IVG truly guaranteed ? These obstacles that remain for women in France

The inscription of "libertyé guarantee " to resort to à abortion in the Constitution generates a right subject to à cumbersome obstacles.

With the constitutional revision, the first under the mandates of Emmanuel Macron, France becomes the first country to adopt a constitutional order. register freedom for women to resort to à abortion in the Constitution and protect the right to abortion which is declining in certain countries, notably in Europe and the United States. However, in reality, despite a potential inclusion in the Constitution, access to IVG in France turns out to be unequal and confronted with difficulties. &agrav; certain obstacles.

Significant geographic disparities in access to IVG

In France, the number of abortions is increasing over one year. In 2022, 234, 300 voluntary terminations of pregnancies were reported. recorded, i.e. 17,000 more than in 2021 according to figures from the Department of Research, Studies, of Evaluation and Statistics (Drees). Until 2005, only hospitals and clinics were authorized to use medical insurance. realize it. Now they can be carried out in local health centers. or family planning and education as well as in city practices with a general practitioner or a gynecologist. On the other hand, access to IVG remains fragile for some, even in the event of a favorable vote by parliamentarians.

IVG is faced with significant geographical disparities. In certain departments, the infrastructures “are not available” height" deplores a 2020 parliamentary report. A factor which lengthens consultation times and travel time for women. In Ain, 48.3% of abortions are carried out outside the department of residence of the patients according to the Drees. This is the most affected department. by this phenomenon in France.

Outside the mainland, the trend is confirmed: "We have a very extensive territory and a large part of it is rural. When we look at the list of practitioners, there is a strong concentration in the metropolis, regrets Annie Carraretto, president of Family Planning in the columns of franceinfo. The closure of establishments practicing abortions does not help anything, Le Monde believes 45 the number of hospital establishments practicing abortion having closed between 2007 and 2017. Add à this caused the number of maternity units opened in France to drop between 1996 and 2019, from 814 to 2019. 461 according to the Drees, and you obtain a drastic drop in the number of abortion centers in public hospitals.

The question of the conscience clause

"The doctor who does not want to (perform an abortion) will obviously have the right and freedom to do so. not to want. We are not going to violate consciences. And this is already happening. guaranteed by the Constitution. These were the words of the Minister of Justice, Eric Dupond-Moretti, this Sunday on Radio J. As a reminder, according to the code of ethics of doctors, except in cases of vital emergency, any practitioner “has the right to refuse care for professional or personal reasons”, this is the double conscience clause. Within the framework of the health code public, a doctor "is never required to perform a voluntary termination of pregnancy, but he must inform, without delay, the interested party' ;eacute;e of his refusal". In other words, a doctor can refuse to perform an abortion, a clause introduced by the Veil law.

For their part, feminist associations are fighting for the removal of such a clause which would, for them, be a brake on their progress. access to abortion for women. Voilaà why the Minister of Justice insisted on clarify the position of the executive on the issue and defuse any fire in a historic moment for women's rights, particularly towards the medical profession. For him, the inclusion of abortion in the Constitution, if this is the case, "absolutely does not" makes the conscience clause of health professionals obsolete. "There is no fear, neither for doctors nor for midwives. We are dealing with societal issues and we must respect each other's convictions" he recalled. The order of doctors such as the National College of Gynecologists and Obstetricians is also opposed to this practice. &agrav; the removal of this conscience clause because “it protects the woman, by imposing an obligation to redirect her towards a practitioner or a health establishment” practicing abortion" he tells Le Monde.

A lack of specialized personnel

À Added to these obstacles is the lack of doctors and health professionals. who practice voluntary termination of pregnancy in France. According to the 2020 parliamentary report carried out by Marie-Noëlle Battistel and Cécile Muschotti, abortions performed in the city have been reported by Marie-Noëlle Battistel and Cécile Muschotti. by 1 932 approved practitioners. Which represents 2.9% of general practitioners and gynecologists and 3.5% of midwives. Clearly, the practice of this act relies on the skills of a handful of practitioners "many of whom will soon find themselves in the field. retirement" alerts the report.

Figures offset by the meteoric rise in medical abortion in the city or by aspiration in health centers, in particular thanks to to midwives on a liberal basis. According to the figures from the Drees, the balance of power has completely reversed. between medical and instrumental abortion. The share of medical abortions increased from 30.6% to 78.5% between 2001 and 2022. At the same time, that of instrumental abortions collapsed over the same period, going from 69.4% à 21.5%.