No woman is, course, being forced to have an abortion either. And there are women who are very, very undecided and, do have lots of visits and then come back and say, actually, I've just spoke with a midwife. I'm having this baby after all.
Speaker 2:And at that point, she'll call it a baby even if it's only a 8 weeks pregnancy. So, you know, it is a very, very individual thing, isn't it? At what point does a woman say this is a baby? At what point is the woman actually interested embryologically? And sometimes I do have that discussion with our patients.
Speaker 2:They are very interested, and they want to know. And some of them, just like Alexandra said, will perhaps even base their decision on that. But that is the exception. Most women realize that they cannot have a child because they've already got 6 or because their husband has just beaten them up and they need to leave them or because they've just lost their job. There are so many different reasons.
Speaker 2:And then they say, well, yes. What is it? And I will describe the detail they want to know. And then we make a decision depending on what she wants to do. But it has to be jointly, and it's a decision between the doctor and the woman.
Speaker 2:And sometimes, she will involve perhaps a partner or a friend. But usually, it's the doctor and the woman who will find the right solution, just like for antenatal care. Antinatal care, as we rightly said, pregnancy is not a disease. So pregnancy is a result of having sex. And pregnancy can end in abortion.
Speaker 2:Pregnancy could end in miscarriage or an ectopic or another abnormal pregnancy. Pregnancy can also end in full term delivery. If you're lucky, you have a healthy baby. Sometimes you're not so lucky, and it's a tragedy. And either the baby or even the mother dies.
Speaker 2:And that happens a lot more often than something awful happening to somebody who's having an abortion. So I think every woman has the right to think about, do I want to undertake this dangerous thing? Do I really want to go through all that? Because I really, really want a baby. So I'm doing it now, and I'm risking my life, literally, because it's dangerous even if it's normal.
Speaker 2:So all these things have to be individual decisions between the doctor
Speaker 1:abortions are on the decline, dropping to under 95,000 last year compared to about a 131,000 in 1996. In fact, one statistic I saw said 7 women per 1,000 get an abortion here, which is one of the lowest rates in Europe. What do you think accounts for that decline and for that low number?
Speaker 5:Well, it's not really a decline because the abortion rate has been constantly on about 59 per, 10,000 women. If there is a small decline, it's good, whatever the reason is. I think it's a social, thing. We always talk about, the patients, the women every day. Most of them in Germany, I can I can speak for Germany, are under great pressure?
Speaker 5:Especially pressure by the men involved, by the father of the child, for example. So most of the women in Germany say, I would have this baby if so. My solution of the problem or our solution of the problem should be, how can we help these women to fulfill their real wish to have the baby? This is the first thing. We never see the surrounding of the woman.
Speaker 5:For example, if you do a teleconsulting, you do not know if there's somebody sitting there and pressuring this woman. Most of the women in Germany are under pressure. And if you have a law where a consulting is necessary, you first have the opportunity to talk in neutral, anonymous manner about the real problems you have. Then in most cases, the child is not a real problem. Mostly, the problem existed before.
Speaker 5:So the consulting is that you to help women to see the problems and to find a solution for the problem.
Speaker 1:So when you're talking about consulting, just to make it clear, you're talking about the 3 days that exists?
Speaker 5:Not a consulting. No. The consulting is before. You go to the, if you want to not to be punished in Germany, you go within the first 14 pregnancy weeks to a consulting. And after the consulting, you get a documentation.
Speaker 5:This documentation is your allowance to go to an abortion 3 days later. And what we see is that you have to help women solve the problems. What what, Constance said about the, African American women in the USA, why do we not help them to prevent the situation of an unwanted pregnancy? Why do we not help them to get, for example, contraception or to get preventive lessons or to help in any other way so that all these women do not get in this situation. I would like to have a baby, but I can't have it.
Speaker 5:So I think abortionist solution is the wrong way for the women. And so the German law gives them a chance by this consultation to get help, and the social feeling is we have to help this woman because she is in a perhaps, tragic situation, and we have to help her. And so in Germany, it's a little bit better than in other countries.
Speaker 1:Yeah. I'm not sure I agree. And I think Constance was about to jump in too. Go ahead, Constance. What were you gonna say?
Speaker 6:Yeah. Alexandra, I would just argue that what you're saying is taking agency away completely from women. I understand you're saying that, some women are put under pressure. I think that is a very select few, actually. And instead, women are the best people to make the decision about whether or not they want to carry and have a child.
Speaker 1:Let me just, ask Carolina one, last question to wrap it up, and then, we're gonna have to call it a day because we're already over time here. So, Carolina, do you expect that women in Germany are gonna have a more difficult or easier time getting abortions in the foreseeable future given the changes that are coming about and the discussions that are being had here?
Speaker 2:I'm hoping it will be slightly simpler gradually because the existing clinics and doctors are able to provide a bit more detail so the women understand what they need to do about Beratomschein and Kost Nivannama and all that running around that they have to do, but it will take some time. And I think the, move that this law is going means that the German public and the German government have a general drift into the right direction into accepting that this is a fairly common situation that needs to be provided within the usual health care services. And, yes, pregnancy is not an illness, but health care is not just about illness. Health care is also about managing pregnancies and their outcome and about prevention. So contraception goes there, which German women have to pay for, and abortion goes there.
Speaker 2:And to say is that the rates in Europe are hugely variable, and they do not necessarily relate to how difficult it is to obtain the abortion. The statistics in Germany imply that it's gone down. But if you ask someone like me, I would say that's because women have actually figured out that there are ways outside the law how to obtain abortion treatment, and that is becoming more and more commonplace. These are, of course, unrecorded abortion treatments. And there are some publications that you can find in the usual journals in the English literature, the British Journal of Sexual Reproductive Health, for instance, the BMJ Journal.
Speaker 2:There was a report about the increased requests from German women to certain online Internet providers, and that was even before the pandemic. So my suspicion with all the pandemic difficulties and access and travel and all the rest of it, that number would have gone up, and those figures will soon be published. So they're out there.
Speaker 1:K. That's all the time we have today. My guests were Alexandra Lindor, who heads Bundesverbant Lebensrecht, a Berlin based association of German groups that organizes the annual march for life in Berlin, doctor Carolina Scharf, a German gynecologist who works in the UK and Germany, and Constance Chokolovsky, a public affairs expert who chairs the Berlin chapter of Democrats Abroad. Thanks to all of you for being on Common Ground Berlin. Thank you.
Speaker 5:Thank you, Soraya. Thank
Speaker 2:you. Thank you.
Speaker 1:And thank you for listening to our podcast. Our senior producer is Dina l Saied and our social media editor is Stefano Montali. Former intern Abigail Meginson also contributed to and helped produce this episode. Common Ground Berlin is made possible through through a grant administered by the German Ministry For Economic Affairs and Climate Action. Our partners are the German Marshall Fund of the United States and Goethe Institut.
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