Fewer and fewer abortions in hospitals, but more and more in the city: this is what the Île-de-France Regional Health Observatory highlights. In his report covering the period 2015-2017, he also notes that the use of abortion remains stable despite strong departmental disparities.
In 2015, for the 40th anniversary of the promulgation of the Veil law, Marisol Touraine, then Minister of Health, announced the implementation of a national action plan to “reaffirm this right to abortion by making it more accessible”.
Among the measures then taken by the government: the abolition of the 7-day reflection period, but also better reimbursement of acts and the possibility given to midwives to perform medical abortions.
Four years later, where are we with women’s access to abortion? A report conducted from 2015 to 2017 by the Île-de-France Regional Health Observatory provides some leads. Developed at the request of the Regional Health Agency (ARS) and the Regional Council, it provides an enlightening inventory of access to abortion for Ile-de-France women.
A stable abortion rate
First observation made by the report: in Île-de-France as elsewhere in mainland France, the rate of recourse to abortion remains stable despite strong sub-regional disparities. Thus in 2017, 52,080 abortions were performed in the region, representing a referral rate of 17.4%. From 13% in Yvelines, this rate climbs by way of comparison to 22% in Seine-Saint-Denis. It is women aged 18 to 34 who have the most recourse to voluntary termination of pregnancy, abortions carried out on minors corresponding to only 3% of interventions.
An increase in supply in town
The report also mentions an increase in supply in the city and a reduction in hospital supply, a consequence of the practice of abortions by midwives and private doctors. Thus, the number of hospitals having carried out at least 50 abortions increased from 90 in 2015 to 79 in 2017. In the same period, the number of independent doctors practicing abortions increased from 449 to 483, i.e. a density of 15 doctors per 100,000 women in 2014 and 16.2 per 100,000 women in 2017. Over the same period, the number of health centers performing abortions increased from 59 to 76.
Moreover, more and more abortions are performed before 9 weeks of amenorrhea, but still 5% of abortions after 12 weeks, the legal time limit for termination of pregnancy. The proportion of abortions beyond 12 weeks is higher among women in Seine-Saint-Denis.
More and more medical abortions
The report also mentions an increase in the proportion of medical abortions in all the departments of Île-de-France. Authorized in hospitals since 1988, the medical technique has spread widely since 1990 to become the most common method since 2008: 16% of abortions performed in France in 1990 were medical, 36% in 2002 and 55% in 2011. These are performed mainly in the hospital or clinic. However, the proportion of medical abortions taking place in private practice has increased since its authorization in 2004. What these new data attest to: more than two out of three abortions performed in Île-de-France are performed medically.
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