More than 243,000 women had an abortion in 2023: how to explain the increase in abortions in France ?

IVG : comment expliquer la hausse des avortements en France ? 

In 2023, more than 243,000 women had recourse to voluntary termination of pregnancy in France, a figure up from 2022, according to a study by the Directorate of Research, Studies, Evaluation and Statistics (Drees).

The number of voluntary terminations of pregnancy is at its highest level in France since 1990. In 2023, 243,623 IVGs were carried out, according to a study by the Directorate of Research, Studies, Evaluation and Statistics (Drees) published at the end of September. This is 8,600 more abortions than in 2022. Thus, in 2023, the rate reaches 16.8 IVGs per 1,000 women aged 15 to 49. A figure much higher among 20-34 year-olds, at 28.2 ‰.

The number of abortions has increased throughout France, but there are marked territorial disparities, varying from 1 to 4, between the Pays de la Loire (lowest rate) and Guyana (highest rate). “In metropolitan France, they vary from 12.4 ‰ in Pays de la Loire to 23.3 ‰ in Provence-Alpes-Côte d’Azur. In the DROMs, the rates range from 19.4 ‰ in Mayotte to 48.9 ‰ in French Guiana", writes the Drees.

79% of medical abortions

41% of abortions were performed outside of health facilities in 2023. The medical method represents 79% of all abortions: 48% of them take place in health facilities, 46% in private practice and 6% in health centers or sexual health centers.

Medical abortion consists of taking two drugs in succession: mifepristone, which terminates the pregnancy, then misoprostol, which expels the embryo. As a reminder, until 2005, all medical abortions were performed in health facilities. They were then authorized in the city, then in health centers and sexual health centers.

Until Covid-19, at the 8th and 9th week of amenorrhea (6th and 7th week of pregnancy), medical abortion had to be performed in a health facility. The rules had changed during the pandemic in order to meet requests for abortion, within the legal time limits, despite the health situation: it was now possible to perform medical abortion outside of health facilities (doctors, city midwives and authorized centers). The measure was maintained after Covid and could explain, only in part, the increase in the number of IVGs.

9.5% of late IVGs

In 2022, the time limit for recourse to voluntary termination of pregnancy was extended, from 12 to 14 weeks of pregnancy (14 to 16 weeks of amenorrhea). What impact has this change had on the number of IVGs? ? So-called late IVGs, performed from 12 weeks of amenorrhea, represent 9.5% of all IVGs performed in health establishments, where three out of four IVGs take place between 5 and 9 weeks of amenorrhea. 2.5% of these hospital IVGs are affected by the extension of the legal deadline, or 1.5% of all IVGs.

Sarah Durocher, president of the Family Planning Association, stressed on Wednesday morning on Franceinfo that while “the increase in the number of abortions is not a problem” in itself, she regretted that there was “very little information about contraception” and too little sex education, particularly at school.

At the end of August, the World Health Organization warned of a decline in condom use among young people. “Many countries still fail to provide comprehensive, age-appropriate sexuality education, and where it does exist, it has been increasingly criticized in recent years due to the mistaken assumption that it encourages sexual behavior, when in truth, equipping young people with the knowledge they need at the right time optimizes health outcomes through responsible behavior and choices “, criticized Hans Henri P. Kluge, WHO Regional Director for Europe.

Finally, the president of Family Planning also denounced on Franceinfo “a lack of access to health” while in some regions, waiting times are sometimes long to consult a gynecologist or a midwife.