The right to abortion will perhaps soon be included in the constitution. In France, voluntary termination of pregnancy can be carried out up to the 14th week of pregnancy, i.e. 16 weeks of amenorrhea (since the first day of the last period). Medical abortion, not to be confused with the morning-after pill, represents 78% of all abortions performed in France in 2022 (compared to 31% in 2000). What is it about?
Medical abortion consists of taking 2 medications orally, one to terminate the pregnancy, the other to expel the embryo. The first compound is mifepristone (or RU 486), a molecule that has the same shape as the hormone that causes the uterus to develop during pregnancy, progesterone. Mifepristone binds to progesterone receptors in the uterus, preventing the hormone from attaching there. This causes the uterus to stop developing during pregnancy. Then 24 to 48 hours after taking the first tablet, a second (misoprostol), close to prostaglandins, causes contractions of the uterus accompanied by periods and expulsion of the embryo. This mechanism generally occurs within 3 to 4 hours after taking the medication but can sometimes occur within 24 to 72 hours.
» READ ALSO – Morning after pill
Women wishing to opt for medical abortion can have it prescribed in a town practice, in a health center or by teleconsultation. Medicines are dispensed in pharmacies. There is no longer a “mandatory minimum reflection period” after a first appointment with a health professional.
Medical abortion is generally favored by doctors before the 9th week of amenorrhea (7th week of pregnancy). Beyond that, an instrumental abortion (by surgical intervention) will be more readily performed. The choice of the technique used, however, takes into consideration the woman’s preferences and the care available during the consultation. Minors must be accompanied by an adult of their choice.
According to the High Authority for Health (HAS), all studies show that there is no increased risk of infertility after an abortion. In 2015, in more than 2 out of 3 cases, women who had an abortion used a method of contraception that did not work (such as a condom, forgotten pill, etc.), twisting their necks idea of a “comfortable abortion”.
Medical abortion avoids surgery; it can be carried out at the start of pregnancy and carried out in a city office. However, it takes place over several days, and can cause significant bleeding with pain, nausea, vomiting and diarrhea.
According to the official website IVG.gouv.fr, medical abortion is 95% effective. For the remaining 5% of cases it is necessary to perform an instrumental abortion. In its September 2023 report, the DREES (directorate of research, evaluation studies and statistics) indicates a drop in the number of abortions in 2020 and 2021, during the Covid-19 pandemic. The abortion rate increased again in 2022, and it is at its highest since 1990.
On average, 16.2 abortions are performed per 1000 women aged 15 to 49. The 20-30 year olds represent the age group that uses it the most. The abortion rates vary from one department to another (11.6‰ in Pays de la Loire, 48.7‰ in Guyana in 2022). According to DREES figures, 8,615 women had more than one abortion in 2022. 76% of abortions are carried out at less than 10 weeks of amenorrhea and 55% at less than eight weeks.
