Activity and access of surgical abortion in metropolitan France.

Objective: To report the territorial distribution and characteristics of healthcare centres performing surgical abortion in France, along with the accessibility of these centres.

Material And Methods: A nationwide population-based cohort study of all women hospitalized for surgical abortion was conducted from January 1 to December 31, 2022 in metropolitan France. Number, location, activity volume and use of local anaesthesia rate of surgical abortion centres were reported as distribution activity across metropolitan France. Correlation between socioeconomic status neighbourhood and surgical abortion centre was evaluated.

Results: There were 52,292 surgical abortion hospital stays among 51,507 women in 497 centres in 2022. Majority of them were performed in public sector (46,979/52,292 (89.8%)). More than half of surgical abortion centres perform a maximum of 50 IVTP/year (277/497 (55.7%)). There was an Inequality in the distribution of surgical abortion across centres with 49 (10%) centres performing 50% of surgical abortion. Only 10,141(19.4%) surgical abortion were performed under local anaesthesia and more frequently in centres with high activity. Women residing in the most deprived areas had longer average travel distances (mean: 21.82 ± 25.98 Km) and times (mean:19,87±19,2 min) to reach surgical abortion centre.

Conclusion: activity of surgical abortion is unequally distributer in metropolitan France. There are significant regional variations and unequal access depending on place of residence. Access to surgical abortion centre is more difficult for populations with low socioeconomic status. It is important that health system managers take into account this inequality, which concerns populations where abortion is more frequent.