Anne-Marie Rey


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    Abortion practice in Swiss hospitals – results of an inquiry by APAC-Suisse in 2009

    Anne-Marie Rey, secretary of APAC-Switzerland

    Despite a liberal legislation since 2002 (abortion on request in the first 12 weeks of pregnancy and without time limit if it is necessary to turn away from the pregnant woman the „risk of a serious emotional distress“), we suspected certain gaps in service provision in Switzerland.

    In summer 2009, we made an inquiry among private and public hospitals, including some day care clinics we were aware of. Out of 157 clinics contacted, we received 113 answers that could be evaluated (72%). Among these, 93 clinics (82%) practice abortions.

    In the first trimester, two thirds of them offer the surgical as well as (in the first 7 or 9 weeks) the medical method with mifepristone plus misoprostol. Only 12 clinics (13%) offer local anesthesia for surgical abortions.

    As for abortions after 12 weeks, an earlier inquiry among family planning centers had revealed that almost half encountered difficulties in their region in this respect. In fact, after 12 weeks gestation, only 49% of the clinics accept psychosocial indications as defined by law and most limit abortions for these reasons to 14 or 16 weeks.

    Access to abortion in the second trimester or later remains very restricted in Switzerland. The range of discretion allowed by the law is not sufficiently used. Moreover, the surgical method is very rarely offered in the 2nd trimester

    These are the reasons why a certain „abortion tourism“ still exists, estimated at 50 women who every year have to seek second trimester abortions in clinics in other countries.

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    Different strategies to legalize abortion: Successes and lessons from Switzerland

    Anne-Marie Rey (Switzerland)


    Situation in Switzerland before start of pro choice campaign in 1971. Penal Code of 1942: abortion allowed for health reasons only, to be certified by a second doctor. By 1971, 6 out of 25 cantons applied the law quite liberally and accepted mental and social health reasons for legal abortion, most of the other cantons stayed rather or very restrictive. Hence:

    • abortion tourism from conservative to liberal cantons or to other countries,
    • 20.000 illegal abortions estimated per year, with concomitant complications and death cases,
    • some 100 women condemned each year for illegal abortion.

    30 years of campaigning. June 1971 launch of a radical initiative for a constitutional amendment aiming at the repeal of abortion legislation. Its primary purpose was to break the taboo and raise public and parliamentary debate.

    1975: launch of a second „reasonable“ initiative (abortion on request within the first 12 weeks of pregnancy), which was narrowly rejected on the ballot in 1977, by 51.7% of the votes.

    1978: referendum and vote on a very unsatisfactory compromise law, rejected by a 2/3 majority.

    1985: an initiative by the antis to write the right to life from conception into the constitution was rejected by 69% of the votes.

    1993: a parliamentary bill proposed legalization of abortion on request in the first few months of pregnancy.

    In March 2001 Parliament finally approved a corresponding amendment to the Penal Code. Conservatives immediately asked for a referendum.

    June 2002: 72% of voters approve the new legislation. On the same ballot, an anti-initiative asking for a total abortion ban is defeated by a 82% majority.


    • Gradual liberalization of abortion in practice over a period of 30 years (1971-2001).
    • Reimbursement of the costs of abortion by health insurance (1981).
    • Obligation for the cantons to create family planning counselling centers (1981).
    • Abortion on request in the first 12 weeks of pregnancy (2002), no compulsory counselling except by the doctor himself, no „cooling off period“, no parental consent necessary for minors. Explicit mention of severe mental distress as a legally accepted reason for later abortions, without compulsory second medical opinion. Cantons have to designate clinics and doctors authorized to perform abortions.

    Particularly successful strategies used.

    • Personal contacts with the media, giving them regular and factual information,
    • networking, building alliances with women’s, youth, political and professional organizations, mobilizing and briefing them,
    • lobbying of parliamentarians, intensive personal contacts with some of them,
    • formulating legislative texts and amendments for members of parliamentary committees,
    • pragmatism, readiness to compromise, using moderate language and adapting our arguments to the changing situation.

    Other reasons for our success.

    • Decreasing influence of religion,
    • changing role of women in society,
    • growing open-mindedness in matters concerning individual lifestyles and sexuality.

    In conclusion. Strategies must adapt to the situation, to political and religious forces present in a country and to the strength of pro choice mobilisation. Our experience: every time a broad public debate arose, some progress resulted. But: the battle for women’s right to decide whether and when to become a mother is hard and long. It needs dedication and perseverance. But in the end, I think, we have the better arguments.

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    Since 1942, abortion has been authorised if the woman’s life is in danger. A
    certificate signed by 2 doctors is required. The law is strict in theory, but very
    flexible in its application. Terminations are performed in hospitals, in clinics
    and private practice.