Voluntary interruption of pregnancy (abortion) allows all women, adults and minors alike, to terminate an unwanted pregnancy within 14 weeks. How is an abortion carried out? What are the stages prior to the procedure? Elia tackles this vast subject and explains everything in detail...
What is voluntary interruption of pregnancy?
An abortion, or voluntary termination of pregnancy, is an intervention initiated by any pregnant woman and consists in terminating a pregnancy. unwanted pregnancy unwanted pregnancy. It is available to all women in "distress" due to their pregnancy.
The legalization of abortion dates back to 1975 (or rather, its decriminalization), which we owe largely to Simone Veil, thanks to whom the Loi Veil of January 17, 1975 came into being. The law stipulates that "the woman is the sole judge of this situation and is free to make her own decision": an important phrase, and one which stipulates that the choice to continue or terminate a pregnancy belongs to any woman who feels that she does not want the child.
In France, abortion is a completely legal, voluntary medical procedure that enables women to terminate a pregnancy for personal reasons. The procedure can be medical or surgical, and aims toexpel the fetus or embryo from the uterus.
"Women's freedom to have recourse to voluntary interruption of pregnancy" is a right that should moreover soon be enshrined in the Constitution, according to Emmanuel Macron's announcements on March 8, 2023 at the national tribute to lawyer Gisèle Halimi.
Do not confuse withmedical termination of pregnancywhich is declared by a doctor when the pregnancy endangers the mother's health.
What techniques are available for voluntary termination of pregnancy?
At lt the present time, there are two methods of performing an abortion: the "medicated" method and the "surgical" method, with different procedures and access times.
Medical abortion (7 weeks)
Medical abortion is the "easiest" option for terminating a pregnancy. It is carried out in a health facility (public hospital or clinic), a doctor's office, a planning center or an accredited health center.
This method has several different timeframes, depending on where it is performed: in a healthcare facility, it is possible up to the end of the 7th week (i.e. 9 weeks of amenorrhea, counted from the start of the last periods). This deadline was extended in 2021, at the time of the Covid epidemic. In an office, planning center or health center, medical abortion is possible up to the end of the 5th week of pregnancy ( i.e. 7 weeks of amenorrhea).
Surgical abortion (14 weeks)
Surgical abortion is performed in a healthcare facility (clinic or public hospital) using instruments or suction. It can also be performed in an accredited health center, provided it has a cooperation agreement with a health facility.
This method can be used up to the end of the 14th week of pregnancy, i.e. 16 weeks after the start of the last periods (16 weeks of amenorrhea).
How does voluntary interruption of pregnancy work?
Voluntary interruption of pregnancy is a procedure that takes place in several stages, or rather, consultations.
Medication abortion in and out of healthcare establishments consists of an information consultation, followed by a consultation with delivery of the medication (in two stages) and a follow-up visit to ensure that the embryo has been correctly expelled.
First appointment: find out about abortion
The aim of the first appointment is to confirm the pregnancy, and above all to find out how far along it is (date of last periods, circumstances, etc.), as well as the reasons behind the desire for abortion. The patient receives full information on the abortion procedure, as well as on the help available if she wishes to keep the child. Emphasis is placed on contraception options.
During this initial consultation, a blood test is also prescribed to determine the woman's blood group . The woman is given one week to think about her decision (not compulsory, but shortened to two days if the pregnancy is too far advanced).
All women over 18 will be offered a social interview, which is compulsory for under-age patients. The aim of this interview is to understand the social context and, above all, to find out about the person's lpsychological state .
Second appointment: choice of technique and consent
During the second consultation (which takes place after the week of reflection), the patient's wish to have an abortion, and therefore her consent, is confirmed in writing at l. The health professional in charge of the procedure gives her a copy of her request, and can prescribe the contraceptive method chosen if she did not have one.
Third appointment: the abortion procedure
Medicated abortion is performed during the third consultation: this option avoids the need for surgery, since it involves taking a drug in two doses, one or two days apart: mifepristone and misoprostol. The first dose is taken in the presence of the healthcare professional during the 3rd consultation (to ensure that the dose is controlled and to avoid resale or donation to a third party), and the second dose is taken during a short hospital stay the following day or two.
Mifepristone interrupts pregnancy by blocking the action of progesterone. But it's the second drug (also taken orally), misoprostol, which causes uterine contractions, ensuring expulsion of the embryo. If necessary, the patient can take painkillers to alleviate the pain.
Surgical abortion is also performed during the third consultation of the abortion procedure: the patient is hospitalized in an outpatient clinic and receives local or general anesthesia. The doctor sucks out the egg using a suction cannula, which passes through the vagina before passing through the cervix (endo-uterine suction). Dilatation of the cervix is facilitated by medication. The procedure takes around ten minutes, and the patient is generally discharged the same day. Once the abortion has been performed, contraception is essential to avoid any risk of pregnancy in the near future.
Fourth appointment: check-up
The fourth and final appointment is a non-compulsory but highly recommended check-up. The aim is to check that the uterus has been "emptied", and that no pregnancy is progressing (by measuring the beta-hCG hormone). This consultation takes place 2 and 3 weeks after the abortion. An endo-uterine aspiration is performed if the medical abortion fails. During this visit, the patient is offered psychological support.
Can a termination of pregnancy be retracted?
As abortion is a right that belongs to women's personal choice, it is only logical that they should be able to retract their decision during the procedure, even if written consent has already been signed. Withdrawal must be initiated by the woman herself, and not by a third party.
How does an abortion work for a minor?
Underage girls do not need parental consent to undergo medical or surgical abortion, provided they are accompanied by an adult. But the basic rule is still to obtain parental consent.
Underage patients must first undergoa psychosocial interview with a marriage and family counselor. If they wish to keep the procedure secret, they can go to a family planning center and ask for the procedure to be kept secret, so that it does not appear on their health insurance card. A word of clarification: if the abortion requires anaesthesia, the under-age woman must leave the facility in the company of an adult accompanying her.
After abortion: is psychological follow-up necessary?
Although not compulsory, some women may find it difficult to recover from an abortion. Sleep disturbances, anxiety disorders, stress, feelings of guilt, sadness... in such cases, it's advisable to contact a psychologist or psychiatrist to receive a sympathetic ear and find appropriate solutions.
In all cases, the healthcare professionals who performed the abortion are obliged to offer the patient psychological support and to refer her to a person qualified to provide this follow-up.
Some figures on abortion Abortion in Europe
Now that we've covered all the bases, let's take a look at the abortion figures in Europe at l:
- Of the 27 member states of the European Union, 24 have legalized or decriminalized abortion, with no need for justification on the part of the woman;
- Iceland and Sweden are considered the countries with the most protective and effective policies in terms of women's right to abortion;
- In Finland, abortion is permitted before the age of 17 up to the twentieth week of pregnancy;
- Portugal partially legalized abortion in 2007, and the number of abortions has risen every year since.
FAQs on voluntary interruption of pregnancy
Do I have to pay for an abortion?
In France, labortion is reimbursed at 100% by Social Security, whether the woman is a minor or an adult, and requires no advance payment, regardless of the lhealth facility where it is performed.
How do I get a prescription for an abortion pill?
Prescribing an abortion pill falls within the scope of medical abortion, and therefore requires following the applicable procedure: a first appointment to find out about abortion and the options available, a second appointment at which the doctor receives the patient's consent to proceed with the abortion, and finally a third appointment at which the patient takes the first medication required to stop the pregnancy (in the doctor's presence), followed by the second medication 24 to 48 hours later in an outpatient clinic.
What are the reasons for terminating a pregnancy?
Apart from medical reasons (complications, foetal malformations, risks to the mother's health), an abortion can be requested on a woman's own initiative, provided she has the freedom to dispose of her own body. Whether the pregnancy is unwanted (for personal, family, professional or economic reasons), or due to previous trauma or sexual violence at the origin of the pregnancy, women are entirely free to request an abortion, as long as the procedure is carried out within the legal timeframe.
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