Abortion in Germany

Abortion in Germany is legal under specific conditions, primarily within the first trimester. The process is structured to ensure informed decision-making while respecting personal autonomy.

If you're an expat navigating this for the first time, it can feel overwhelming — especially in a foreign language. This guide covers everything you need to know: the legal requirements, step-by-step process, available methods, costs, insurance coverage, and how to find English-speaking providers.

How to get an abortion in Germany: Step by step

Here's the process from start to finish. Time is a factor — the sooner you start, the more options you have.

1. Confirm you're within the legal time window

Abortion under the counseling regulation (Beratungsregelung) is permitted up to 12 weeks after conception (roughly 14 weeks after your last menstrual period).

There are two ways pregnancy is counted in Germany:

• From conception (post conceptionem): used for the 12-week legal limit
• From last menstrual period (post menstruationem): used by most doctors and ultrasound scans

This distinction matters. When your doctor says "you're 10 weeks pregnant," that typically means 10 weeks since your last period — which is about 8 weeks since conception. You'd still have roughly 4 weeks left under the legal limit.

If you've just found out you're pregnant and are considering abortion, act quickly. The steps below take at minimum 4–5 days, and booking appointments can take longer.

2. Attend mandatory counseling (Schwangerschaftskonfliktberatung)

Before an abortion can take place, you must attend a counseling session at a government-approved counseling center. This is a legal requirement under §219 of the German Criminal Code.

What happens at the counseling session:

• A trained counselor discusses your situation, options, and any support available (financial aid, childcare assistance, adoption)
• The session is non-directive — the counselor is not there to talk you out of your decision
• You can bring a partner, friend, or interpreter
• The session is confidential and free of charge

At the end, you receive a Beratungsschein (counseling certificate). You'll need this document for the procedure.

Where to find a counseling center:

• Use the BZgA counseling center finder to search by postcode
• Pro Familia is the largest provider of pregnancy conflict counseling in Germany and offers services in multiple languages
• Many local Gesundheitsämter (public health offices) also offer pregnancy conflict counseling

For non-German speakers: Pro Familia and many other certified centers offer counseling in English and other languages. If no multilingual counselor is available, you can bring your own interpreter or request one.

3. Wait at least 3 full days

After receiving your Beratungsschein, there is a mandatory 3-day waiting period before the procedure can take place. The rationale under German law is to ensure the decision is carefully considered.

The 3-day period begins the day after counseling. Plan accordingly — this means you cannot have the counseling session and procedure on back-to-back days.

4. Choose your method and book the procedure

You now need to find a doctor or clinic that performs abortions. The doctor who performs the abortion must be different from the counselor.

There are two methods available in Germany (detailed below):

• Medical abortion (pill) — available up to 9 weeks after conception
• Surgical abortion (vacuum aspiration) — available up to 12 weeks after conception

Your doctor will discuss which option is appropriate based on how far along the pregnancy is and your medical situation.

5. Have the procedure

Bring your Beratungsschein and health insurance card (or proof of coverage) to your appointment. Both methods are outpatient procedures — you go home the same day.

Is abortion legal in Germany?

Technically, abortion remains a criminal offense under §218 of the German Criminal Code (Strafgesetzbuch). However, it is exempt from punishment (straflos) under three legal pathways:

The counseling regulation (Beratungsregelung)

This covers approximately 96% of abortions in Germany. To be exempt from punishment, all of the following must apply:

• The pregnant person requests the abortion
• They have received a Beratungsschein from an approved counseling center
• At least 3 full days have passed since counseling
• No more than 12 weeks have passed since conception
• A licensed doctor performs the procedure
• The doctor performing the procedure is not the same person who did the counseling

If all conditions are met, neither the pregnant person nor the doctor faces prosecution.

Medical indication

An abortion can be performed at any stage of pregnancy if continuing the pregnancy poses a serious risk to the physical or mental health of the pregnant person. A doctor must certify the medical necessity. The counseling requirement and waiting period do not apply.

Criminological indication

If the pregnancy resulted from a sexual crime (rape or sexual assault), an abortion is permitted up to 12 weeks after conception. The counseling requirement still applies, but there is no waiting period.

What does abortion cost in Germany?

The total cost of an abortion in Germany typically ranges from €350 to €600, depending on the method, the provider, and whether anesthesia is used.

What public health insurance covers (and doesn't)

If you're on public health insurance (GKV), your insurer will cover:

• The pre-procedure medical examination
• The mandatory counseling session
• Follow-up appointments after the procedure
• Treatment of any complications

Your insurer will not cover the procedure itself under the counseling regulation. This means the doctor's fee for performing the abortion and any medications or anesthesia must be paid out of pocket.

Exception: If the abortion is performed due to a medical or criminological indication, the procedure is fully covered by public insurance.

For more on how the public system works, see our guide to public health insurance in Germany.

Low-income cost exemption (Kostenübernahme)

If your net monthly income is below €1,446, you can apply for the state to cover the full cost of the procedure — including the parts that insurance doesn't pay.

To apply, contact your health insurance provider or a Pro Familia counseling center before the procedure. They can help you with the paperwork. The application needs to be approved before the abortion takes place.

Private health insurance and abortion

If you have private health insurance (PKV), coverage varies by provider and tariff. Many private insurers follow a similar pattern to GKV — covering medical exams and complications but not the elective procedure itself. Check your policy or contact your insurer directly.

If the abortion is medically indicated, private insurance typically covers the full cost.

Expat health insurance and abortion

Expat health insurance plans are designed for emergency and essential medical care during temporary stays. These plans are unlikely to cover an elective abortion procedure, though they should cover complications and emergency treatment.

If you're on expat insurance and considering an abortion, your best option is to contact Pro Familia to discuss cost assistance, especially if your income qualifies you for the low-income exemption.

Abortion methods available in Germany

Two methods are available. Your doctor will help you decide which is appropriate based on how far along you are and your health.

Medical abortion (Mifegyne) — up to week 9

Medical abortion uses a combination of two medications: mifepristone (brand name Mifegyne) and a prostaglandin (typically misoprostol).

How it works:

1. First visit: You take mifepristone at the clinic under medical supervision. This medication blocks the hormone progesterone, which is needed to maintain the pregnancy.
2. Second visit (36–48 hours later): You take the prostaglandin, which causes the uterus to contract and expel the pregnancy. This can happen at the clinic or, in some cases, at home under guidance.
3. Follow-up visit (~14 days later): An ultrasound or pregnancy test confirms the abortion is complete.

Key facts:

• Available up to the 9th week after conception (approximately 63 days)
• Effectiveness: approximately 97–99% — in rare cases, a surgical follow-up is needed
• The process typically takes a few hours on the second visit, with bleeding and cramping lasting 1–2 weeks afterward
• No anesthesia is needed

Surgical abortion (vacuum aspiration) — up to week 12

Surgical abortion in Germany is performed using vacuum aspiration (suction), not D&C (dilation and curettage). German medical guidelines no longer recommend D&C for abortion.

How it works:

• The cervix is gently dilated, and the pregnancy tissue is removed using gentle suction
• The procedure itself takes about 5–10 minutes
• It's done under local anesthesia or short general anesthesia, depending on the clinic and your preference

Key facts:

• Available up to the 12th week after conception
• Effectiveness: approximately 99%+
• You can usually go home 1–3 hours after the procedure
• Most people take 1–2 days off work afterward

How to choose between the two methods

Your doctor can help you weigh these factors. If you're past week 9, surgical is your only option.

For more context on this and other aspects of sexual and reproductive health in Germany, see our complete guide.

Where to find an abortion provider in Germany

Not all gynecologists in Germany perform abortions. You'll need to find a doctor or clinic that is specifically certified for the procedure.

Finding an English-speaking provider

If you don't yet have a gynecologist, or your current one doesn't perform abortions, here's how to find a provider:

• Doctolib — filter by language and specialty to find English-speaking OB-GYNs. Not all listed gynecologists perform abortions, so call ahead to confirm
• Ask your counseling center — Pro Familia and other counseling centers maintain lists of providers and can refer you directly
• BZgA provider search — the Federal Centre for Health Education provides a searchable list

For general tips on navigating the German medical system, see our guide on how to find a doctor in Germany.

Pro Familia centers

Pro Familia is Germany's largest provider of reproductive health counseling and services. They offer:

• Certified pregnancy conflict counseling (Schwangerschaftskonfliktberatung)
• Referrals to abortion providers
• Cost assistance and social support
• Multilingual services in many locations

You can find your nearest center on their website.

City-specific resources

In major cities, additional organizations can help:

• Berlin: Familienplanungszentrum Berlin offers counseling and procedures in multiple languages
• Munich, Hamburg, Cologne, Frankfurt: Pro Familia has local branches in all major cities — search by postcode on their website
• Nationwide: Doctors for Choice Germany provides information about providers and the legal framework in English

After the abortion: Recovery and follow-up

Most people recover quickly from an abortion, but there are a few things to be aware of.

Physical recovery:

• Light bleeding and cramping can last 1–2 weeks (typically lighter after surgical abortion)
• Avoid strenuous activity for a few days
• A follow-up appointment is important — especially after medical abortion, to confirm the procedure was complete

Contraception:

Your doctor will usually discuss contraception options at your follow-up appointment. Fertility can return quickly after an abortion, so it's worth having this conversation early.

Sick leave:

If you need time off work, your doctor can issue a sick note (Arbeitsunfähigkeitsbescheinigung). There is no special reporting requirement — it's treated like any other medical procedure.

Mental health:

Everyone responds differently. If you're experiencing anxiety, sadness, or stress — before or after the procedure — support is available. See our guide to mental health resources in Germany, or ask your counseling center about follow-up emotional support.

The legal debate: Will Germany decriminalize abortion?

While abortion is accessible under the current framework, it remains technically a criminal offense under §218. This has been a source of ongoing political debate.

A brief history of §218

Germany's abortion law dates back to 1871, when §218 was introduced in the original German Criminal Code. Key milestones include:

• 1974: West Germany legalized first-trimester abortion, but the Constitutional Court struck it down in 1975
• 1972: East Germany (DDR) legalized abortion up to 12 weeks with no conditions — reflecting its policy of gender equality
• 1990–1995: After reunification, a compromise was negotiated. The result — the counseling regulation model (Beratungsregelung) — is the system still in place today
• 2022: §219a, which had banned doctors from providing information about abortion services online, was repealed. Doctors can now freely publish details about procedures, methods, and costs on their websites

2024 Commission and reform attempt

In April 2024, the Commission on Reproductive Self-Determination published its report. Key recommendations included:

• Legalizing abortion (not just exempting it from punishment) during the first 12 weeks
• Removing the mandatory 3-day waiting period
• Ensuring access "promptly and without barriers"

In November 2024, a cross-party group of lawmakers introduced a reform bill based on these recommendations. However, the bill failed to advance in the Bundestag in February 2025 after the Legal Affairs Committee declined to vote on it.

Current outlook

Under the current government coalition, further reform of §218 appears unlikely in the near term. The existing system — counseling requirement, 3-day waiting period, 12-week limit — remains in place.

For expats, this means the practical process described in this guide is the current framework you'll navigate. If and when the law changes, we'll update this article.

This article is for informational purposes only and does not constitute medical or legal advice. If you're considering an abortion, contact a certified counseling center for personalized guidance.