An unplanned pregnancy can trigger a crisis in the life of a woman, a man or a couple. Fundamental questions are raised: only you are in a position to judge what a pregnancy means in your situation, and only you can decide whether you want to continue the pregnancy or end it.

In Switzerland, pregnant women and people involved in a pregnancy are entitled under federal law to free counselling and assistance. Regardless of whether or not you have already made a decision about the pregnancy: the sexual health and family planning counselling centres approved by the cantons are available to provide information, assistance and counselling (Federal Act 857.5 of 1981).

1. Swiss laws on the termination of pregnancies

During the first 12 weeks of pregnancy (calculated from the first day of the last menstrual bleeding), a woman has the right to decide whether or not to terminate her pregnancy. If she decides to terminate her pregnancy (abortion), she will have to sign a document, in the course of a medical consultation, declaring herself to be in a situation of distress. She alone defines this situation of distress and is not required to provide substantiating evidence.

After the 12th week of pregnancy, termination of pregnancy is legal if the physical or mental health of the pregnant woman is endangered. The medical doctor has the responsibility of assessing this danger and making a decision. According to the law, the more advanced the pregnancy, the greater the danger must be (Swiss Criminal Code, article 119).

Young women under the age of 16 are required to contact a specialised counselling centre. In most of the cantons, this is the approved sexual health and family planning counselling centre and/or a child and adolescent psychiatric service.

2. Methods for terminating pregnancy

A pregnancy can be ended by means of drugs or through a surgical procedure. The choice of methods depends on the preference of the pregnant woman, how far along the pregnancy is and any diseases or health risks the woman might have.

Drug-based method

Two different drugs are prescribed. The first drug, containing the active ingredient mifepristone, interrupts the development of the pregnancy. Two days later, the second drug, a prostaglandin, causes the uterus (womb) to contract. As a rule, the contents of the uterus are then expelled within a matter of hours.

The drug-based method is used up to the 7th or 9th week of pregnancy. Depending on the situation, the drug can be taken in the doctor’s office, in a clinic or hospital, or at home. A follow-up examination is necessary in every case.

Surgical method

Pregnancy termination procedures can be carried out under general or local anaesthetic. The cervix (neck of the womb) is gently stretched a few millimetres, a tube is inserted and the contents of the uterus are removed through suction (aspiration). A prostaglandin is often given before the procedure to make the cervix softer, in order to protect it. Surgical termination of pregnancy is carried out in a clinic or hospital (on an outpatient, or if necessary inpatient, basis) or in a doctor’s office specifically equipped for the purpose.

Side effects

Drug-base method

As a rule, the pain experienced is similar to that associated with menstrual bleeding, but is more severe. Once the contents of the uterus have been expelled, the pain gradually goes away. Sometimes the discomfort lasts longer, but pain medication is prescribed if needed.
Frequently, heavier bleeding than that associated with normal menstrual bleeding; duration can vary from woman to woman (from a few days to a few weeks).
Prostaglandin can cause nausea and mild diarrhoea.

Surgical method

In some cases, pains of short duration are felt after or during the procedure when local anaesthetic is used. Pain medication is prescribed if needed.
As a rule, lighter bleeding than that associated with menstrual bleeding over the course of 4 to 5 days.
The anaesthesia can cause nausea.

Risks and possible complications

The risks involved in both methods are minimal. Serious complications are very rare.
Women remain fertile and able to have children after having terminated a pregnancy; a woman can become pregnant again quickly.

Drug-based method

Incomplete expulsion or heavy bleeding requiring treatment with medication or, in rare cases, aspiration of the uterus.
Failure of the method, with continuation of the pregnancy.

Surgical method

Injury to the cervix and/or wall of the uterus.
Infections, heaving bleeding, clotting in blood vessels (thrombosis).
Incomplete aspiration, necessitating a second procedure.

3. Basis for the choice when both methods are options

Drug-based method

No anaesthesia.
If a clear decision is taken early on in the pregnancy, this method can be used to terminate the pregnancy within a short space of time.
The contents of the uterus are generally expelled a few hours after being given the prostaglandin. However, it can sometimes occur earlier (rarely) or later.
Termination is consciously experienced.
Some bleeding of longer duration.
Abdominal pains, which can continue for a variable length of time after the contents of the uterus have been expelled.

Surgical method

Surgical procedure under general or local anaesthetic.
Allows more time to make the decision.
Procedure is generally not carried out before the 7th week.
Date and time of procedure is clearly fixed.
Procedure is not consciously experienced, if performed under general anaesthetic.
Some brief and usually light bleeding after the procedure.
Associated with pains of longer duration in rare cases.

4. How much does termination of a pregnancy cost ?

Costs vary from place to place. Terminating a pregnancy can cost between CHF 700 and CHF 3000. The procedure is covered by the basic insurance policy of the health insurance provider, minus the annual deductible premium and the 10% retention fee.

5. Is the termination of a pregnancy likely to have psychological after effects?

Serious psychological impacts are rare. The termination of a pregnancy can lead to mixed emotions, such as feelings of relief mixed with sadness, or the urge to grieve. A range of reactions are normal. How a person experiences the termination of a pregnancy varies with that person’s psychological state and situation in life. Get counselling if sadness or feelings of guilt persist after the termination of a pregnancy.

6. After terminating a pregnancy

Use an effective method of contraception appropriate to your situation, because it is possible to become pregnant again quickly.
Remember to protect yourself against sexually transmitted infections.
To avoid a genital infection, follow the recommendations you received for the length of time needed: use sanitary towels only, do not have sexual intercourse, shower only (no baths or swimming, do not use vaginal douches or go to a sauna or hammam).
Go to the follow-up examination planned with your doctor.

Sexual health and family planning counselling centres in the event of unplanned pregnancy

Confidential and free consultations for the women, men and couples involved – regardless of age, country of origin or religion – in a neutral setting. Appointments can be scheduled at short notice.
The opportunity to meet with a sexual-health counsellor to consider your situation and express your feelings, doubts and needs, regardless of what you decide and for as long as you wish.
Information about terminating a pregnancy and about private and public assistance should you decide to have the baby.
Assistance with the steps involved in terminating a pregnancy or carrying on with the pregnancy.
Counselling on the range of contraceptive methods available and on the prevention of sexually transmitted infections.
If you wish, support after termination of the pregnancy.

Additional services and contact information for counselling centres at www.sante-sexuelle.ch

2014, SANTÉ SEXUELLE SUISSE, Fondation suisse pour la santé sexuelle et reproductive; ALECSS Association suisse latine des spécialistes en santé sexuelle, Éducation – Formation – Conseil; faseg, Fachverband sexuelle Gesundheit in Beratung und Bildung

With professional and financial support of migesplus
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