Fact Check: What about the statements of abortion opponents?

1. Claim: There is a high number of unreported cases of abortion in Germany.

The view of the abortion opponents: Among other things, the association "doctors for life" claims that not all doctors in Germany report abortions. In addition, there are illegal crashes. In order to do justice to reality, the official numbers for abortions would have to be multiplied by a factor of two.

The check: In Germany, a law since the mid-nineties, prescribes that medics must report abortions. The Federal Statistical Office is responsible for the implementation. Since 1996, it has maintained a database of all doctors and clinics able to perform abortions.

On this basis, a multi-stage procedure is carried out:

• If the institutions do not inform themselves, the Federal Office reminds them of their obligation to provide information, together with a response period.
• If this is missed, followed by a second letter with the announcement of an imminent fine of up to 5,000 euros.
• If the clinics and clinics do not comply with this request, the legal department of the Federal Statistical Office will initiate proceedings.

"As a rule, report failing respondents at the latest in the second round of reminder, so rarely an administrative offense procedure must be initiated," writes the Federal Statistical Office on demand of SPIEGEL ONLINE. On the basis of the current procedure one can rule out that there is a significant number of unreported cases of abortions.

Conclusion: There is no high number of unreported cases.

2. Statement: The unborn child is already very well developed between the sixth and twelfth week - and therefore able to feel pain and panic.

The Abortion Opponents' View: The Pro Life page states that unborn babies are able to experience pain and panic early if their lives are threatened. The "doctors for life" write that children from the ninth week of pregnancy through the already existing nerve structures have a sense of pain.

The check: In Germany, women can abort until the 12th week * impunity if they prove that they have participated in a consultation. By that time, all the organs have been created in the fetus. Especially complex functions have yet to be developed. This also applies to the sensation of pain.

In order for a person to feel pain in an injury, there must be three structures in his body that interact with each other:

• A receptor that senses the pain and turns it into a nerve stimulus.
• Nerve pathways that transmit the signal across the spinal cord to the brain.
• Structures in the brain that translate the stimulus into a sense of pain.

If one of these components is missing or a connection is disturbed, the whole system collapses, as paraplegia shows. Cutting through the nerves in the spinal cord also destroys the sensation of pain in parts of the body.

As a rule, fetuses do not develop the physical conditions to experience pain until the last third of the pregnancy, as can be seen in a 2005 study summary.

Thus, even in the 7th to 15th week of gestation, the pain receptors form. The nerves in the spine, however, are around the 19th week so far as to forward signals from the receptors. In the 23rd to 24th week of gestation, the stimuli reach the cerebral cortex. However, according to the researchers, it takes at least until the 30th week until the baby is awake and able to notice something.

Therefore it is impossible that fetuses can feel pain in the twelfth week. However, what they develop earlier are reflexes. For example, a fetus may instinctively withdraw when touched. Such reflexes happen unconsciously, as a rule, the brain is not involved. For that reason, it is wrong to infer from the existence of reflexes to the existence of pain.

Conclusion: In the twelfth week, the fetus lacks the physical conditions to feel pain.

3. Claim: Little is known about how much abortion puts a psychological strain on women.

The view of the abortion opponents: How abortions affect the mental health, is not well known. This is also the view of the Federal Ministry of Health led by Jens Spahn (CDU). The Federal Cabinet has just approved five million euros to explore the psychological consequences of abortions.

The check: Researchers have been working since the eighties with the question of how abortions affect the psyche. In a survey, a group of the American Psychologists Association came across more than 70 international studies in 2008, the first of which were published in 1989.

Although the researchers criticized the validity of part of the studies, they only referred to special cases:

• Little is known, therefore, about the psychological burden in women who have stopped several pregnancies
• or late due to medical reasons, a wanted pregnancy.

The psychological consequences of a typical abortion but - so a single abortion in a woman who has become pregnant unintentionally - the researchers evaluated ten years ago as relatively well studied. Since then several more examinations have been published, some of them with thousands of participants (including these, these and these, see next item).

Conclusion: Only a few, relatively rare cases lack information on how abortions affect the psyche.

4. Claim: Abortions make women mentally ill, and many develop post-abortion syndrome. However, the existence of this mental disorder is concealed.

The view of the abortion opponents: Among other things, the "doctors for life" claim that almost every second woman mentally ill after an abortion. That this is unknown is explained by "collective repression".

On behalf of the Ministry of Health, British researchers summarized findings on the psychological effects of abortions. They focused on the data of women who had become unwanted pregnant for the first time:

• Whether the women gave birth or opted for an abortion, they developed mental health problems about the same. An abortion does not increase the risk of getting mentally ill.
• However, people with mental illnesses became unusually pregnant more often than not. This explains why women who have been aborted are more mentally ill than the social average.
• Whether or not women develop mental illness after having been aborted depends primarily on whether they had previously had psychological problems. The same was true for women who had the child.
• In addition, there are also factors that are specifically related to abortion and increase the risk of mental problems: It was problematic if the partner urged the woman to an abortion or she herself had a negative attitude to abortions.

In summary, it can be said that while women who abort are more likely to suffer from mental health problems, abortion is not the cause.

"Decades of research show that abortions do not cause mental illness, but they are still teeming with misinformation," concludes Nada Stotland and Angela Shrestha of the University of Illinois at Chicago in an editorial by the journal Jama Psychiatry.

Of course, abortions are often a dramatic experience and could take place in difficult circumstances, the doctors write. "Women considering abortion and thinking about sequelae should be well informed."

The best result, however, is always to be expected when women make an autonomous decision based on their values, beliefs and situation - and then receive unconditional support regardless of their decision.

Conclusion: A "post-abortion syndrome" does not exist.

* Regarding abortions, the 12th week after fertilization is meant. Doctors often calculate the pregnancy from the first day of the menstrual period. Since this takes place two weeks before ovulation and thus two weeks before fertilization, a termination is usually allowed up to the 14th medical calculation week.