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J Gynecol Obstet Hum Reprod. 2018 Oct;47(8):371-377. doi: 10.1016/j.jogoh.2018.06.005. Epub 2018 Jun 26.

Healthcare itinerary of women undergoing an abortion according to their vulnerability.

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Réseau Périnat Aquitaine, 33000 Bordeaux, France. Electronic address: sami.haddad@ch-pé
Réseau Périnat Aquitaine, 33000 Bordeaux, France.
Institut de santé publique et d'épidémiologie, Université de Bordeaux, 33000 Bordeaux, France.



Precariousness is increasing among all populations and especially among women. The access to healthcare is increasingly unequal upon the population and particularly in access to contraception methods or abortion according to their vulnerability level.


Our main object is to describe the socio-demographic specifications, the different steps involved in the healthcare itinerary to contraception and abortion, according to the level of social vulnerability for a woman population sample requesting an abortion. The secondary objects are to detect the existence of a difficult healthcare itinerary and to describe the exposure to risky situations or behaviors according to their vulnerability level.


It is an observational cross-sectional survey to women having recourse to induced abortion in centers providing them, during 3 month in 2014, in the Aquitaine area. The validated tool to evaluate this situation in a psycho-social approach is the "EPICES score".


Our sample identifies 49% of women in a precariousness situation. These women are younger and more often less employed. They benefit less often from a regular gynecology follow-up, do not use contraception as often and resort to abortion more often. They relate more often risky behavior for the health, conflict with the partner and psychological, physical violence.


Special attention should be brought to all women in request of an abortion, for half of them are in a precarious situation and this physical might be a rare occasion of access to healthcare. Violence screening should be systematic and the choice of a long term birth control method should be encouraged.


Precariousness situation; Previous abortion; Violence; “EPICES score”

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