Why has the number of abortions not declined in France over the past 30 years?

Abstract

Abortion is a final resort after contraception has failed. When the Veil Act legalizing abortion in France was passed 30 years ago, the frequency of abortion was expected to decrease as modern contraception methods spread. Though the number of unplanned pregnancies has gone down, the number of abortions has not. As Nathalie Bajos and her colleagues explain, women with unplanned pregnancies more frequently resort to elective abortion. The legalization of abortion in France, as in other countries, has substantially improved the health care conditions in which termination is performed, producing an impressive reduction in serious complications and deaths: there is now less than one abortion-related death a year in France (0.3 deaths per 100,000 terminations). Furthermore, legalizing abortion has had no demographic impact. French fertility dropped sharply from 1964 to 1976. But in the past 30 years, the desired number of children, and the number of children per woman, have remained unchanged. While public opinion is very largely in favour of legalizing abortion, the conditions of application of certain provisions of the law still call for ongoing support. Anti-abortion movements are active in France, and even more so in other countries (the United States, in particular), though their violent methods have been punishable by law since 1992. For these minorities, the moral case against the principle of termination brooks no argument, and their aim is to throw liberal laws into question. Some doctors are also ambivalent, either on principle or with regard to specific statutory provisions. On balance, however, the real fear is not the abolition of the right to abortion but rather a steady decline in care provision for women wishing to terminate pregnancy. (Summary, S. 4) Inhalt (Introduction) Box - Main changes introduced by the Act of 4 July 2001 Figure - Frequency of recourse to induced abortion and of unplanned pregnancies in France - a) Annual terminations per 1,000 women aged 15-49; b) Proportion of unplanned pregnancies (per 100 pregnancies) and frequency of recourse to induced abortion (per 100 unplanned pregnancies) A paradox: contraception has spread, but the number of abortions has not fallen Greater frequency of abortion in cases of unplanned pregnancy At-risk women or abortion-risk situations? Table 1 - Women’s contraceptive status at the time of the conception resulting in subsequent abortion (around 1998) A decision that takes account of the emotional and material context A health care system that offers far from satisfactory service References