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Introduction: Barriers to accessing abortion care can delay access to services, which can lead to delayed abortion and health risks. Barriers include geographical accessibility, confidentiality, waiting times, stigmatization, poor or inaccessible information and the cost of abortion. This article examines barriers to accessing abortion care in Germany. This includes barriers in the availability and accessibility of care services, access to information, costs associated with abortion and organisational barriers., Methods: The analyses are based on data from an online cross-sectional survey of 594 women in Germany who had an unwanted pregnancy terminated, which was conducted as part of the ELSA Study in 2021 and 2022., Results: The findings indicate that access to abortion care in Germany is associated with various barriers for many women. Of the respondents, 80.1% reported at least one barrier to accessing abortion, 65.5% reported more than two barriers and 40.5% reported three or more barriers. In particular, the non-disclosure of the procedure and the associated fear of stigmatisation represented hurdles for many participants., Discussion and Conclusion: The results of the study underline the need to improve access to safe abortions. Reducing access barriers therefore includes the decriminalisation of abortion, a comprehensive care structure, financial support services, improved information services and the reduction of stigmatisation and discrimination., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: D. Hahn, R. Torenz, I. Thonke, S. Eckardt, M. Schneider, A. Wyrobisch-Krüger, U. Busch, C. Helfferich, T. Knittel, M. Böhm, P. Brzank, C. Knaevelsrud, S. Krumm und S. Schumacher geben an, dass kein Interessenkonflikt besteht. Die Befragungen von ungewollt Schwangeren wurden mit Zustimmung der zuständigen Ethik-Kommission der Hochschule Fulda (positives Votum vom 27.04.2021, Az.: 3.1.9.2-kkm), im Einklang mit nationalen Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patient/-innen liegt eine Einverständniserklärung vor., (© 2024. The Author(s).)

Background: Despite widespread access to contraception, it is observed that women without pregnancy intention do not use contraception and become pregnant., Aim of This Paper: The analyses conducted in this paper aim to assess the prevalence of the phenomenon of non-use of contraception for Germany and to gain a better understanding of the reasons why women risk unintended pregnancy., Materials and Methods: Using quantitative survey data on 17,400 pregnancies and 116 open qualitative interviews from the study "Women's lives 3: Family planning in women's lives" conducted on behalf of the Federal Centre for Health Education (BZgA), statements can be made on the prevalence of non-use of contraceptive methods despite a lack of pregnancy intention and on the underlying reasons., Results: The reasons given for not using contraception can be assigned to three very different motives: a) playing with a desire to have children, which is mentioned by just under one third; b) individual and structural barriers, such as health reservations or too high costs; and c) not using contraception because of the erroneous assumption of not being able to get pregnant. It can be seen that these motives vary in prevalence depending on the biographical situation., Discussion: The results point to the need for a more differentiated understanding of unintended pregnancies in both research and prevention. A limitation and thus a need for future research is that the influence of the (sexual) partner on the contraceptive behaviour of women and on the intentionality of the pregnancy cannot be examined within the framework of the study., (© 2021. The Author(s).)

Objective: The study examines the differences within unintended first pregnancies in the life course of 20-44 year old women. Special attention is paid to response and pregnancy acceptance. Exploring determinants and dynamics, this study will contribute to a better understanding of 'happiness with an unintended pregnancy', as this is assumed to be indicative of fewer social problems and health risks., Methods: Retrospective survey data on first unintended pregnancies carried to term ( n  = 2,306) were analysed using bivariate analysis. Qualitative analysis of the narrations of such pregnancies ( n  = 59) used the technique of comparing cases. Standardised and qualitative data are available for first intended or aborted pregnancies as comparison groups. All data were collected from the cross-sectional mixed-methods study of 'Women's Lives: Family Planning in the Life Course' (2012-2018, Federal Centre of Health Education, Germany)., Results: Two-fifth of the unintended pregnancies carried to term were '(very) welcome'. Pregnancy intention, contraceptive use, living conditions, and attitudes had a significant impact. Five pathways of acceptance - sooner or later, more easy or hard to achieve - were identified in the qualitative data., Conclusion: Unintended pregnancies form a continuum ranging from readily accepted 'happy' pregnancies to pregnancies hard to accept. A new measure should also include postconception acceptance, besides preconception desire.

Objective: In this contribution unintended pregnancies are studied as a multidimensional concept from a life-course perspective. Standardized data on the prevalence of unwanted pregnancies in different stages of women's life course are combined with a qualitative analysis of the subjective meaning of "unwanted" and of subjective explanations of getting pregnant unintentionally., Methods: The study "frauen leben 3" on family planning in the life course of 20-44 year old women was conducted on behalf of the Federal Centre for Health Education (BZgA) from 2011 until 2014 in four federal states in Germany. A standardized questionnaire was used to collect retrospective information on 4794 pregnancies (including induced abortions), and biographical in-depth interviews provide qualitative information on 103 unwanted pregnancies. The standardized data were analyzed with bivariate methods and multivariate logistic regression models. The qualitative procedure to construct typologies of subjective meanings consisted of contrasting cases according to the generative approach of Grounded Theory., Main Results: In contrast to unwanted pregnancies, mistimed pregnancies are characterized to a greater extent by negligence in the use of contraceptives, by a positive reaction to the pregnancy and by a more general desire to have a child. Four different subjective meanings of "unwanted" are constructed in qualitative analysis. The logistic regressions show that the selected factors that increase the likelihood of an unwanted pregnancy vary according to age and stage in the life course. The quantitative analysis reveals furthermore that relationship with a partner had a significant effect in all stages of the life course. The qualitative interviews specify the age- and life course-related aspects of these effects., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Within the German part of an European Community study of the epidemiology of infertility and subfecundity we analysed the fetal loss (i.e. spontaneous abortions, artificial abortions, ectopic pregnancies, stillbirth, early neonatal death and all babies who died after the 7th day within the first year of life). For this investigation women from 5 urban and rural regions in Germany in the age group 25-45 years were selected in five districts from random samples of the local registers. 1531 interviews were conducted in 1992 by trained female interviewers in the same way as in the other participating European countries. 1248 of the women had a positive reproductive anamnesis with 3018 pregnancies. 565 (= 45.3% of women who were pregnant at any time) had fetal loss. In East Germany as well as in West Germany we found a positive age and pregnancy association. The main loss we observed in the age group under 20 and over 35 years. In all groups artificial abortion was the most important part of fetal loss (rural region of East Germany: 15.5% and West Germany: 13.1% of all registered pregnancies). The time to pregnancy (TTP) was prolonged in women over 30 years of age. Here we also found an increasing rate of spontaneous abortions. Smokers are more prevalent in women with ectopic pregnancies, spontaneous abortions and live born babies who died within the first 7 days after delivery.(ABSTRACT TRUNCATED AT 250 WORDS)