More than 40 years after its decriminalization, abortion is still considered by many health care providers as, at best, a separate right, at worst, an ungrateful task. Between admonitions and moral lessons, some people then go beyond the Hippocratic oath.
"No, no, I'll not abort you. I'm not a butcher (...) Look at him, ma'am. Take a good look at him...". Among the many testimonies collected in her book Le livre noir de la gynécologie [The black book on gynecology], journalist Mélanie Déchalotte reports that of Rachel, 33 years old in 2003, pregnant, in a couple and desiring an abortion.
There are (too) many of the 220,000 women in France who still have abortions every year that are confronted with these words, as harsh as they are guilt-tripping. However, most do not immediately realize they are facing a case of gynaecological abuse.
From inappropriate remarks to the moral lesson
"Are you sure you've thought this through?", "You're 40, it's probably your last chance", "Maybe you should give yourself another week of reflection"... Apparently harmless, these ready-made sentences that distil doubt and thus call into question the choice of the main people involved are still regularly reported to the Family Planning, says Caroline Rebhi, co-chair of the movement. The patients of these dubious, confused carers then need to be reassured. "No, abortion will not prevent you from getting pregnant again. No, you are no longer legally bound (since 2015, editor's note) by an imposed reflection period. No, being overweight does not prevent drug-induced abortion. No, there is no need to hear the foetus' heart beat. No, you don't have to justify yourself. We try to give them as much information as possible to assess their situation and know how to respond to a professional who would play on his authority”.
Sometimes the words are accessory. "I have already met anxious women following the dating ultrasound, during which the doctor, although perfectly aware of his patient's desire to terminate pregnancy, voluntarily turned the monitor towards her so that she could see the embryo," says Baptiste Beaulieu, doctor and writer. All these insidious schemes are reminiscent of the methods of anti-abortion activists, who are now very active on the Internet and via telephone call platforms. For more than 40 years, they have been spreading a chain of beliefs that, for some of them, seems to have succeeded in infiltrating the medical profession.
"When I hear a doctor explain to me that he refused an abortion to a 16-year-old girl so as not to be responsible for her future infertility, there are grounds for questioning their training and information," Caroline Rebhi points out, whose daily life consists in "passing reminders to these problematic cases".
Worse still, these doctors who play moral preachers and "grant" abortion on condition that their patients proceed at the same time with the insertion of an IUD (Intrauterine Device). "It is perfectly illegal, but it has happened in some hospitals," says the co-chair of the Family Planning, who points out that more than 70% of female abortion requestors are on contraception when they become pregnant.
Abortion as a last resort, or the tree that hides the forest
These humiliating practices reveal the impregnation by "the patriarchal ideology of medicine in France", decrypts Marie-Hélène Lahaye, lawyer and author of Accouchement, les femmes méritent mieux [Delivery, women deserve better]. "We are in a society where the doctor considers, as being the one who knows, that he or she has the right to control women's bodies, from the prescription of contraception to childbirth and abortion," this act - which is not very technical and therefore poorly valued in the community - being considered as "the last resort and not as a way to manage one’s fertility". A consideration with a more moral than medical value and yet integrated by a large part of the medical profession and women themselves.
"When the entire training of doctors is based on the idea that women are destined to give birth, it is a whole discourse, a way of thinking that must be deconstructed," notes Mélanie Déchalotte. She adds, to illustrate her comments: "There are still seminars in medical schools today that are entitled, ‘How to avoid to make an abortion?’ That says a lot..."
A remark shared by Baptiste Beaulieu, who still remembers his medical years precisely: "Of course, we are taught what abortion is, in which cases and how to practice both methods (by medication and by aspiration), but what we are not taught is History or rather the stories behind this right. We are not told, for example, that maternal mortality in countries where abortion is prohibited is ten times higher! Because a woman who wants to get rid of an unwanted pregnancy, whether or not she is allowed to do so, will do so. This should be enough to cut short any judgment. As a doctor, our role is to save lives, not to validate life choices."
Not overlooking anything
Does a doctor have the right to refuse an abortion? "Of course, he or she can invoke his/her conscience clause," says Caroline Rebhi. Nevertheless, the latter must immediately inform and redirect the patient to appropriate care. What if he doesn't? "This is a serious misconduct. In this case, as in other cases of gynaecological abuse, we always advise women who are victims of such abuse to report the professionals concerned to their regional health agency. We can then file a complaint with the National Council of the Order of Physicians," she explains. "Of course, we'll never go and seek attention there, but it's important to do it, to leave a trace, for the other women."
In another, less formal, register, Marie-Hélène Lahaye suggests leaving a comment about one’s bad experience on Google Maps. Another recommendation: to be accompanied by a relative. "It is important to find support during and after this intervention. Yes, abortion is a right, a choice, but it does not mean that the act itself is not tiring, if only physically (you lose blood...). In such moments, you can be more vulnerable."
On the ground, Baptiste Beaulieu also deplores, too often, the loneliness of women. "Just as contraception remains their responsibility, in six years of practice, in the context of an abortion where the woman was in a relationship, I only met the man twice!" A proof - if any were needed - that the road to equality is still long.