Contraception and Abortion: The French Paradox

Nathalie Bajos, Institut National de la Santé et de la Recherche Médicale (INSERM)
Aline Bohet, Institut National de la Santé et de la Recherche Médicale (INSERM)
Mireille Le Guen, Institut National de la Santé et de la Recherche Médicale (INSERM)
Arnaud Régnier-Loilier, Institut National d'Études Démographiques (INED)
Henri Leridon, Institut National d'Études Démographiques (INED)

Despite the large-scale increase in use of very effective contraceptive methods in the last decades, abortion rates have remained surprisingly stable since the early 1990s around 15°/°°today. Based on five fertility surveys, our analysis shows that the regular drop in the proportion of unintended pregnancies(46% in 1978, to 32% in 2010) is statistically cancelled by the increase in the propensity to terminate an unintended pregnancy (41% in 1978, to 65% in 2010), resulting in stable abortion rates. The stability in abortion rates in the last twenty years in France hides different issues. As the vast majority of abortions follow contraceptive failures, policy recommendations should favor the switch towards highly effective methods and promote use emergency contraception to increase contraceptive effectiveness. Ultimately however, the higher propensity over time to end an unintended pregnancy in abortion reflects changes in the French procreative norm which goes far beyond health policies.