Abortion among minors. A French perspective
A. Durrieux, Pascale Roblin, A. Agostini, F. Bretelle, R. Shojai (France)
University Hospital of Marseille, France
Objective.The rate of abortions among teenagers is steadily increasing in France. We aimed to analyse the medical and social characteristics of minor patients requesting an abortion in order to improve preventive actions.
Patients and Methods.A retrospective analysis of 184 minor patients requesting an abortion in our department between 2005 and 2007. Minors represented 16% of the population requesting an interruption of pregnancy in our center.
Results.Mean age was 16.2 years (rang 14-17), 10% had already a child and 5% had repeat abortions during this period. Mean gestational age at abortion was 63 days. One third had a medical abortion and 70% surgical aspiration with general anaesthesia. The adolescents were accompanied during the procedure by their companion in 26% of cases. In 35% of cases, teenagers came with no family members and were accompanied by a social counsellor. Teenagers had been referred to the abortion clinic through a family physician in 47% of cases, through the Family Planning associations in 11% and had come directly to our center in 43% of cases. Concerning contraception, 51% had declared using a condom, 25% used no method and 16% used an oral contraceptive. None of our patients used a dual contraception combining a condom and hormonal contraceptives. Only 5% had used an emergency hormonal contraception. Post abortum contraception prescriptions were : 75% oral contraception, 6% long term reversible contraceptions (IUD or implant) and 4% contraceptive patch or vaginal ring. 15% of the teenagers refused a contraception prescription. At the post abortum visit 46% did not show up for further explanations on their contraceptive method.
Conclusion.Minors accessed at our abortion center at advanced gestational ages often unaccompanied by their companions. Condoms were frequently used by minors but seem insufficient in preventing unwanted pregnancies. Use of emergency contraception was exceptional. Post abortion contraception was mainly tailored on oral contraceptives and follow-up visit attendance for further contraceptive counselling was low. Other contraceptive options such as IUD or implants were underutilized in post abortum and need to be evaluated.