Conflict between gynecologists: Abortion opponents at the forefront of gynecology

“It’s not a good day today – not for the women and not for the doctors.” CSU MP Susanne Hierl said this almost two years ago, in December 2024, in the German Bundestag. The mood that day was heated; a group proposal to delete Section 218 in the Criminal Code was being debated. While some hoped that history would be made and abortions up to the twelfth week would soon be decriminalized in Germany, others - like Hierl and almost her entire CDU/CSU faction - were strictly against it.

Then Hierl said something else: “I can only recommend that you read the open letter from the gynecologists, which should have reached all of us.” This letter to members of the Bundestag urgently appeals to adhere to Section 218 in the Criminal Code. 218 generally criminalizes abortion. They are only exempt from punishment after mandatory counseling and a three-day waiting period up to the twelfth week.

The DGGG is the oldest specialist society for gynecology in Germany; today it has around 6,000 members. The declared goal as a scientific society is to “further develop gynecology and obstetrics and continually strengthen the evidence-based level of comprehensive care” – this is what it says on the DGGG website. To this end, they publish scientific guidelines and offer further education programs. But the board's public positions on the subject of abortion raise doubts about the scientific quality of the professional society.

DGGG President Gert Naumann is co-author of the essay “One Body, Two People” from 2025. In it, he and his co-authors advocate maintaining compulsory counseling before an abortion, as this is aimed at “encouraging the woman to continue the pregnancy and opening up perspectives for her life with the child”. It goes on to say: Leaving the pregnant woman to decide whether the more developed fetus should be aborted or not is constitutionally unjustifiable. It forces doctors into an avoidable moral dilemma.

Köninger also wrote the DGGG's official statement to the Commission on Reproductive Self-Determination and Reproductive Medicine set up by the federal government. In it, she argues that the rule in the criminal code protects the pregnant woman from the interference of third parties - and from herself. "The plight of the woman, the will of the child's father or the fear of the burden on the environment, society and donors in the event of a possible disability of the child can otherwise very quickly lead to SSA [abortion of pregnancy] being carried out for motives that contradict the actual will of the pregnant woman and as a result put her in severe psychological distress." The fact that unwanted pregnant women supposedly do not know what they “actually” want has long been an argument used by abortion opponents.

In the letters and DGGG statements it becomes clear again and again: personal beliefs often seem to be in the foreground, and scientific arguments are rarely used. And this despite the fact that there is a broad scientific consensus nationally and internationally. The World Health Organization recommends the complete decriminalization of abortion. Figo, the international scientific society for gynecology - in which 132 national organizations are represented - has long been committed to liberalization.

In Germany, both doctors and legal scholars are in favor of liberalization. In April 2024, an expert commission made up of legal scholars recommended that Section 218 be abolished. The authors of the Elsa study, the first broad quantitative and qualitative survey on the experiences and life situations of unintentionally pregnant women, recommended new regulations on abortion in order to combat the stigmatization of unintentionally pregnant women. And other medical organizations such as the German Medical Association or the German Society for Psychosomatic Gynecology and Obstetrics also advocate abolishing paragraph 218.

The DGGG's position seems at least unusual. This has already led to conflicts within the professional society in the past. The upcoming election is causing these conflicts to flare up again. Some members of the German branch of the organization Doctors for Choice (DfC) are also part of the DGGG. They are committed to reproductive self-determination and want to decriminalize abortion. The DfC are concerned about the scientific independence and public representation of the specialist society.

In an open letter to the DGGG, DfC asks about Köninger's candidacy: "How can a functionary who positions herself publicly in this way carry out representative leadership tasks within a specialist society that is committed to evidence-based medicine and the best possible care for patients?" Doctors for Choice sees the candidacy as a danger that personal ideological convictions will influence the scientific positioning of the specialist society.

The DGGG, in turn, responded with its own open letter and its own question: “Can a doctor’s personal conscientious decision lead to exclusion from a leadership position in a scientific society?” The DGGG's answer: No. What is important is not the private convictions of a board member, but rather that they loyally represent the scientific positions, guidelines and resolutions of the DGGG. But do Köninger and other board members represent them loyally? The taz asked the DGGG about this, but they wanted to concentrate on the congress, according to a spokeswoman.

Doctors for Choice has doubts about this. If a new board is elected at the congress on Friday, it is almost certain that the old board will remain the new one. According to the current statutes, the board is elected as a joint list; members cannot vote on individuals. And since there is only one list - the requirements are high; according to the current regulations, three of the five positions must, for example, be filled by university professors in management positions - the members have little choice.

“We criticize the fact that the candidates can only be elected together as a closed list of five; the procedure forces a yes-no decision,” says Alicia Baier from Doctors for Choice to the taz. This has a negative impact on intra-association democracy, said Baier. Doctors for Choice have therefore submitted an application to change the statutes in order to be able to elect individuals in the future. Depending on the members' decision on Friday, this possibility could then exist at the next board election at the DGGG Congress in 2028.

The current DGGG board is against the change in the statutes - and also recommends this to the members: "The board expressly recommends sticking to the list election," it says in an email. How many members follow the recommendation of their board or would prefer to elect individuals will become clear on Friday evening. In any case, one thing can be assumed: After the heated open letters and requests for changes to the statutes, the members will examine their board particularly closely in this election.