France on Friday marks 50 years since the law decriminalising abortion came into effect. Since then, the law has undergone numerous updates to reflect changes in society and was even enshrined in the Constitution in March 2024. But despite these advances, advocates warn that access to abortion remains fragile in practice.
The law to decriminalise abortion was proposed by then-health minister Simone Veil in November 1974. She was one of only nine female MPs at the time and faced enormous pressure – and abuse – during the 25-hour parliamentary debate.
"I never imagined the hatred that I would unleash," Veil later said, recalling how some lawmakers likened abortion to the Holocaust – of which Veil was a survivor, having been deported to the Auschwitz-Birkenau and Bergen-Belsen concentration camps.
After concessions on adding a conscience clause for doctors who refused to perform the procedure, the bill was adopted with 284 votes for and 189 against.
It was enacted after approval by the Senate on 17 January, 1975, becoming what was known as the Veil Act. It was initially adopted for a period of five years, then prolonged indefinitely in 1979.
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There were originally two sets of circumstances under which abortion was accepted by the law – the first for an elective abortion due to a woman’s "distress" and the second for medical reasons.
Veil herself said that abortion should only be carried out as an exception, hence the inclusion of a seven-day waiting period and a "psycho-social" interview among the conditions for a termination, both of which have fallen by the wayside in recent years.
An evolving law
Fifty years on, the legacy of the Veil Act continues to mark French society. The technical aspects of the law have significantly evolved over time, with six major modifications between 1979 and 2024, when it was enshrined in the French constitution.
In 1975, elective abortion was initially authorised up to the 10th week of pregnancy. This limit was extended to 12 weeks in 2001 and to 14 weeks in 2022.
In 1975, terminations had to be performed surgically by a physician in a hospital. Under today’s legal framework, they can be performed in a range of settings, by both physicians and midwives, using various methods.
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One of the biggest changes in the last 50 years is access to medical abortions, those in which medications are used rather than surgery, which accounted for four out of five abortions in 2023, according to a November report by the National Institute for Demographic Studies (INED). The figure for surgical abortions went down to one in five the same year.
Initially administered in hospitals, these drugs also became available in physicians’ offices, clinics and sexual health centres in the 2000s. Since the Covid-19 pandemic, women seeking medical abortions can also access health practitioners remotely.
Increase in abortions
France is among the European Union countries with the highest abortion rate. In 2023, in France as a whole (including its overseas departments) there were 17 elective abortions (16 in mainland France) per 1,000 women aged 15-49, according to the INED report.
It also shows that France has seen an increase in abortions. Stable at around 220,000 per year for the last three decades, the figure began rising sharply in the early 2020s, reaching 241,700 in 2023.
The report's authors suggest that the increase in elective abortions may be "in response to greater social and economic insecurity and increasing uncertainty about the future".
Despite the legal and logistical advances in the law, access to abortion remains fragile in practice and unequal across the country.
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Planning Familial ("Family Planning"), an advocacy group, found in a survey commissioned by polling group the IFOP Institute in July 2024, that 27 percent of women who sought an abortion over the last five years had been faced with a refusal.
Some of these refusals may have been linked to the “conscience clause” which has been part of the law from the outset. It states that a medical practitioner has the right to refuse to carry out an abortion, but must immediately refer the patient to a service that can perform the procedure.
Furthermore, the survey found that 31 percent of women who terminated their pregnancy before its eighth week said they were given no choice of method – medical or surgical – even if the right to this choice is inscribed in the law.
Planning Familial also reported that 130 abortion centres have been closed over the last 15 years in France, and others are under threat.
Geographical discrepencies
A Senate report from October 2024 also pointed to geographical discrepancies when it came to accessing abortion.
In France's overseas departments and regions the rate reaches close to double that of mainland France. However, it was these same departments – including Guyana, Guadeloupe and Réunion Island – where women found it difficult to access health centres due to distance and lack of transport.
Rural areas in France were also subject to similar difficulties, as well as long waiting times and under-equipped regional health facilities.
The Senate report stated that the number of medical staff willing to carry out abortions was not sufficient and that this was perhaps due to a lack of training, poorly updated information campaigns and in some cases, too much red tape.
Stigma
Both the Senate report and Planning Familial survey also pointed to the need to counter the stigma associated with abortion, which stemmed from aggressive disinformation campaigns and activism online.
In its July survey, Planning Familial found that 41 percent of women who recently had an abortion stated that they felt "the right to abortion was taboo", and 63 percent feared being judged by those around them or by health professionals.
Meanwhile, 37 percent said they felt pressure over their choice to have an abortion, either from their entourage or society at large.
This concern was also highlighted in a 2024 report from the La Fondation des Femmes (Women’s Foundation), which pointed to a change in public opinion following the June 2022 ruling of the Supreme Court of the United States, which rolled back the Roe vs Wade decision that had guaranteed abortion rights on a federal level.
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According to the Fondation, this gave anti-abortion groups in France a sense of legitimacy in carrying out "attacks against the premises and organisations fighting for reproductive rights" and campaigns such as putting anti-abortion stickers on hire bikes in Paris.
Planning Familial said that while 85 percent of people questioned in the IFOP poll said they are very strongly attached to the right to abortion, 89 percent of people were aware that obstacles persist in France.
The recent addition of abortion rights to the constitution does not seem sufficient to reassure people moving forward, the group said. "The fear of a possible challenge to the right to abortion in France is present, and particularly among women who have already had an abortion – 51 percent compared to 30 percent of the general public."
