Four decades after abortion became legal in France, too often women face moral judgment and physical pain, not to mention unsympathetic health care professionals.
PARIS — Alice was 20 years old when she had an abortion. It was in 2008, in an ordinary town in southern France.
"I was crouching down on the ground, contorting myself with pain, my forehead against a chair," she recalls. "I was in so much pain that sweat was dripping from my hair. I stayed four to five hours like that, all alone in a waiting room. Not once did the nurse who gave me the abortion pill offer me a painkiller. I was treated like a dog. As if I were the worst person in the world, committing an abominable act."
Forty years after abortion was legalized in France via the "Veil Law," it's still uncommon for women to undergo the procedure without being judged, without suffering, without going through a nightmare. About 220,000 women resort to abortion every year in France. More than one in three women have an abortion sometime during their lives, a proportion that should make the procedure relatively common.
"It is still not considered a fully legitimate right," says Véronique Séhier, co-president of Planning Familial, an association fighting for abortion rights in France.
At most, women are afforded the right begrudgingly.
"We only have to listen to women," Simone Veil famously said at the French National Assembly in 1974. And if we do, we will hear about the sense of humiliation and shame, the feeling that they must "pay" for this hitch in their contraceptive process. Two-thirds of women who undergo abortion use contraceptives.
"I'm a child of 1968," explains Camille, a 39-year-old professor who had an abortion in 2000 at the age of 25. "I thought abortion became something normal. I was 15 days away from the maximum period 12 weeks or 14 weeks of amenorrhea when I realized it. It was a real struggle to get the appointments. They offered them for a month later, even though I explained my situation."
Just to receive an ultrasound so that the pregnancy could be dated, she had to call a dozen different clinics, she says. "And it went terribly. When the sonographer understood I came for an abortion, his expression changed. He turned the sound of the monitor, which was resonating in the room, to full volume. He said, "See, he's fine. His heart is beating perfectly." I was deeply shocked by his nastiness. What did he know about my situation? I left completely stunned."
Too much waiting, not enough empathy
Over the past 10 years, 130 abortion clinics have shut down in France. And reorganization of public hospitals has limited the procedure to certain clinics, congesting services and extending waiting periods.
"There are strong inequalities across the country," Séhier explains. "Some establishments are on a just-in-time basis. Others are open for abortions only twice per week."
Around Paris, women have it relatively well, but near Nantes, in western France, it's another story.
"When you have to wait up to five weeks for an abortion, you can't live your decision serenely," says Françoise Laurant of the High Council for Equality Between Men and Women.
That's what happened to Nathalie, a 38-year-old farmer, in early 2013. She started the process after a month of pregnancy and could only abort up to two and a half months. "They left me pregnant, event though I was very, very depressed and ill," she says.
Nathalie wasn't even able to choose the abortion method, as the law allows. She wanted general anesthesia, but instead she was given only local anesthesia.
"I was lying in the lithotomy position," she recalls. "The surgeon arrived, angry. No "hello." I didn't feel the anesthesia injection or the warmth of the product. And suddenly, the horrible pain. I felt it scraping my uterus. I was crying. The surgeon had to have noticed it. She seemed annoyed during the whole procedure, sighing, complaining because my "cervix was too tight," as if I could do anything about it! I don't think the anesthesia worked correctly. It lasted 45 minutes, twice the normal amount of time. She left without a "goodbye," not a sign of empathy. I never saw her face. She only talked to my back. As if I weren't a person."
Far beyond the technical obstacles many patients encounter, they complain that the inappropriate attitudes hurt them most. "Most people still think women should not find themselves in this situation and that there are too many abortions," explains Nathalie Bajos, a sociologist specializing in sexuality at the French Institute of Health and Medical Research.
"We have difficulty accepting that abortion goes hand in hand with contraception, as a whole allowing women to control their fertility — because there will always be contraception failures," she says. "Reproaching women for resorting to abortion is in fact reproaching them for having a sexuality that does not aim to be reproductive."
Michel Teboul, head of abortion services at the Port-Royal Hospital in Paris, estimates that a woman using oral birth control between the ages of 15 and 49 will take about 8,000 pills and will have an average of two full-term pregnancies. "So it's a miracle that women don't have more unwanted pregnancies," he says. "This proves they are very careful."
As proof that it's possible to improve conditions, motivated teams have taken initiative to provide better care for these women — like in Armentières, in northern France. This is where Alice went for a second abortion in 2012, even though she had taken the morning-after pill.
After the abortion, a gynecologist told her more about contraception, and she received a more secure implant.
"I had a room and was given a powerful painkiller along with the tablet," Alice recalls. "I didn't suffer at all, and the nurses were extremely kind. This time, I was receiving medical care. My problem was simply being resolved."