In the adjoining offices of the 13th arrondissement of Paris, the Family Planning telephone rings almost continuously. On this Friday morning in July, the marriage counsellors, overwhelmed, naturally stop their current activities to respond to them. At the other end of the line, women of all ages try to obtain, as quickly as possible, support and answers concerning their sex life, their contraception or their pregnancy – desired or not. In a soft voice, Isabelle Louis directs them, proposing solutions and urgent appointments in one of the three Parisian centers of the association. “We have a lot of work to do: just last year, our center supported around 900 women in their journey of voluntary termination of pregnancy [IVG] drug, and advised nearly 600 others to perform an abortion abroad”, she testifies.
An employee of the organization for fifteen years, the marriage counselor insists: in the majority of cases, these abortions go “very well, even if they are never cheerful”. But sometimes, Isabelle Louis collects testimonies that revolt her. A few months ago, one of her patients would have been refused the painkillers that were to accompany her medical abortion in the hospital. “The nurses who accompanied her told her that intelligent as she was, she should not have gotten pregnant. That it was normal to have pain, and that she had to understand the consequences of her act “. Rarer than ten years ago according to the Family Planning of Paris, these value judgments still exist among certain health professionals, who thus come out of their duty of reserve. Above all, these reflections are added to the lack of general information, to the refusal of care, to the attempts of guilt, even sometimes of dissuasion on the part of a certain number of practitioners in different structures or Parisian offices. “I would say we get one complaint like this a week at Planning 75, and maybe one a day on our national freephone number“, deplores Isabelle Louis. “You have doctors who refuse to give information on the legal framework surrounding abortion, others who will not help women date their pregnancy, still others who will refuse to practice what they call ‘that’ without directing them to colleagues capable of performing an abortion…”, she lists, annoyed.
The examples follow, numerous. “There are also gynecologists who make women listen to the baby’s heartbeat when they don’t want it, doctors who ask that the father be present before accepting the abortion, totally inappropriate moral lessons, structures where the abortion is followed by ‘we don’t want to see you again madam'”. By force, Isabelle Louis has even sorted out the establishments to which to refer the patients she meets. Private clinics in Paris, for example, are no longer part of its list since “too many negative testimonies” and “exaggerated fee overruns” were reported to the association by women who had performed an abortion there. “And when we hear about a malicious doctor, we do not hesitate to report it”, warns the marriage counselor, who claims to have recently written a letter “as long as the arm” to the Council of the Order of Physicians, after that one of his patients was received “anyhow” by a practitioner. “We certainly make fewer reports than before. But in 2022, this type of obstacle to abortion still exists,” she breathes.
“Are you sure you thought it through?”
The law is clear. According to the article L. 2212-8 of the Public Health Code, a doctor or a midwife is certainly “never required to carry out a voluntary termination of pregnancy”, but “he must inform, without delay, the person concerned of his refusal and immediately communicate to him the names of practitioners or wise men – women likely to carry out this intervention according to the procedures provided for by law. According to the article L.2223-2, the act of “preventing or attempting to prevent practicing or obtaining information about a voluntary termination of pregnancy or the prior acts” is punishable by two years’ imprisonment and a fine of 30,000 euros. “But in fifty years, the issues have changed. We are no longer simply ‘for’ or ‘against’ abortion, but rather against the methods of this abortion: for whom, when, how”, underlines Raphaël Perrin, sociologist and author of a thesis in progress at the University of Paris I on the behavior of health professionals in the face of abortion work. “Doctors will no longer openly refuse an abortion without further guidance, because they are aware of the risks to their career or reputation. But there will be more insidious reflections or refusals on late or repeated abortions, on the method used, or even on the contraception used by women”.
Everywhere in France, the testimonies are the same. In 2018, the Planning Familial de l’Isère thus alerted to “the abuse of power by certain professionals”, and listed the acts of a doctor recommending a reflection period of 15 days for an adult woman – while this period has was legally abolished in 2016 -, of a gynecologist accepting the practice of an abortion only if his patient authorized the placement of a contraceptive implant in return, of a private clinic asking minors for parental authorization… In June 2021 , a survey carried out by the Family Planning of Seine-Saint-Denis reported that 58.3% of telephone calls made to public establishments to obtain an appointment for a medical or instrumental abortion resulted in no response. Worse: when someone finally picks up the handset, 3.3% of calls result in a refusal from the establishment, without referral to another professional. In the private sector, this figure explodes: 33.3% of calls made to clinics in the department thus ended in an outright refusal from practitioners, who, again, left no address to turn to.
“Of the seven private clinics that we still believe perform abortions [en Seine-Saint-Denis]only one remains easily accessible […]. Concerning the six other clinics: one no longer performs abortions, another only performs them for its patients, one does not, in fact, offer any appointments, one does not perform abortions by aspiration, one still another does not practice abortions beyond 12 SA [semaines d’aménorrhées]. In addition, the telephone reception is often dissuasive, the situation is not analyzed with the person calling, little or no information is given, some of which is erroneous”, regrets the organization in its report. “There also has the murderous little guilt phrases imposed on patients, such as: ‘Are you sure you thought it through? What are the reasons for having an abortion at your age? Or: ‘Do you know that women are permanently traumatized after an abortion?'”, says Marie-Liesse Montès, director of Family Planning in Gironde, who also lists “completely illegal behavior”, as requested permission from the parent before performing the abortion, or even the refusal to prescribe painkillers.
“Alone, dirty and ashamed”
For some patients, the consequences are devastating. Last winter, a pregnant woman would have gone to Gironde Family Planning after being denied access to abortion in a hospital in the region for an abortion deemed too late. “However, she respected the new deadlines provided for by the law of March 2, which authorizes an abortion up to 14 weeks of pregnancy”, assures Marie-Liesse Montès. “But when she arrived with us two or three weeks after this refusal, it was really too late. We had to direct her to Spain, where abortion is free and very expensive… She was stunned and in a state of total distress”. A witness to such pressure despite herself, Marion Monet, regional coordinator of the national IVG family planning toll-free number for the Paca region, insists on the long-term impact of these attempts at deterrence on the psychological health of women. “Borrowful abortions are very often due to these bad encounters or these guilt-inducing receptions, which can be much more violent than the abortion itself”.
Five years after her abortion in Alsace, Mélissa can only confirm. At the age of 22 and then suffering from eating disorders, the young woman became pregnant. Very quickly, she decides to have an abortion. “I felt completely at peace with this decision,” she says. But his practitioner does not hear it that way. “One more!” the gynecologist stabs her as Mélissa makes her request. “She then explained to me that I was responsible, and that I only had to assume, put myself in front of a plate and eat. That there was also social assistance in France to take care of a child. , and that moreover I should have been on contraception”. As the examination progresses, the doctor goes further.
While Mélissa had asked her not to see the ultrasound, she nevertheless turns the screen towards her patient, and activates the sound. “I heard the beating of the heart and she said to me: ‘This is what you are going to kill’. I found myself petrified, in a terrible state”. At the exit of the cabinet, a photo of the ultrasound is entrusted to the young woman, accompanied by a reflection which she still remembers. “Here, it may help you make your choice. I’m waiting for you to find your reason,” says the doctor. When the young woman asks to be reoriented, she is told to “deal with a local hospital”, without further details. Mélissa will end up having an abortion with an “extremely benevolent” team at the hospital in her city, but recounts “six months of hell”. “For a long time, the ultrasound and its sounds did not come out of my head. I felt dirty, alone and ashamed. When I should never have suffered such judgment”.