Termination of Pregnancy for Medical Reasons in France: To What Extent Healthcare Services Ensure Access to Abortion across the National Territory?

Justine Chaput , Ined ; Université Paris 1 Panthéon Sorbonne

In France, while elective abortions can be performed on the women’s request up to 14 weeks, terminations of pregnancy for medical reasons (TPMR) are possible with no time limit but only in case of a “serious danger for the woman’s health” or if there is a “probability that the unborn child will suffer from a particularly serious condition recognized as incurable at the time of diagnosis” (art. L2213-1 of the French Code of Public Health). A TPMR necessitates an authorization of a medical team, often the one of a Multidisciplinary centre for prenatal diagnosis (MCPD). However, these centres exist only in 38 of the 101 French départements. This communication explores inter-départments mobility for TPMR, as well as its effects on the care provided (lengthening of the procedure and duration of pregnancy). Based on the French national health insurance database, this research includes all women who had a TPMR between March 2019 and December 2022 in France. TPMR rates varied widely across the national territory. Départements with a smaller TPMR rate had a bigger proportion of TPMR performed outside the départment of residence and more often had a MCPD. While TPMR performed in the départment of residence varied with the holiday period, it is not the case for abortions performed outside. These results suggest that TPMR access may be restricted by the distance between the place of residence and of abortion, which certainly delays healthcare, as the duration of pregnancy increased when TPMR were performed outside the department of residence.

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 Presented in Session 77. Reproductive Health and Family Planning