According to Elsa's study, Lower Saxony is in the middle zone when it comes to abortion care. But some regions are worse off.

A red cross in front of a clinic.

Click here to go to the emergency room: In many places, the road to an abortion is too long Photo: Julian Stratenschulte / dpa

BREMEN/MEPPEN/NORDHORN taz | When the results of Elsa's study on abortion were presented in a six-hour video conference a week ago, Dagmar Wölk-Eilers was sitting in front of the monitor in her home in Emsland, one of hundreds of people who they looked She heard what she has known for more than 20 years, since she has been advising women who want to terminate a pregnancy: that in her region there is no office or clinic that can help them.

He had already told the taz seven years ago, when it was the first media outlet in Germany to report on the gaps in abortion care in Germany. They are not only particularly numerous in southeastern Bavaria, as is often said in the media, but also in western Lower Saxony. Depending on where they live, women have to drive 100 kilometers or more to the nearest office or clinic that performs abortions.

When asked how it intends to improve the situation for the benefit of women living there until 2021, the Ministry of Health of Lower Saxony responded with the following formula: “The Ministry has no information on the deficiencies in care in the state of Lower Saxony. Lower Saxony”.

He can't do that anymore. According to the results of Elsa scientists, who for the first time examined the level of care by the federal government, Lower Saxony is one of six federal states in the middle camp. Women in Bavaria, Baden-Württemberg and Rhineland-Palatinate receive worse care. In the other three northern German states, the level of care is classified as high.

However, in several regions of Lower Saxony the car journey takes more than 40 minutes. Scientists coordinated by the University of Fulda developed this criterion and based it on the accessibility requirements of gynecological consultations. The reason for this approach: the legislator only obliged the states to guarantee a sufficient supply without defining “sufficient.”

Uneven distribution in Lower Saxony

Accidentally pregnant women living at the mouth of the Elbe, in the Wendland, in the Harz Mountains, on the coast and in western Lower Saxony drive more than 40 minutes to the nearest doctor's office or clinic. The scientists also calculated what percentage of a district's population lives in such a poorly supplied region. These results are available for the taz.

In Emsland it is 45.7 percent, in the county of Bentheim 30.1 percent, in Cloppenburg 26.1 percent and in Lüchow-Dannenberg 20 percent. In all other districts it is less than six percent. In Schleswig-Holstein, the coverage level is similarly low in only one district: in North Frisia, at 21.5 percent. In Bavaria there are districts where 100 percent of the inhabitants are affected.

When presenting the results on Wednesday of last week, the scientists pointed out that, on the one hand, not everyone has a car and, on the other hand, the distances can be much greater if the doctor does not arrive on time to the nearest consultation or clinic. close. .

“Women are surprised when they tell us where they have to go for an abortion,” says Wölk-Eilers, who together with her colleague Anja Mählmann heads the pregnancy conflict counseling department at Diakonisches Werk Emsland-Bentheim. Wölk-Eilers works in Meppen, 20 kilometers from the Dutch border, Mählmann a little further south, near North Rhine-Westphalia, in the border town of Nordhorn.

Counselors take the women to the clinic.

In the Zoom conversation with the taz they list what those affected must organize in addition to the trip – whose expenses they have to cover themselves -: a companion if it is a surgical intervention under general anesthesia and, in many cases, childcare for several hours or an entire day. And this usually happens twice, because some centers postpone the medical consultation before the operation to another day.

The Osnabrück clinic usually sees its patients at seven in the morning, regardless of when the procedure is, says Mählmann, who has been working in pregnancy conflict counseling for 15 years. The first train from Nordhorn, which leads at 6:45 am to Osnabrück central station with a stopover in Bad Bentheim, leaves at 5:30 am “But it is often canceled and then you stay there, you have everything organized, you are excited and you know that now the stress starts again and you need a new appointment as soon as possible.”

There are always cases where women have no one to help them because they keep the abortion a secret for fear of being treated with hostility or being persuaded or forced to give birth. Some do not have mobility because there is no public transportation and they cannot afford a taxi. These are often women who live in precarious situations, are poor and speak little or no German.

“Then we have to intervene,” says Wölk-Eilers. This happens about once or twice a year. His colleague Mählmann remembers three women last year. Advisors will pick you up in their own car outside of their working hours and will have to cancel other professional and private appointments. This is not your job. “But what should we do when they sit in front of us to consult us and we know that if we don't do it, no one will?” asks Mählmann.

Ignored by politics

Both women speak of a lot of helplessness. “What has to happen for something to finally change?” asks Wölk-Eilers. They were never informed about the situation by a local politician, when asked if what the taz has been reporting since 2017 is true, nor by a parliamentarian or a Minister of Health, also responsible in Lower Saxony for women's equality.

The example of Bremen shows that it is possible to get more doctors to perform abortions. In 2018, according to the Federal Statistical Office, only 13 places in the state of Bremen reported abortions. This number gradually increased to 23 last year.

However, in Bremen, unlike in Lower Saxony, both the state medical association and the professional association of gynecologists and politicians work to improve the conditions of involuntarily pregnant women. In the federal parliament, even FDP and CDU politicians voted, after a remarkably objective debate with the Greens, the left and the SPD, in favor of a law that obliges the federal state of Bremen to guarantee “abortion offers based on the needs”.

Failed to fetch data from the URL.