Access to health care for induced abortions : analysis by means of french national survey

Aims: Despite recent studies that evidence some problems in the organisation of the French health care system concerning access for an abortion, far little is known on the reality of access conditions and the views of women on the difficulties they experience when they attend an abortion clinic. 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 national sample of 2 863 women aged 18 to 44, randomly selected from the telephone directory was interviewed by telephone in 2000. Of these women, 480 had an abortion in the last ten years. Results: Results show that 61% of women had a direct access to abortion services. However patterns of care differed according to the type of first professional they contacted. The choice of first professional depended on women’s social background. 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 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.