[Medical indication for abortion based on psychological distress - Gaps in professional expertise and healthcare provision: A qualitative interview study with physicians].

AIM: In Germany, abortion after 12 weeks is only permissible based on a medical indication. The study explores how physicians evaluate this indication in cases of psychological distress without foetal diagnoses.

METHOD: 17 semi-structured interviews with physicians were conducted and analysed using qualitative content analysis.

RESULTS

Participants reported psychological distress due to unintended pregnancies in the context of mental illness, social difficulties, and sexualised violence. They described substantial legal and clinical uncertainties regarding the medical indication, as well as unclear responsibilities between gynaecology and psychiatry. Considerable access barriers were reported.

CONCLUSION

The findings suggest gaps in expertise and service provision for medical indications based on psychological distress. Closer collaboration between gynaecology and psychiatry, improved training and legal reforms appear necessary.