WESTERN

MINDANAO STATE
UNIVERSITY

REQUIREMENTS
IN
SOCIOLOGY

REPRODUCTIVE HEALTH IN
SWITZERLAND

Submitted by:
Jesse Mae F. Paculdo
BPE IV-A

Submitted to:
Mr. Albert Alejado
 The Reproductive Health Law
[ REPUBLIC ACT NO. 10354 ]
AN ACT PROVIDING FOR A NATIONAL POLICY ON
RESPONSIBLE PARENTHOOD AND REPRODUCTIVE HEALTH

REPRODUCTIVE HEALTH LAW IN SWITZERLAND

ABSTRACT
Switzerland allows abortion in the initial weeks of pregnancy, as does most of Europe. The
government has defended the policy when presented with a petition from abortion opponents.
A Christian circle represented by the association “March for Life” is demonstrating in Zurich on
September 14. In February, the group submitted a petition with 24,000 signatures to the
federal government, requesting that it “raises public awareness about the consequences of
abortion”.
The petitioners believe that hospitals and family planning counseling centers caring for women
with unwanted pregnancies provide one-sided information.

INTRODUCTION
Abortion in Switzerland is legal during the first twelve weeks of pregnancy, upon condition of
counseling, for women who state that they are in distress. It is also legal with medical
indications – threat of severe physical or psychological damage to the woman – at any later
time. Switzerland is among the developed nations with the lowest rates of abortions and
unwanted pregnancies.

Abortion was legalized by popular vote in 2002, after its criminal prohibition had ceased to be
observed in practice for some time. In 2014, Swiss voters rejected an initiative to remove the
coverage of abortions by the public health insurance system.

Persons performing illegal abortions are subject to a monetary penalty or imprisonment of up

to five years. A pregnant woman who procures the illegal abortion of her unborn child is also
subject to a monetary penalty or imprisonment of up to three years.

SANTÉ SEXUELLE Suisse (SEXUAL HEALTH Switzerland)

SEXUAL HEALTH Switzerland (SANTÉ SEXUELLE Suisse) is the umbrella organization of the Swiss
centers for sexual and reproductive health and the professional association’s active in the areas
education and counseling on sexual and reproductive health and rights (SRHR). SEXUAL HEALTH
Switzerland runs a total of three offices in the French, the German and Italian speaking region
of Switzerland. 
In its role as umbrella organization, SEXUAL HEALTH Switzerland offers information and
guidelines for professionals, develops and coordinates the training for professionals together
with the universities of applied sciences and advocates for SRHR on cantonal, national and
international level. Moreover, SEXUAL HEALTH Switzerland is partner of the Federal office of
Public Health for the implementation of the Swiss national program on HIV and other sexually
transmitted infections (STI) 2011-2017.

SEXUAL HEALTH Switzerland has developed a broad variety of materials on different SRHR
topics that contribute to reach out to different target groups as for example to persons with
disabilities or migrants. SEXUAL HEALTH Switzerland has also created the website sex-i that
provides up-to-date and high quality information on a wide range of sexual health issues in
twelve languages.

Another important area of work is the promotion of comprehensive sexuality education in

Switzerland. In this context, SEXUAL HEALTH Switzerland has established an alliance on
sexuality education that includes more than 65 organizations.

SEXUAL HEALTH Switzerland provides the secretariat of the Swiss parliamentary group CAIRE+.
Moreover, SEXUAL HEALTH Switzerland is partner of Countdown 2030 Europe, a European
consortium under the lead of IPPF Europe that advocates for increased international aid for
family planning and sexual and reproductive health.

Low abortion rate

“Is the executive prepared to meet the demands of this petition?”

In May he received a categorical reply that the government “has no evidence of any
shortcomings and sees no need to adopt specific measures”.

The Federal Council reiterated that Switzerland has very low abortion rates, and particularly
few abortions among adolescents.

What does the law say?

The Swiss Penal Code permits abortion in the first 12 weeks after the first day of the last
menstrual period, under the following conditions:

- During a consultation with a doctor, the woman signs a form in which she states her
distress about the unwanted pregnancy and requests an abortion.

- The doctor must inform her in detail about the physical and psychological effects of the
procedure. If not, the doctor can be penaFranz Ruppen, a parliamentarian from the
conservative right Swiss People's Party, asked the Federal Council (Switzerland’s
government) in March.lised.

- The woman receives a list of free counseling centers and information on the possibility
of having the child adopted if she continues the pregnancy.

- If the woman is under 16 years old, she must be directed to a specialized center for
guidance.
METHODS
Different methods exist for terminating a pregnancy. Medication abortion is the most prevalent
(74%). It is most used before the ninth week of pregnancy.

The surgical method is used in 26% of cases.

Late abortion
In all, 95% of abortions in Switzerland take place during the first three months of pregnancy.

The secret of Switzerland’s low abortion rate

After a decade of largely unrestricted access to abortion, the rate in Switzerland remains stable
and is among the lowest in the world. How is the country achieving the oft-cited formula of
‘safe, legal and rare’?
One of the few women to go public about her abortion experience, Doris Agazzi, told
swissinfo.ch she received understanding from her immediate community but also hate mail.
“I never felt ashamed or considered that it should be kept secret but I know many women did
feel that way,” Agazzi said. 

Swiss law changed in 2002 to allow abortion on request in the first 12 weeks of pregnancy, a
liberal approach accepted by 72 per cent of voters (see sidebar). Agazzi told her story on
television at that time as part of the campaign to liberalise the law.

Since then, the abortion rate has gradually fallen and stabilized and Swiss abortion statistics are
published every year with little fanfare.

In 2011, the rate was 6.8 per thousand women aged between 15 and 44. This is remarkably low
compared to the United Kingdom (17.5), France (15 in 2009) and the United States (16 in 2008),
for example.
A handful of other countries, including the Netherlands, Belgium and Germany have rates
closer to the Swiss level. The average annual worldwide abortion rate is 28 per thousand
women of childbearing age.

Family planning
A low abortion rate goes hand in hand with a low rate of unwanted pregnancy. So what puts
Swiss women in a stronger position when it comes to control over their fertility?

Sexual health experts point to three main factors: education, contraception and socioeconomic
level.
Sex education is relatively well established in Switzerland although it is not mandatory,
according to Rainer Kamber of the Swiss Association for Sexual and Reproductive Health.

“It is provided in almost all Swiss public schools, usually co-operatively by class teachers and
external experts, and to a high standard," Kamber said.
When young women and girls become sexually active, it is standard to visit a gynecologist to
sort out contraception.

Johannes Bitzer, chief physician at the department of obstetrics and gynecology at University
Hospital Basel, has more than 30 years’ experience in women’s reproductive health.

“We have a relatively large number of gynecologists who work in the field of what is actually
primary health care. In some Anglo-Saxon countries this work is done by general practitioners,”
Bitzer said.

Unprotected sex
The morning-after pill, which prevents the establishment of a pregnancy after unprotected sex,
was released for sale without prescription in 2002.

This form of emergency contraception also plays a significant role. More than 100,000 packs of
the morning-after pill are sold per year, according to industry estimates, although Sandoz, the
manufacturer of the only brand available in Switzerland, does not give out sales figures.

Underlying all the other factors keeping the level of unwanted pregnancy low is the relative
wealth of the country.

“Although unwanted pregnancies are aborted by women of all child-bearing ages and
socioeconomic status, one of the most important risk factors is still a lower socioeconomic
status," Kamber explained.

Resistance
An annual total of more than 10,000 abortions per year (or 6.8 abortions per thousand women
aged 15 to 44) corresponds, over time, to one in five women in Switzerland having an abortion
at some point in their lives. But the termination of unwanted pregnancies is not seen as a “fact
of life” by everyone.

Last month more than 1,000 people took part in a "March for Life" event in Zurich. The
organizers distributed white coffins to the crowd.

On a political level a fresh effort is underway, driven by those who fought against full
legalization prior to 2002, to question the general acceptance of the issue by taking aim at
abortion funding.

The initiative ‘Abortion is a private matter’, due to come before a nationwide vote next year,
seeks to remove abortion from the list of procedures covered by the general compulsory health
insurance package.

As an alternative, it proposes a system whereby women could either insure themselves

separately against the eventuality of wishing to terminate an unwanted pregnancy, or pay for
the procedure out of their own pocket.

It’s as much a moral issue as a cost-saving measure, according to Peter Föhn, a parliamentarian
from the rightwing Swiss People’s Party who is co-president of the initiative committee.
“I personally am not prepared to co-finance an abortion and I also don’t expect people who are
against abortion and condemn it to have to do so.” The initiative makes an exception for cases
when the mother’s life is in danger and for pregnancies as a result of rape.

Ethics
In an ideal world Föhn would like to see the abortion rate in Switzerland reduced to nil. “Every
killing of an unborn person, like the killing of any person, is one killing too many,” he told
swissinfo.ch.

Failing that, he believes it is necessary to act, if only on a small scale. “Under no circumstances
should the state or the community make abortion easy, encourage it, or as happens in
Switzerland, have it paid for by basic insurance.”

Veteran abortion campaigner Anne-Marie Rey sees the initiative as a ploy by anti-abortion
campaigners to turn the clock back.

“It’s just a pretext for them to have the whole abortion issue discussed again. The only women
who would be affected would be the poor. It’s highly unethical and discriminatory,” she told
swissinfo.ch.

As for the medical professionals, like Johannes Bitzer, they will continue to try and improve
contraceptive prevalence and efficacy as well as provide care for women facing crisis
pregnancies.

“We still have the situation of unwanted pregnancies and I think the ethical discussion will go
on. It will always be unresolved,” he said.

SWITZERLAND VOTING ON ABORTION REFORM

GENEVA, Sept. 23—In what is known here as direct democracy, Swiss citizens this week are
deciding such major national issues as whether to ,give all women the legal right to have an
abortion within 12 weeks of becoming pregnant.

In balloting ending on Sunday, the voters are deciding the fate of a proposed constitutional
amendment that would end the present virtual ban on abortions. Exceptions are now allowed
only when two physicians certify that a pregnancy endangers a woman's life or threatens to
impair her health seriously.

The proposal has been placed on the ballot in accordance with a constitutional provision that
allows 50,000 registered voters to sponsor an amendment for adoption in a nationwide vote.

That procedure is itself at issue in the voting this week. Voters are asked to approve or reject a
proposal by Parliament that the signatures of 100,000 registered voters, instead of the present
50,000, be required for the initiation of constitutional change.
Another proposal from Parliament before the electorate calls for increasing the number of
signatures needed to demand a .referendum on legislation from the present 35,000 to 50,000.

In proposing these changes, Parliament pointed out that with the expansion of population and
the enfranchising of women the number of voters had increased sixfold since the current
signature totals were decided upcn in 1874. As a result, it argued, the present totals allow so
much polling as to be detrimental to efficient government.

But opponents see in these proposals an attempt .to curb the rights of the ordinary citizen.

Environmentalists have placed on the ballot through the initiative route a proposed
constitutional amendment that would demand immediate compliance with strict clean‐air
regulations for cars that the Government, Parliament and the Swiss automobile trade regard as
impossible to enforce. The Government has drafted plans for meeting approximately the same
goals as the proposed measure, but by stages extending to 1982.

Voters also have before them two proposals for protecting tenants from unreasonable rent
increases.

In addition to these national issues, most of the voters will be called upon to pass on a broad
array of proposals dealing with local affairs.

The most divisive of the national issues is the proposed constitutional amendment on
abortions.

Reflecting the diVisions between and within the country's almost equally numbered Roman
Catholic and Protestant populations as well as its political parties, medical associations,
women's groups and other private organizations, the federal Parliament was unable to agree on
whether to recommend the acceptance or rejection of the proposed 12‐week abortion rule.

As a result, for the first time Swiss citizens are voting on a private initiative without the benefit
of Parliament's advice.

The present law has many opponents because its enforcement is left up to each cf the 25
cantons that compose the Swiss confederation. Some cantons, particularly those with large
urban populations, interpret the law liberally.

Supporters of the 12‐week rule say that as many as 70,000 abortions are performed in
Switzerland each year, either illegally or by stretching the present law. The approval of this rule,
they contend, would end the hypocrisy that now surrounds abortions and make them equally
attainable for all women.

The abortion measure, like all proposed constitutional amendments, must win majority of the
votes cast both nationwide and in a majority of the individual cantons. This second hurdle is
particularly feared by the measure's supporters because opposition is strongest in the smaller,
conservative cantons, which outnumber these where the late urban populations are
concentrated.
Conclusions:

Although Swiss law only permitted abortion under strict conditions, this procedure was widely
available in Vaud, which nevertheless has one of the lowest rates worldwide. Efforts must be
intensified to ensure universal access to family planning services, especially for foreign women
and adolescents. Professionals should also target "repeaters" to provide personalised
counselling.