By Laura Rahm, Silvia de Zordo, Joanna Mishtal, Giulia Zanini, Camille Garnsey, Derek Clougher & Caitlin Gerdts
This is the first study contrasting the experience of women residing in France and traveling for abortion services inside and outside their country of residence. Based on the main findings of a mixed-methods research project funded by the European Research Council, we compare travel reasons and costs as well as our study participants’ opinions of abortion legislation. Almost no study exists on abortion travel in countries where abortion is legal in Europe. Some data exist on the number of travelers from countries with legal abortion (e.g. France, Germany, Belgium, and Italy) crossing national borders to seek abortion care in England and the Netherlands. In some countries (Italy, Spain, France) existing data show that pregnant people also travel from one province/region to another to seek care. This mixed-methods, multi-disciplinary research project is a groundbreaking investigation that provides new data on an understudied topic, which is relevant from academic, public health, legal, and human rights perspectives, filling a significant gap in the existing literature and contributing to current debates beyond academia, including national/international debates on human rights, reproductive governance, and justice.
The paper documents legal and procedural barriers related to accessing local and timely abortions and explores in-country and cross-border travelers’ perspectives on the abortion legislations in their country of residence. In particular, legal time limits appear to be the key driver for abortion-related travel of French residents. Having passed or being at risk of exceeding the gestational age (GA) limits cause women to travel outside their country or department of residence for abortion care. Our investigation found that more of those traveling cross-border (rather than in-country travelers) support the extension of GA limit in France and many take the law of their destination country as a model. Chantal, for example, who traveled to the Netherlands, stated, “The law, they should do like… in Holland, they should extend the dates, to 22 weeks.”
The paper also provides policy recommendations to broaden care options. First, states should eliminate or expand GA limits, to allow women to access abortion care in their country of residence, free of charge and without delays. The recent GA extension to 14 weeks for abortions on request in France is an important step in this direction. Second, decentralizing abortion services within France, especially in Île-de-France, would improve access to timely and local care, reducing the need to come to Paris for services. As we argue in another article recently published in Social Science & Medicine, since the 1990s progress in the domain of neonatology, assisted reproductive technologies, and new discussions of “rights” as assigned to embryos and fetuses have provoked many debates on abortion in Europe. These debates have made discussion on expanding GA limits difficult in Europe. Simplifying access to early, medication abortion, including via telemedicine since the Covid-19 pandemic hit, has proven to be easier for EU States than extending GA limits, with the notable exception of France.
Further research is needed both on in-country abortion travel in other French regions and on implementation of the extension of GA limits, as well as of the provision of medication abortion via telehealth. By implementing policy changes as outlined in the paper, women and pregnant people will be able to obtain abortion care where they live, thus preventing the need to travel for abortion.
About the authors
Laura Rahm, Ph.D., is a MSCA Research Fellow at the Democracy Institute of the Central European University and the lead investigator of H2020 GlobalKnoT project. Prior to that she served as a postdoctoral fellow in the ERC-funded project on abortion access and travel in Europe.
Silvia de Zordo (PhD), social anthropologist, is Associate Professor at the University of Barcelona. Her research interests encompass reproductive governance, abortion and social/gender inequalities in Latin America and Europe.
Joanna Mishtal is a professor of anthropology at the University of Central Florida, Department of Anthropology. Her research interests are at the intersection of gender and governance; specifically, reproductive rights, health, and policies.
Giulia Zanini is an anthropologist in the field of reproduction, health and gender. She has conducted research on assisted reproduction and transnational flows in Mediterranean countries, on abortion travels, and on permanent childlessness.
Camille Garnsey is currently a doctoral student in Clinical Psychology at the University of Connecticut. Her research explores if and how lifestyle interventions and integrative mind-body practices can aid in healing following exposure to trauma.
Derek Clougher is an Early Stage Researcher and General Health Psychologist based at Hospital Clínic, Barcelona. His research interests include inter alia mental health, child and adolescent psychology, health psychology, therapeutic interventions, technological evaluation in severe mental health disorders, technology transference, and increasing access to healthcare.
Caitlin Gerdts, Ph.D., MHS is an epidemiologist and the Vice President for Research at Ibis Reproductive Health. Her research has included clinical and epidemiologic studies, on self-managed abortion, access to abortion, and digital technologies to support abortion access.