Abortion Laws in Germany: Counseling, Exceptions, and Costs

Abortion laws in Germany treat the procedure as a criminal offense under Section 218 of the Criminal Code, but it goes unpunished when specific conditions are met. The most common route requires counseling at a state-recognized center, a three-day wait, and completion of the procedure within 12 weeks of conception. Separate rules apply when there is a medical reason or when the pregnancy resulted from a sexual offense.

How the Law Is Structured

Section 218 of the German Criminal Code makes abortion punishable by a fine or up to three years in prison.¹ The next provision, Section 218a, then removes punishment when certain conditions are satisfied. So while the procedure is technically unlawful, it is widely accessible during the first trimester if you follow the correct pathway. The rules that matter in practice are the conditions attached to Section 218a.

The Counseling Pathway

The general route to a lawful abortion has three requirements. Missing any one of them removes the legal protection.

Mandatory Counseling

You must attend a counseling session at a government-approved pregnancy conflict counseling center. The session is confidential, free, and meant to be open-ended rather than directive. The center then issues a certificate confirming that counseling took place, and you present that certificate to the doctor performing the procedure.²

One rule that trips people up: the doctor who performs the abortion cannot be the same person who conducted the counseling. They must be separate practitioners.³ If you are not a German speaker, the counseling center can arrange an interpreter.⁴

Three-Day Waiting Period

At least three full calendar days must pass between the counseling session and the procedure. Counseling on a Monday means the earliest possible appointment is Friday. Under the general pathway, the waiting period is not waived for any reason.²

12 Weeks From Conception

The procedure must take place no later than 12 weeks after conception. The math matters, because doctors normally date pregnancies from the first day of your last period, which typically runs about two weeks ahead of the actual conception date. In everyday terms, 12 weeks since conception is roughly 14 weeks of pregnancy measured from the last period.⁵ A counseling center or doctor can confirm where you are in the timeline.

Medical and Criminological Exceptions

Two situations sit outside the counseling pathway, and each has its own conditions.

Medical Indication

A doctor can certify a medical indication when continuing the pregnancy poses a serious danger to your life or to your physical or mental health, and that danger cannot reasonably be resolved another way. There is no gestational time limit in this case, and neither the mandatory counseling session nor the waiting period applies, though psychosocial support should still be offered.⁶

Germany does not treat fetal abnormality as a separate legal ground. That indication was removed from the law in 1995. A serious fetal diagnosis can still lead to a lawful termination, but only when a doctor finds that the diagnosis creates a real threat to the pregnant person’s mental or physical health. The legal basis is the medical indication, not the fetal condition itself.

Criminological Indication

If the pregnancy resulted from a sexual offense such as rape or sexual abuse, the abortion can be performed within 12 weeks of conception. The mandatory counseling and waiting period do not apply, though counseling should be offered. No police report or formal proof of the offense is required; a doctor’s note based on your own account is enough.⁶

Available Methods

Two methods are used in the first trimester. Which one is available depends mainly on how far along the pregnancy is.

Medication abortion uses two drugs taken in sequence. Mifepristone is taken first, under medical supervision. Misoprostol follows about two days later. This method is approved up to the 63rd day from the first day of the last period, or roughly the 9th week of pregnancy.⁷

Surgical abortion is done by vacuum aspiration and is available up to the end of the legal window at 12 weeks from conception, about 14 weeks from the last period.⁵ It is a short outpatient procedure, usually with local anesthesia or sedation.

Some clinics also offer telemedicine-based medication abortion. You consult a gynecologist by video, receive the pills by mail, and take them at home with remote supervision. The service started as a pilot and has expanded, but it is not yet available everywhere in the country.⁸ Counseling and the waiting period still apply either way.

Finding a Doctor

Access can be the hardest part. Doctors are not required to perform abortions, and many exercise conscientious objection. In some regions, especially rural ones, the nearest willing provider may be far away. States are supposed to ensure enough inpatient and outpatient capacity, but enforcement is uneven.³

The German Medical Association keeps a monthly-updated list of doctors, hospitals, and clinics that voluntarily report performing abortions, and the same information is available through the Federal Centre for Health Education at familienplanung.de. A helpline for pregnant women in distress (+49 800 40 40 020) can point you to providers and counseling centers.³ Counseling centers themselves are also a practical starting point for referrals.

Citizenship and residency do not affect your access. Non-German nationals living in or visiting Germany use the same pathway on the same conditions.

Rules for Minors

There is no fixed age at which a minor can consent. The question is whether the young person understands the decision and its consequences. In practice, doctors generally treat patients aged 16 and older as capable of consenting on their own. For those under 14, parental consent is usually required. Between 14 and 16, the doctor assesses maturity individually, and many providers will want a parent or guardian involved. The counseling requirement still applies, and counseling centers can help minors work through the consent question.

Costs and Insurance

What you pay depends on which pathway applies.

Under the standard counseling pathway, statutory health insurance does not cover the procedure itself. Out-of-pocket costs generally run from about €350 to €600, depending on the method and provider. Insurance does cover related care: preliminary exams, medical counseling, prescribed medications, and any treatment for complications.⁶

If your income is low, you can apply to your statutory health insurance fund to have the procedure costs covered on financial-need grounds. The application should go in before the procedure.⁶

Under the medical or criminological indication, statutory insurance covers all costs, including the procedure, and the doctor bills directly through your electronic health card.⁶

Where Reform Stands

The current framework has long been criticized. In April 2024, a government-appointed commission on reproductive self-determination recommended decriminalizing early-stage abortion and moving it out of the criminal code. A cross-party group of lawmakers introduced a bill in November 2024 that would have made abortion during the first 12 weeks lawful rather than merely unpunished, kept mandatory counseling but dropped the three-day waiting period, and regulated the procedure under health law.

The bill had its first reading in the Bundestag in December 2024 but did not reach a vote before the February 2025 federal election. The new Bundestag’s Legal Affairs Committee then declined to advance the reform. Sections 218 and 218a remain in full effect, and no legislative change appears imminent.

1
Cornell Law Institute. Section 218 Strafgesetzbuch (StGB) – Abortion
2
InformedHealth.org. Abortion in Germany
3
Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. Pregnancy Counselling Section 218
4
Federal Foundation Mother and Child. I’m Pregnant – Help from the Federal Foundation Mother and Child
5
InformedHealth.org. Abortion in Germany During the First 12 Weeks of Pregnancy – Medication or Surgery
6
Bundesportal. Apply for Cost Absorption for Abortion at the Statutory Health Insurance Company
7
National Center for Biotechnology Information. Abortion in Germany – Medication or Surgery
8
World Health Organization. Self-Management of Medical Abortion via Telemedicine in Germany