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Termination of Pregnancy in Germany: Law, Counselling, Deadlines and Costs

Termination of Pregnancy in Germany: Law, Counselling, Deadlines and Costs

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Termination of pregnancy in Germany is called Schwangerschaftsabbruch. The matter is regulated by the German Criminal Code (Strafgesetzbuch, StGB) and the Pregnancy Conflict Act (Schwangerschaftskonfliktgesetz, SchKG). In ordinary circumstances, an abortion is possible without punishment only if the prescribed procedure is followed: counselling at a recognised centre, obtaining a Beratungsschein, waiting at least three days, and having the procedure carried out by a doctor within the permitted time limit.

This article provides a general overview. In a specific situation, it is important to contact a gynaecologist, a recognised counselling centre or a Krankenkasse: deadlines, medical indications, documents and payment depend on the circumstances. Basic questions about pregnancy and childbirth are closely related to pregnancy care in Germany.

Under §218 StGB, termination of pregnancy in Germany is formally classified as a criminal offence. §218a StGB describes situations in which no punishment is imposed or the abortion is not considered unlawful.

In practice, the three most common grounds are:

  • Beratungsregelung — termination at the pregnant person’s request after mandatory counselling and within the time limit.
  • Kriminologische Indikation — the pregnancy resulted from a sexual offence; mandatory conflict counselling is not required on this ground.
  • Medizinische Indikation — continuing the pregnancy poses a danger to the pregnant person’s life or a serious risk to their physical or mental health; the time limit is assessed by a doctor on medical grounds.

In all cases, the procedure must be performed by a doctor, and the pregnant person’s decision and consent are essential conditions.

Time limits: until which week is an abortion possible?

Under the Beratungsregelung, an abortion must be performed within the first 12 weeks after conception. In everyday and medical communication, the time is often counted from the first day of the last menstrual period; under that method, this is about 14 weeks of pregnancy.

The same 12-week limit after conception applies to a kriminologische Indikation. For a medizinische Indikation there is no fixed general deadline, but a medical opinion confirming a risk to life or serious harm to health is required.

If the gestational age is unclear, the first step is usually an appointment with a gynaecologist: the doctor confirms the pregnancy, determines the gestational age and explains which options are still available.

Counselling and the Beratungsschein

For a termination under the Beratungsregelung, counselling at a state-recognised Schwangerschaftskonfliktberatung centre is required. After the counselling, you receive written confirmation — a Beratungsschein.

It is important to follow the sequence:

  1. Confirm the pregnancy and gestational age with a doctor.
  2. Find a recognised counselling service.
  3. Attend counselling and obtain a Beratungsschein.
  4. Wait at least three days between the counselling and the procedure.
  5. Make an appointment with a doctor, clinic or facility that performs Schwangerschaftsabbruch.

Counselling must be open and supportive. It must not pressure anyone into a particular decision. Counselling centres also help with questions of financial support, anonymity, interpreters, pregnancy in difficult life circumstances and alternatives.

Useful official and non-governmental resources:

Minors

For minors, not only age but also the ability to understand the significance of the medical intervention and its consequences is decisive. In practice, the doctor assesses the patient’s maturity; in some cases, the involvement of parents or legal representatives may be required. If speaking to parents is unsafe or impossible, contact a recognised counselling centre as early as possible: it can explain the options for confidential help.

Where terminations of pregnancy are performed

The procedure is performed by doctors, clinics and facilities authorised to carry out Schwangerschaftsabbruch. You can find an address through a counselling centre, a gynaecologist or the official list on familienplanung.de.

The doctor performing the abortion generally must not be the same specialist who issued the Beratungsschein. Before the procedure, the doctor explains the method, risks, anaesthesia, follow-up care and signs that require urgent medical attention.

Methods: medication and surgery

Two main options are used in Germany. Before choosing a method, an appointment with a doctor is usually necessary.

Medical abortion is performed using medication and is possible only in early pregnancy. Familienplanung.de states that the medical option is used up to the end of the 9th week of pregnancy, calculated from the start of the last menstrual period. The process takes several days and requires medical supervision.

Surgical abortion is most often performed by vacuum aspiration (Absaugung) on an outpatient basis in a doctor’s practice, an OP-Zentrum or a clinic. Curettage (Ausschabung) is generally no longer the standard method for an ordinary early termination and is more often used in specific medical situations.

The choice of method depends on gestational age, health, availability of doctors and medical contraindications. It is better to compare methods in consultation with a doctor, rather than through forums or advertising descriptions.

Risks and medical follow-up

Every medical intervention carries risks. Possible complications include bleeding, pain, inflammation, incomplete completion of the procedure, a reaction to anaesthesia, or the need for another medical appointment. Follow-up is particularly important after a medical abortion to make sure the pregnancy has actually ended.

Seek urgent medical help if you have heavy bleeding, a high fever, pronounced weakness, sharp pain, foul-smelling discharge or a suspicion that the pregnancy is continuing.

How much it costs and who pays

If an abortion is performed on the grounds of a medizinische or kriminologische Indikation, the costs are usually covered by insurance. Under the Beratungsregelung, the procedure itself is generally paid for privately, but medical services before and after the intervention are covered under the applicable rules.

If you have a low income, you can apply for cost coverage. If you have statutory health insurance in Germany, the application process is usually clarified through your Krankenkasse. The application is made before the procedure, usually through the Krankenkasse. The costs are then reimbursed by the federal state. Eligibility depends on income, family composition, housing costs and other conditions.

Public sources give different cost estimates for early termination of pregnancy. It is safer to ask the particular practice or clinic for the price in advance and ask the Krankenkasse separately about possible Kostenübernahme.

Statistics

According to the Federal Statistical Office, 106,218 terminations of pregnancy were recorded in Germany in 2023. In 2024, the figure remained at roughly 106,000, and Destatis public notices for 2025 indicated around 106,000 cases and a slight decline compared with 2024.

These statistics do not explain people’s individual reasons for their decisions. They show only recorded cases in the established categories: age, gestational age, method, place of procedure and legal basis.

Emergency contraception: Pille danach

Pille danach is emergency contraception after unprotected sex or a contraceptive failure. It is not an abortion and does not terminate an existing pregnancy. In Germany, it is available from a pharmacy without a prescription; the sooner you seek it, the greater the chance of preventing pregnancy. A pharmacist or doctor can help choose the suitable option based on the time since intercourse, medications and health status.

Contraception and cost coverage

Condoms are sold in pharmacies, supermarkets and drugstores. At school, the subject of contraception and consent is usually connected with sex education lessons. Hormonal contraception generally requires a doctor’s prescription. Under statutory insurance, the cost of prescription contraceptives for young women is covered according to age-related rules; after reaching the applicable age, the cost more often falls to the patient. Check the specific conditions with the Krankenkasse and a gynaecologist.

If you cannot or do not want to continue the pregnancy, but abortion is not suitable

Counselling centres discuss more than abortion. They help people understand financial support, housing, safety, medical care, adoption and the possibility of confidential childbirth (vertrauliche Geburt).

With a vertrauliche Geburt, a woman gives birth with medical safety while her personal data are protected through a special procedure. Information is available from counselling services and the federal helpline 0800 40 40 020.

What to check before making a decision

  • the gestational age and how it is calculated;
  • whether Schwangerschaftskonfliktberatung is required in your particular situation;
  • where to obtain a Beratungsschein;
  • which doctors or clinics are available in your region;
  • which method is possible given the gestational age and your health;
  • who pays for the procedure and whether an application must be made in advance;
  • whether you need an interpreter;
  • how to arrange support after the procedure.

FAQ

The legal structure is more complicated: §218 StGB retains a general prohibition, while §218a StGB sets out conditions under which no punishment is imposed or the abortion is not unlawful. It is therefore important to follow the procedure and time limits.

Can I attend counselling anonymously?

Counselling services offer confidential help. If you need special protection for your personal data, ask the centre about the options for anonymous or confidential counselling.

Do I have to wait three days after counselling?

Under the Beratungsregelung, yes: the statutory waiting period must pass between counselling and the procedure. Rules may differ in medical emergencies.

Does GKV cover abortion on request?

Under the Beratungsregelung, the procedure itself is generally not automatically covered, but people with a low income can apply in advance for Kostenübernahme. Medical services before and after the procedure are covered separately under the insurance rules.

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