If employers felt that civilian forced laborers were no longer “fit for work” due to illness or pregnancy, they were sent back to their native countries during the early years of the war. Their inability to work had to be confirmed by doctors attached to the employment offices. The employment office then issued a Rückkehrschein, a pass releasing them to return to their native country. This regulation changed over time, and pregnant women had to give birth or undergo a forced abortion in the Reich.