Acces to abortion in the Grand Est region in 2023

Objectives: Although access to abortion is a national priority in France, there is little documented evidence that it is actually respected. In the Grand Est region, the 2021–2023 plan for access to abortion includes a review of family planning practices and health care provision, to update the 2019 report. It raises the question of access to abortion in all its dimensions, and aims to implement improvement actions best suited to the region’s problems.

Method: An online questionnaire was sent to hospitals, local perinatal centers, sexual health centers, and independent professionals with presumed family planning activity. Of those who responded, only those with actual family planning activity were included.

Results: The five-day deadline for the first appointment recommended by the HAS can be met by 73% of those surveyed. During pre- or post-abortion consultations, a psychosocial interview is offered to 92% of patients, and the detection of violence to 97%. Although 14 hospitals (38%) have extended their abortion access time to 16 weeks of amenorrhea, the number of facilities handling abortions beyond 13 weeks of amenorrhea has fallen since 2019. In primary care, 70% of private practitioners and 61% of sexual health centers offer abortions up to 9 weeks of amenorrhea.

Conclusions: Access to abortion has weakened in the Grand Est region between 2019 and 2023. New laws and regulations could be a lever for improvement, provided that the professionals involved are given the means.