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The European Journal of Public Health 2004 14(4):369-374; doi:10.1093/eurpub/14.4.369
© 2004 by European Journal of Public Health
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Health services

Access to health care for induced abortions

Analysis by means of a French national survey

Caroline Moreau1,*, Nathalie Bajos1, Jean Bouyer1 and the COCON GROUP2

1 National Institute of Health & Medical Research (INSERM) INSERM-INED U569/IFR 69, Hôpital de Bicêtre, Le Kremlin Bicêtre Cedex, France, 2 The COCON Group also includes: Pascal Arduin, Jean Bouyer, Beatrice Ducot, Michèle Ferrand, Hélène Goulard, Danielle Hassoun, Nadine Job-Spira, Monique Kaminski, Nathalie Lelong, Henri Leridon, Pascale Oustry, Josiane Warszawski

Background: With an incidence of 15{per thousand}, abortion is a common reproductive event in France. This study describes conditions of access to health care for abortions based on women's reports, taking into account the woman's background and the influence of the first professional contacted. Methods: A representative sample of 2,863 women, aged 18 to 44, was interviewed by telephone between September 2000 and January 2001. Of these women, 480 had an abortion in the last 10 years. Main results: The choice of first professional depended on women's background, as we found differences according to age, educational level or past induced abortion. This choice affected subsequent access conditions, in terms of time delay or complexity of patterns of care to access abortion services. Women who first contacted a private gynaecologist, which is the most frequent situation in France, had more direct and shorter patterns of care. Conversely, general practitioners were associated with longer and more indirect patterns of care, especially when women were less well educated. Conclusion: This study reveals the heterogeneous nature of patterns of access to an abortion in France. It also raises questions concerning the training of general practitioners, who seem to be less well prepared to take charge of a request for an abortion than other professionals. Efforts must be made to better inform women and these professionals about the process required for abortions.

Keywords: access to health care, induced abortion

Received 18 July 2002. Accepted 1 July 2003.

* Correspondence: Caroline Moreau, MD, INSERM U569, Hôpital de Bicêtre, 82, rue du Général Leclerc, 94276 Le Kremlin Bicêtre Cedex, France, tel. +33 (0)1 45 595 086, fax +33 (0)1 45 212 075, e-mail: moreau_c{at}vjf.inserm.fr


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