The situation is encouraging. Apart from the public hospital, around forty doctors and midwives practice medical abortion in the city.
By Nadia Tighidet
© MICHEL GANGNE / AFP
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Samia made a choice. In all conscience and “without possible regret”, she wished to end an accidental pregnancy, last September. Practiced until the 7e week of pregnancy, medical abortion was still possible in her case. “Naturally, I turned to my gynecologist,” recalls this mother, association manager in the north of Marseille. “But obviously, the replacement for her secretary was unaware that the firm was practicing this act. She told me she couldn’t do anything for me and I didn’t want to go to the hospital because I was afraid of a long delay. » Head to the online medical appointment platforms where Samia goes in search of the first available practitioner and obtains a slot a few days later in Saint-Loup (10e), thirteen kilometers from his home. “Subsequently, I learned that my gynecologist practiced abortion well, I had received bad information which added concern to an already difficult process. »
Indeed, in Marseille, only gynecologists who have signed an agreement with the Hôpital Nord or la Conception are authorized to perform medical abortion. General practitioners and midwives also have this possibility, up to the 5e first week of pregnancy, up to the 7e since the outbreak of Covid. Moreover, “doctors and midwives are more numerous than gynecologists to have chosen to practice abortion”, remarks Aubert Agostini, head of the orthogenics department of Conception, which lists 30 to 50 contracted practitioners in Marseille. “The abortion is a very special care, an extreme administrative burden and which is not at all valued financially,” he asks. “In fact, it is always out of commitment that we choose to take care of it. »
A “necessary service”
Midwife in the 11e, Nathalie Caraplis is a clear example of this commitment. Trained in 2019 in the practice of medical abortion, “I made this choice because I find that the profession of midwife has its place. We take care of women’s health and, in terms of access to health, it is a necessary service that we provide to the population. We still live in a country where this act is accepted and understood, so it was important for me to invest myself in it”. For his patients and all those who come to his office. Nathalie Caraplis sees six to ten people a week for this reason.
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“Things are changing in an encouraging way in Marseille, even if we notice a difficulty for people who do not have access to health rights”, continues Aubert Agostini. “When I started in the 1990s, we still had doctors who dealt exclusively with fertility and categorically refused to talk about abortion, as if it went against their profession. The new generation considers women’s health more globally, and if there is still work to be done, I believe that Marseille is on the right track on this issue. »
A complicated situation in other departments
On the ground, Claire Ricciardi, co-president of family planning in Marseille, validates the finding of a “correct situation in terms of abortion in Marseille. The network of city practitioners ensures and, in the event of an emergency, La Conception is always ready to receive the people presented to it within an extremely short time. It is not so obvious in other nearby towns, such as Toulon. When a person calls from Var, we know immediately that it will take longer to find a solution. ” The Var, but also the Alpes-de-Haute-Provence or the Hautes-Alpes: “It must be understood that the difficulty of access to abortion is the first indicator of a reduction in the offer of gynecological activity on a territory”, notes Aubert Agostini. “When you only have two or three gynecologists in a city of several thousand inhabitants, the priority goes elsewhere. In Marseille, this is not the case. »
READ ALSOAbortion in the Constitution: why this project divides lawyersIn 2022, 2,500 voluntary terminations of pregnancy were recorded at La Conception and at the Hôpital Nord, where both medical and surgical abortion are carried out. Between the first appointment and the operation, “the period should not exceed ten days”, attests Aubert Agostini.