Abortion in France is legal upon request until 14 weeks after conception (16 weeks after the pregnant woman's last menstrual period). Abortions at later stages of pregnancy up until birth are allowed if two physicians certify that the abortion will be done to prevent injury to the physical or mental health of the pregnant woman; a risk to the life of the pregnant woman; or that the child will suffer from a particularly severe illness recognized as incurable. The abortion law was liberalized by the Veil Act in 1975.
It is also known as induced abortion or voluntary termination of pregnancy, and refers to the deliberate termination of a pregnancy at the request of a pregnant woman who does not wish to continue the pregnancy.
History
The First French Republic saw the act of abortion being changed from an act punishable by death to a felony with a sentence of up to 20 years in prison. When the 1810 Napoleonic Code was introduced as a revision of the French Penal Code of 1791, as well as the Code of Offences and Penalties of 1795, abortion retained its felony status. Alongside this, the new penal code made it more difficult for women to divorce their husbands.
In 1920, new abortion laws prohibited the act of abortion, as well as the use of contraception, on the grounds of needing new babies to make up for the loss of population caused by World War I and to boost the birth rate of France that had been considerably lower than other European countries for over a century. The introduction of the Law of 27 March 1923 stated that whoever induced a miscarriage was punished with up to 5 years imprisonment, as well as a fine of up to 10,000 FF, while the woman having the abortion could be imprisoned for up to 3 years.
Just a month before the invasion of Poland, the Penal Code was altered to permit abortions, but only in the instance where the mother's life was in danger. However, with the German Occupation and the implementation of the Vichy Government, abortion was made a capital crime, punishable by death, in the Law of 15 February 1942. The last person to be executed for abortion was Marie-Louise Giraud, a faiseuse d'anges (French slang; literally, "maker of angels") who performed abortions in the region of Cherbourg. For her assisted abortions, she was sentenced to death by guillotine on 30 July 1943.
Following the Liberation of Paris in 1944, the death penalty for abortion was abolished, but abortion continued to be prosecuted vigorously. Illegal abortion rates remained fairly high during the post-war period, and increasing numbers of women began to travel to the United Kingdom to procure abortions after the UK legalized abortion in 1967.
During the period of civil unrest during and after the events of May 1968, a new civil rights movement was becoming prominent throughout the media, campaigning for more equal rights and opportunities for women. The Mouvement de Libération des Femmes's ("The Women's Liberation Front") main goal was to advocate for women's right of autonomy from their husbands, as well as rights that pertained to the use of contraception and legalization of abortion.
In 1971, the "Manifesto of the 343", an open letter and petition, was written by Simone de Beauvoir and published in . It included the signatures of 343 women who admitted to having had an illegal abortion (punishable by up to 10 years in prison at the time). The petition included the names of many famous female personalities, including Jeanne Moreau and Catherine Deneuve. The manifesto aimed to highlight the prevalence of abortion in French society, despite its clandestine nature, as well as to call for abortion to be made legal, to provide more safe and hygienic spaces for women who want to have an abortion. Later the same year, lawyer Gisèle Halimi, herself one of the 343 women, formed her own group, ("To Choose"), which worked to protect those who had signed the petition.
In 1975, La Loi Veil ("The Veil Act") was passed, decriminalizing abortion in France. The law was introduced by the presiding Health Minister Simone Veil, under Valéry Giscard d'Estaing. D'Estaing had promised to decriminalize abortion during his campaign; however, Jean Lecanuet, then Minister of Justice, refused to defend the law on personal and ethical grounds, and so, it was up to Veil to prepare the law for vote. The debate that preceded the eventual passing of the vote was accompanied by violent attacks and demonstrations comparing Veil, a concentration camp survivor, with Hitler. In her speech before the National Assembly on 26 November 1974, Veil declared the need for the legalization of abortion, to bring equality in France, as well as explaining to the majority-male assembly that current French law did not protect women who were suffering from the social exclusion and shame as a result of illegal abortions, as well as the after-effects that led to illnesses (such as sepsis) and even death, calling for the law to offer them protection with a change of law to legalize abortions.
The Veil Act (Law 75–17 of 15 January 1975), permitted a woman to receive an abortion on request until the tenth week of pregnancy. This was a temporary law with a sunset clause after 5 years. The law was renewed permanently in December 1979.
Since 1982, much of the costs of abortions have been taken into charge by the French social security system, which allows women in France to access abortion free of charge. France was the first country to legalize the use of Mifepristone as an abortifacient in 1988, allowing its use up to seven weeks of pregnancy under the supervision of a physician, while vacuum aspiration is used for up to 12 weeks.
21st century liberalization
Several reforms took place in the 21st century, further liberalizing access to abortion. The ten-week limit was extended to the twelfth week in 2001, and it was extended to fourteen weeks in 2022. Also since 2001, minors no longer need mandatory parental consent. A pregnant girl under the age of 18 may ask for an abortion without consulting her parents first if she is accompanied to the clinic by an adult of her choice, who must not tell her parents or any third party about the abortion. Until 2015, the law imposed a seven-day "cool-off" period between the patient's first request for an abortion and a written statement confirming her decision (the delay could be reduced to two days if the patient was getting close to 12 weeks). That mandatory waiting period was abolished on 9 April 2015.
In reaction to the Supreme Court of the United States's Dobbs v. Jackson Women's Health Organization ruling, Mathilde Panot, the leader of the La France insoumise group in the National Assembly, introduced a bill for an amendment adding the right to a safe abortion to the Constitution. It passed on a 337–32 vote on 24 November 2023. However, a private member's bill for a constitutional amendment needs to be approved by referendum; in order to avoid one, the government introduced a similar bill in December. It was passed 433–30 by the lower house in January and by the Senate 267–50 in February.
The amendment, which takes the form of a one-line addition to article 34 (the list of matters on which Parliament may legislate), was given final approval in a congress (joint session) of Parliament on 4 March 2024, in a 780 to 72 vote. It was signed into law by President Emmanuel Macron on 8 March (International Women's Day). This amendment made France, as of passage, the only nation (and the first) to guarantee the right to an abortion in their constitution. The amendment describes abortion as a "guaranteed freedom"; while Yugoslavia included similar measures in 1974 guaranteeing the right to "decide on having children", the French amendment is the first to explicitly guarantee abortion.
Medical techniques Two types of medical methods exist for terminating a pregnancy: medication-based and surgical methods. The former does not require hospitalization but is limited to early pregnancies: for example, up to seven weeks of pregnancy under French law, equivalent to nine weeks of amenorrhea. Beyond this period and up to the legal limit for abortion, surgical methods must be used. Surgical abortion is legal up to 14 weeks of pregnancy, or a maximum of 16 weeks from the start of the last menstrual period.
Medication-based method
The medication-based method can be performed during the first trimester, with the duration depending on the applicable legislation.
Two options exist:
Mifepristone (RU 486), which has an antiprogestogenic effect, and misoprostol, a prostaglandin E1 analog, increase contractions and facilitate the expulsion of the embryo. Medically, this can be performed up to ten weeks of gestation. The protocol in France typically involves 600 mg of mifepristone followed, 36 to 48 hours later, by 400 μg of misoprostol. The use of methotrexate combined with a prostaglandin is effective up to seven weeks of gestation.
The combination of mifepristone and misoprostol results in complete expulsion of the embryo but appears slightly more effective when misoprostol is administered vaginally, achieving a success rate of nearly 95%. However, this finding is debated. The vaginal route is better tolerated.
The main side effects of these medications include significant genital bleeding and various digestive issues. This combination is contraindicated in cases of acute or chronic renal failure, hepatic failure, adrenal insufficiency, severe asthma, chronic obstructive pulmonary disease, anemia, coagulation disorders, cardiovascular history, other contraindications to prostaglandins, allergy to mifepristone, or suspected ectopic pregnancy. Age over 35 or smoking increases cardiovascular risks.
This medication-based technique allows for an abortion to be performed at home and is widely used in the United States.
Taking mifepristone as early as possible, followed 24–48 hours later by buccal or vaginal administration of misoprostol, is 98% effective in the first nine weeks of gestation; between nine and ten weeks, the effectiveness drops to 94%. The regimen (200 mg of mifepristone, followed 24–48 hours later by 800 mcg of vaginal misoprostol) previously used by Planned Parenthood clinics in the United States from 2001 to March 2006 was 98.5% effective through 63 days of gestation—with an ongoing pregnancy rate of about 0.5%, and an additional 1% of women requiring uterine evacuation for various reasons, including problematic bleeding, persistent gestational sac, clinician judgment, or a woman's request. The regimen (200 mg of mifepristone, followed 24–48 hours later by 800 mcg of buccal misoprostol) currently used by Planned Parenthood clinics in the United States since April 2006 is 98% effective through 59 days of gestation.
In case of failure of a medical abortion, a surgical abortion remains an option. However, if the patient chooses to continue the pregnancy after a failed medical abortion, there is a risk of fetal malformation.
In France, any physician performing medical abortions must have an agreement with a healthcare facility authorized to perform abortions. A medical abortion requires at least five medical consultations: two preliminary consultations, one for the administration of mifepristone, one for misoprostol, and a follow-up visit 15 days later. The medication is administered in the presence of a physician, midwife, or nurse in an orthogenic center. An abortion must be performed in a healthcare facility if the pregnant woman wishes to remain anonymous.
Surgical method
Abortion under local anesthesia is not painful, except for some women who may experience pain similar to menstrual cramps for a few minutes at the end of the aspiration. However, patients generally prefer general anesthesia (75% versus 20% for local anesthesia in France) to avoid being conscious during the procedure. Both types of anesthesia have equivalent safety, though their complications differ.