Why are there few abortions in Switzerland?

In German-speaking cantons, the rates of artificial pregnancy termination are the lowest. Geneva, Vaud, and Neuchâtel are among the leaders. Swiss medical professionals explain why abortions in Switzerland are carried out in such a "modest" quantity. Compared to neighboring countries, Switzerland has effective educational programs. Additionally, many gynecologists are determined to do everything possible to dissuade women from taking such a step.

Today, the situation is ambiguous. On one hand, Switzerland stands out favorably from the rest of Europe with an extremely low abortion rate. On the other hand, the quantity significantly varies from canton to canton, which still lacks a clear explanation. Commenting on the "unpopularity" of abortion, professionals mention the influence of sex education programs on schoolgirls' minds, as well as informational events in the field of family planning. On the other hand, the relatively low number of abortions can be explained by conservatism, the preservation of cultural and moral traditions, as well as differences in access to medical services in different cantons. This is noted by the newspaper Le Temps based on the results of its journalists' investigation.

One of the possible reasons was mentioned by a doctor who wished to remain anonymous:

"Gynecologists do not welcome pregnancy termination and postpone it, giving patients time to think. And then they inform that it is too late to have an abortion."

Numerous movie plots come to mind. When a doctor, friendly and compassionate, in a casual conversation tries to dissuade a future mother from a fatal step. Of course, often circumstances – medical reasons, lack of a strong financial base, lack of understanding from loved ones – push the girl to postpone the stork's arrival "for later." But is this a simple medical intervention or a crime against one's own flesh and blood? Each woman herself must answer this question. At different times and among different peoples, such an act was interpreted differently. For some, it was unthinkable, as "a child is a gift from heaven!" For others, it was allowed in special cases (when they wanted predominantly male children). Nevertheless, throughout the centuries, a woman more often appeared in the role of the Goddess-Mother, the savior of the human race, the source of eternal renewal and the triumph of life. Her destiny is to give life, not take it away.

In conservative Switzerland, where just a few decades ago there was criminal responsibility for premarital intercourse and the birth of illegitimate children, the attitude toward abortion is still not the most lenient. The instructions of their grandmothers and grandfathers are still vivid in the memory of the population. They actively encouraged children and grandchildren to attend the church on Sundays and listen to the teachings of pastors and abbots. Swiss doctors are no exception. Many remember the oath of Hippocrates, who wrote in the 5th century BCE: "I will not give a woman an abortive pessary."

However, modern times introduce their corrections: education, international experience, WHO recommendations – all seem to suggest that there is nothing wrong with it. And a woman will not suffer any psychological trauma for the rest of her life. But no matter what the official views on abortion are, there are also unspoken attitudes. And in each Swiss canton, there is its own practice.

"When I found out I was pregnant, I was only 23 years old, I hadn't finished my education yet, and my family was abroad. I went to my gynecologist, who literally kicked me out of the office when I mentioned the possibility of voluntary pregnancy termination," one patient said.

According to another, the doctor forced her to wait until only one option remained – surgical intervention. According to the patient, the doctor allowed the possibility that she might realize that a child is a gift from above. "And everything like that, which left me with a real trauma for many years."

Another woman said that she had an abortion two years ago, but that she faced significant ethical challenges. "My gynecologist referred me to the university hospital in my canton (Fribourg). I was surprised by the disapproving comments and behavior of some of the midwives I dealt with."

The second woman said that some gynecologists in French-speaking Switzerland refuse to perform abortions. They do not offer alternatives, such as referrals to other providers. There have also been complaints about administrative hurdles and inflated bills. "My gynecologist only offered me a curettage, even though my pregnancy was at a stage where a medical abortion was possible."

Françoise Piron, head of a women's clinic in Lausanne and an expert on equality, shared the story of a friend who lived on social assistance with one child. When she needed to have an abortion, she was first interviewed three times at the University Hospital of the Canton of Vaud (CHUV). She was not offered an ultrasound to determine the stage of her pregnancy. In the end, she had to go to a private doctor, and the abortion was performed 48 hours before the legal deadline. "This would never have happened to a woman with a better economic status. She would have been able to choose a private gynecologist who was more flexible about abortion."

Data from the Federal Statistical Office (OFS) confirms the differences between cantons. In a report published in June 2023, the OFS notes that the abortion rate per 1,000 women was 25% lower in the canton of Jura from 2011 to 2014 than from 2007 to 2010. In Schaffhausen, the percentage increased by 21%, in Valais and Nidwalden by 18%, and in Neuchâtel by 17%. However, the OFS does not provide a detailed analysis of this information.

It is also worth noting that the percentage of foreigners who have abortions in Switzerland is particularly high. In the cantons of Vaud and Geneva (where immigrants make up 40-50% of the population), this factor can explain the higher than average national rate. The OFS points out that data on nationality is only available for individual cantons. It is not possible to assess the situation from this perspective at the national level.

In addition, attitudes towards abortion vary across cantons. In some regions, it is even easier to talk about migration than about abortion. For example, the family planning service in Fribourg believes that it is impossible to discuss attitudes towards abortion at the cantonal level. It is considered to be too subjective a question. It is worth remembering that the University of Fribourg is home to a well-known Catholic theological faculty. The university was founded in 1580 by Jesuit monks.

It is also worth remembering that abortion was only legalized at the federal level in Switzerland in 2002. However, in some cantons, doctors performed abortions with the support of local authorities. It is worth noting that the Protestant cantons of Zurich, Basel, Geneva, Vaud, Bern, and Neuchâtel have been characterized by liberalism since the middle of the last century. These cantons also had the highest abortion rates in 2015.

The number of artificial terminations of pregnancy is increasing in Valais, Fribourg, Uri, Obwalden, and Appenzell Innerrhoden. Clémentine Rossier, a researcher at the University of Geneva and an expert on abortion, noted that "the change in the number of abortions in connection with the characteristics of medical care and the availability of such a service could be an interesting topic for research in Switzerland, but such research has never been conducted." The researcher also added that social norms in more conservative cantons encourage women to "not resist fate" in the event of an unexpected pregnancy.

It is also worth noting the conditions for conducting this procedure in different cantons. In Geneva, it can be done in any clinic with a gynecology department and the appropriate equipment. In Appenzell, women must go to the cantonal hospital.

Another possible explanation for the heterogeneous statistics by canton is that in Switzerland gynecologists can refuse to perform surgery. For example, in St. Gallen, this right is clearly stated in the local legislation, and therefore in conservative regions it is sometimes difficult to find a specialist ready to "intervene". We should add that, unlike Italy, where 70% of gynecologists refuse to perform abortions for ethical reasons, the Confederation has no statistics in this area. A representative of the Health Data Division of the Federal Statistics Service emphasized that it is not within its mandate to collect such data.

Источник: Наша Газета