In Paris, surgical abortions soon to be performed outside hospitals



This is a first for Paris. In the 20th arrondissement of the capital, a family planning and education center (CPEF) will welcome in the coming months – from the last quarter of 2022 or very early 2023 – women for surgical abortions, that is to say say by aspiration, announced the Paris City Hall on July 1. Until now, only hospitals, as well as health centers (since 2016) had the legal possibility of carrying out this type of abortion. The CPEFs, unless they are backed by health establishments (which is the case in the 20th century), are limited to advice, guidance and medical abortions.

Easy access

With this center, the town hall of Paris shows its desire to make abortion” more accessible “, claims Anne Souyris, deputy mayor of Paris, in charge of public health. “For some women, going to the hospital for an abortion is reassuring, but for others it is an intrusive and cumbersome procedure. Taking surgical abortion out of the hospital means offering a local medical offer, faster, less distant, less complicated”, includes Danielle Hassoun, obstetrician-gynecologist and former head of a hospital orthogeny center in Seine-Saint-Denis.

However, Paris and Île-de-France are areas rather “concerned” by abortions. “In 2021, 12% of women in Île-de-France aged 15 to 49 declared at least one unplanned pregnancy, compared to 10.5% outside Île-de-France” we say at the town hall. Half of these pregnancies resulted in an abortion, 36% in a birth. “If we consider that, in terms of abortion, the important thing is to allow a real choice, the more care offers there are, the better it is”believes Danielle Hassoun.

Sufficient support?

But what care? “I don’t perform surgical abortion outside of hospital, for me it’s a real regression, regrets Brigitte Letombe, obstetrician-gynecologist. Abortion remains a medical act, which requires for me the use of a technical platform, for safety reasons and to have access to a possible general anesthesia if necessary. » In non-hospital centres, where abortion can be performed up to the twelfth week of pregnancy, the anesthesia is only local. “Women don’t have the right to security? », protests the practitioner.

Danielle Hassoun tempers. “In reality, surgical abortions do not require a technical platform or an operating room, she believes. The risks of immediate complications are low, when the abortions are early. » As for psychological support, “He is insured. As in the hospital, an interview with a marriage or family counselor can be offered before or after the abortion. The woman is not left alone,” reassures the doctor for whom, “the more access to abortion will be simple and easy to access, the less the act will make women feel guilty”.

One more step towards trivialization?

Simplification or trivialization? For the Alliance Vita pro-life movement, this type of outsourcing of instrumental abortions, which is part of “in reaction to the American news on abortion”contribute to “always trivialize an act that is not insignificant. As if they wanted us to believe that women have recourse to abortion without qualms”, regrets Caroline Roux, its deputy general manager. For the association, this step constitutes a new addition “ measures taken in recent years to facilitate access to abortion. »

Among these measures: the recent extension of the time limit for recourse to abortion from 12 to 14 weeks of pregnancy, the removal of the distress criterion, the end of the reflection period and compulsory interviews… In wanting to make abortion a treatment proximity, with quick access, streamlined procedures, in the name of women’s freedom to control their bodies, we are in a headlong rush to bring down all the dikes, including those that would allow women to step back and receive complete information on aids to avoid abortion », deplores the association, which considers that “the best abortion is the one that is prevented”notably through information policies.

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