What options for an abortion are available? And what can I expect during a termination? What do I need to bear in mind afterwards? Here you will find an overview of the process of a termination of pregnancy, the differences between medicinal and surgical abortion, and possible risks.
Process of a Termination of Pregnancy
For the abortion, you need an appointment at a practice or clinic that carries out terminations of pregnancy. The pregnancy counselling centre can help you find a suitable doctor. The Federal Medical Association (Bundesärztekammer) also has a list of practices and clinics that carry out terminations.
What is the process for a pregnancy termination? In the preliminary consultation, the gynaecologist will first examine you and discuss which abortion method can and should be used. You can also ask further questions about the process and medical risks of the termination here. You will also need to present the counselling certificate or the medical or criminological indication.
Medicinal Termination of Pregnancy With Mifegyne®
Medicinal termination of pregnancy is a very safe abortion method. It is possible up to the 9th week of pregnancy (from the first day of the last period). After a medical examination, you first receive the medication Mifegyne® with the active ingredient mifepristone. The active ingredient blocks the effect of the body’s own progesterone and initiates the termination. One to two days later, you take a prostaglandin preparation. Both medications can be taken at home. Menstruation-like bleeding then occurs, during which the pregnancy tissue is expelled. These are the same symptoms as in a natural miscarriage. The bleeding can last several days and is sometimes very heavy. If you bleed significantly more heavily than during your period, you should have a medical examination to be safe.
Some doctors accompany the medicinal termination of pregnancy using an app. This provides detailed information in various languages and allows direct feedback and contact with your doctor.
Surgical Termination of Pregnancy: Suction Aspiration or Curettage
Surgical termination of pregnancy is also a very safe abortion method. It is performed under local anaesthesia or a short general anaesthetic. The most common and most gentle method is suction aspiration. A thin tube is introduced through the cervix and the uterine lining and amniotic sac are aspirated. The procedure takes five to ten minutes. Curettage may sometimes be necessary, in which the uterine lining and amniotic sac are removed with surgical instruments. Abdominal pain and bleeding can occur after the termination. Suction aspiration is generally used for a termination between the 10th and 14th week of pregnancy.
“I had of course thought a lot about it beforehand. Everything had to be decided, chosen, organised. But the procedure itself was unremarkable. A few minutes, uncomplicated.”
Risks and Side Effects of Different Abortion Methods
All described medically performed terminations of pregnancy are very safe. Complications such as infections can occur rarely but are easily treated. If you experience heavy bleeding, pain, fever or foul-smelling discharge after a termination, you should see a doctor. Attempted terminations performed without medical supervision, on the other hand, carry high health risks. This also includes so-called ‘natural abortions’ using herbal teas or other home remedies. These frequently endanger the life of the pregnant person and are prohibited in Germany.
Medical Abortion Methods – Risks and Myths
Many myths about the risks of terminations of pregnancy are still in circulation. Here are the facts: Terminations of pregnancy do NOT cause infertility and they have NO effect on the risk of breast cancer or later miscarriages. The so-called Post-Abortion Syndrome does NOT exist. Psychological problems are usually only an issue after a termination if they already existed beforehand. Pregnant people generally make very careful decisions for or against a termination, and the vast majority are satisfied with the decision in the long term. Whether the termination was carried out medicinally or surgically plays hardly any role.
Process of a Termination After Week 12
If the health of the pregnant person is endangered by continuation of the pregnancy, a termination is also permitted at a later point in the pregnancy. This ‘medical indication’ must be confirmed by a doctor. It is often issued when a child is expected to have a severe disability or illness and doctors assume that the mother’s mental health would thereby be endangered. A different medical professional can then carry out the termination.
In the case of a termination after the 20th week of pregnancy, a potassium chloride solution is injected into the foetus, causing cardiac arrest. Labour is then induced with medication. The foetus is born naturally.
Before and after a late termination, you have the right to free psychosocial counselling – for example at AWO pregnancy counselling centres.
Termination of Pregnancy and the Electronic Health Record (elektronische Patientenakte – ePA)
All statutory health insurance members have an electronic health record (ePA), unless they have actively objected or arranged for deletion. Since October 2025, healthcare providers are required to populate it with patient data. However, you decide yourself whether and which health data is stored and who can view it – particularly for a termination of pregnancy.
A termination of pregnancy is among particularly sensitive health data, as are mental illnesses and sexually transmitted infections. Doctors are required to explicitly inform you of your right to object before sensitive data is stored in your ePA. You can exercise your right to object verbally immediately during the consultation. Your decision is documented in the practice but not entered into the ePA. Billing data (e.g., billed treatments, prescriptions) is automatically imported into the ePA, but is visible only to you. Other service providers, such as doctors or psychotherapists, do not have access to this data.
Important: Use of the ePA is voluntary. You determine who has basic access to your data and can revoke access rights at any time. From the age of 15, young people may manage their own ePA, exercise their rights to object independently, and decide what data is stored and who can view it.
For more information, please visit the Federal Ministry of Health. (German)
In standard language: https://www.bundesgesundheitsministerium.de/themen/digitalisierung/elektronische-patientenakte/epa-fuer-alle.html
In easy-to-read language: https://www.bundesgesundheitsministerium.de/ministerium/meldungen/epa-fuer-alle-startet-morgen.html
Aftercare and Emotions
Many people feel sadness and relief simultaneously after a termination of pregnancy – quite independently of the method used. The hormonal changes can lead to intense and shifting emotions. A conversation at a counselling centre can support you after a termination.
Regardless of the method chosen, a few days of rest and recovery are recommended. After 10–14 days, a gynaecological follow-up examination is required. After the termination, a new pregnancy can occur immediately in the absence of contraception. Information about sex and contraception immediately after the termination is available from your gynaecological practice or the pregnancy counselling centre.
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