Record number of abortions Should the morning-after pill be more accessible?

The number of abortions in Switzerland rose to a record high in 2023. This could be due to the declining use of the contraceptive pill or strict regulations for the morning-after pill.

Switzerland has one of the lowest abortion rates in the world. But the number has been rising since 2017. In 2023, more abortions were registered than ever before.

The Federal Statistical Office (FSO) published the latest figures on Thursday: Last year, there were a total of 11,782 abortions among women residing in Switzerland. This is 6.2 percent more than in 2022.

For SVP National Councillors Céline Amaudruz and Martina Bircher, this is a "worrying development", as they explain to 20 Minuten. Amaudruz emphasizes that the observed increase harbours the danger that abortion will "degenerate into a contraceptive method".

Abortions have been permitted in Switzerland for 22 years

Abortion has only been legal in Switzerland for 22 years. On June 2, 2002, over 72 percent of the population voted in favor of allowing abortions up to the 12th week of pregnancy.

The law known as the "time limit regulation" ("Article 119") came into force on October 1, 2002 and stipulates that abortion in the first 12 weeks is exempt from punishment "if the woman requests it in writing and claims that she is in an emergency situation".

In addition, an abortion is permitted if it is medically proven that there is "serious impairment of the physical integrity of the pregnant woman".

Women have less desire for the contraceptive pill

One possible reason for the current increase in abortions could be the declining use of the contraceptive pill, explains Sibil Tschudin, Professor Emeritus of the Department of Gynecological Social Medicine and Psychosomatics at the University Hospital Basel, in an interview with "Watson".

According to a health survey conducted by the Federal Office of Public Health, fewer and fewer women are using the pill as a contraceptive. While 32% of couples aged 25 to 34 still relied on the pill in 2017, this figure had fallen to 19.5% by 2022.

This development could be linked to an increased awareness of the side effects of the pill, but also to a general change in preferences for contraceptive methods. Although safer alternatives such as the IUD have seen a slight increase (from 6 to 9 percent), they cannot compensate for the decline in the pill.

Instead, many couples are turning to unsafe methods such as condoms or natural contraceptive methods using cycle apps and contraceptive computers.

"Morning-after pill" heavily regulated in Switzerland

Another important aspect is access to emergency contraceptives such as the morning-after pill, which has been approved since 2002. In an international comparison, however, access in Switzerland is highly regulated. In no other European country is the morning-after pill so difficult to obtain.

The high cost of around CHF 45 to 70 and the fact that it is not covered by basic insurance are additional hurdles.

GLP parliamentary group leader Corina Gredig criticized this regulation to "20 Minuten" and called for the "morning-after pill" to be downgraded to a lower dispensing category: "Adults are responsible for their own sexuality."

Meanwhile, men can obtain Viagra without a prescription

Gredig underlines the need for the morning-after pill to be available without bureaucratic or moralizing hurdles. The politician regrets that this classification was neglected during the revision of the Therapeutic Products Act.

Since the revision in 2019, it has been forbidden to advertise the drug in Switzerland. Men can obtain Viagra from pharmacies more easily than women can obtain the morning-after pill - namely without a prescription (since 2020) and without a consultation.

This is despite the fact that there is time pressure when taking the morning-after pill: The active ingredients delay ovulation by at least five days - as long as male sperm can survive in the female body. This means that the eggs can no longer be fertilized. However, this must happen before ovulation - taking the pill afterwards is ineffective, an egg that has already been fertilized can still be fertilized.

The morning-after pill must therefore be taken as early as possible, as the sooner it is taken, the more effective it is. The "ellaOne" can be taken up to a maximum of five days (120 hours) after sexual intercourse, the "Levonorgestrel Sandoz" up to three days (72 hours) afterwards. If taken in good time, the risk of becoming pregnant can be reduced to up to 0.9 percent.

Because of the crucial time factor, the obligation to attend a 15-minute consultation at the pharmacy and fill out a questionnaire is also problematic, says Gredig. Studies show that side effects such as nausea, vomiting and headaches are possible but rare. However, hormone administration can temporarily disrupt the menstrual cycle.

Fill in the questionnaire online

SVP National Councillor Martina Bircher also believes that the current hurdles for dispensing emergency contraceptives in Switzerland are too high. She calls for a review of the modalities in "20 Minuten".

Her party colleague Céline Amaudruz agrees: "Anything that can help prevent an unwanted pregnancy, let alone an abortion, should be easily accessible."

SP National Councillor Tamara Funiciello believes that the obligation to provide information when dispensing the morning-after pill makes sense in principle, but suggests improvements to the implementation: "The questionnaire could also be completed online or in an app, for example."

In Basel-Stadt, there is already a corresponding offer where the medication can be obtained from the pharmacy using a QR code. Gredig supports this idea. An online version could also help to overcome language barriers more easily.

Either way, the responsibility for contraception and abortions still lies predominantly with women. Men cannot get the pill for their partners from the pharmacy.

How the use of the pill develops will depend not least on which new contraceptives come onto the market in the future. According to the NZZ, it remains to be seen whether the male pill will be introduced one day. The decisive factor will be whether women can accept the idea of placing contraception in the hands of men and whether they are prepared to take on the responsibility.

Young men are taking responsibility

However, another development that has already taken place shows progress in the contraception debate. Sibil Tschudin and Gabriele Merki, senior physician and head of the consultation on contraception at Zurich University Hospital, tell the NZZ that "contraceptive issues are now discussed in a more straightforward way in relationships".

Young men in particular are increasingly willing to take on their share of the responsibility. While the use of condoms is increasing, vasectomy, i.e. contraception, remains a rare form of contraception.

Parallel to the debate on contraception, Switzerland is experiencing a significant baby boom. In 2023, 80,024 children were born, almost 10,000 fewer than in 2021. With a birth rate of 1.33 per woman, Switzerland is at an all-time low.