If the Veil law, promulgated on January 17, 1975, opened the way to a progressive “liberalization” of voluntary termination of pregnancy (IVG), abortion was then considered, at least by a majority of parliamentarians, as last resort. Many felt that the extension of contraception – legalized in 1967 and for which they had just decided to reimburse it – would limit the practice. But this scenario has not completely come true.
What followed has shown that while the number of births is decreasing, this is not the case for abortions. Since the 1990s, this number has fluctuated between 220,000 and 230,000 per year. Above all, according to Drees, the ministerial health and social statistics service, all indicators have been on the rise since 2021 – after a decline at the time of Covid – and the movement continues to grow. In absolute numbers, the number of abortions increased from 223,000 in 2021, to 234,300 in 2022 and 243,600 in 2023.
A ratio of one abortion for three births
The recourse rate, which measures the number of abortions performed each year per 1,000 women of childbearing age, increased over the same period from 15.5‰ to 16.8‰, which places France in second place among European countries – behind Sweden – where the most abortion is practiced. So much so that today there is one abortion for every three births, whereas yesterday this ratio was still one for four.
And even if the latest data should be taken with caution – because three years are not enough to establish the establishment of a basic trend – a double-barrel question arises: why the number of abortions has not decreased over duration, and how to explain the recent increase?
A first explanation relates to the continued facilitation of access. “ If the care is far from perfect, remaining very variable depending on the territory, it tends to improve with the diversification of places, methods, prescribers and the extension of the appeal period from 12 to 14 weeks. , underlines Isabelle Derrendinger, president of the national council of the Order of Midwives.
In fact, abortions are now carried out in hospitals as much as in town offices or health centers, medical abortions clearly prevail over the more invasive instrumental method by aspiration, and midwives have established themselves , in a few years, as essential players while for many doctors, general practitioners or specialists, the activity remains unattractive.
The alleviation of a taboo
Caroline Roux, deputy general director of the pro-life movement Alliance Vita, points out the fact that “all the legislative changes that have taken place since 1975 have been in the direction of removing compulsory measures which protected women from too much pressure, such as the reflection period, the notion of distress, the psychosocial interviewfor adults”, for the benefit of a public policy which, according to her, facilitates abortion.
The lawyer Lisa Carayon, lecturer at Sorbonne Paris Nord University, draws a very different conclusion: “Yes, the stigmatizing taboo of abortion is lightening. Its inclusion in the Constitution contributes to women increasingly considering it as a right and a fundamental freedom and that is so much the better. »
But if the facilitation of access plays a role, it is not enough to explain the scale of the movement. Another reason is changes in contraceptive practice. This is the bitter observation made by Doctor Joëlle Belaisch-Allart, president of the National College of French Gynecologists and Obstetricians (CNGOF).
-“If, to paraphrase Simone Veil, no woman resorts to abortion willingly, this signals our failure to promote effective contraception,” she emphasizes. The reason: distrust, even rejection, developed around the hormonal method, theoretically the most efficient, in favor of techniques perceived as less restrictive or deemed more natural, but less safe. “In one generation, we went from the pill being experienced as a liberation to the pill being seen as a burden,” summarizes Joëlle Belaisch-Allart.
The weight of the “procreative norm”
“The pill remains the primary means used and contraceptive coverage is still very high in France, puts sociologist Laurine Thizy, professor of economic and social sciences, into perspective (1). Moreover, two thirds of abortions performed concern women who used contraception during the month of the start of pregnancy.» An apparent paradox, because no contraceptive method protects 100% against the risk of an unwanted pregnancy, not to mention forgetting the pill, faulty condoms or incorrect application of a vaginal cap.
For Laurine Thizy, as for many of her colleagues, the main reason which explains the relative constancy of the number of abortions is to be found in the “procreative norm” which has become established in recent decades.
“With contraception and the legalization of abortion, we have moved from the model of induced maternity to that of chosen maternity which is accompanied by strong requirements surrounding the reception of a child”, she explains. To be a “good parent”, one must satisfy a whole series of criteria – age, stability of the couple, material conditions, availability in relation to professional life, etc. – which, if they are not met, mean that women will more often resort to abortion when faced with an unplanned pregnancy.
A context that is not very favorable to birth rates
A phenomenon correlated by statistical data. «The recourse rate increases the most in the age categories 20-24 and 25-29 years, on whom this procreative standard weighs. The youngest delay entry into parenthood, the oldest postpone the arrival of an additional child», underlines Magali Mazuy, researcher at the National Institute of Demographic Studies (INED).
Added to this are the effects of a depressed international and national context. “Conflicts, climate anxiety, rising insecurity, political instability mean that people have less desire to have children and may resort more frequently to abortion in the event of contraceptive failure,” supports Lisa Carayon.
“All these explanations are only valid as hypotheses due to the lack of studies to objectify them,” specifies Magali Mazuy. In 2024, INED launched a major survey to better understand the motivations and expectations of women, but the results will not be known until the end of the year. In the meantime, the researcher invites us to shift our gaze. “Instead of focusing on the figures for terminated pregnancies, let’s think about what a public policy that promotes sexual and reproductive health could be. By including women as well as men, who still have too little responsibility on these subjects. »
(1) Co-author with Marie Mathieu of Sociology of abortion, Ed. La Découverte, 2023, 128 p., €11.
