Access to health care for induced abortions: analysis by means of a French national survey.
BACKGROUND
With an incidence of 15 per thousand, abortion is a common reproductive event in France. This study describes conditions of access to health care for abortions based on women's reports, taking into account the woman's background and the influence of the first professional contacted.


METHODS
A representative sample of 2,863 women, aged 18 to 44, was interviewed by telephone between September 2000 and January 2001. Of these women, 480 had an abortion in the last 10 years.


RESULTS
The choice of first professional depended on women's background, as we found differences according to age, educational level or past induced abortion. This choice affected subsequent access conditions, in terms of time delay or complexity of patterns of care to access abortion services. Women who first contacted a private gynaecologist, which is the most frequent situation in France, had more direct and shorter patterns of care. Conversely, general practitioners were associated with longer and more indirect patterns of care, especially when women were less well educated.


CONCLUSIONS
This study reveals the heterogeneous nature of patterns of access to an abortion in France. It also raises questions concerning the training of general practitioners, who seem to be less well prepared to take charge of a request for an abortion than other professionals. Efforts must be made to better inform women and these professionals about the process required for abortions.
Moreau
Caroline
C
National Institute of Health & Medical Research (INSERM) INSERM-INED U569/IFR 69, Hôpital de Bicêtre, Le Kremlin Bicêtre, France. moreau_c@vjf.inserm.fr
Bajos
Nathalie
N
Bouyer
Jean
J
D000028:Abortion, Induced / Q000523:psychology / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002983:Clinical Competence; D005194:Family Practice / Q000193:education / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006176:Gynecology / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D010817:Physician-Patient Relations; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D011275:Pregnancy, Unwanted; D012959:Socioeconomic Factors