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France

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Revision as of 22:22, 14 August 2019 by 90.45.252.60 (talk) (Ajout d'une mention et d'un lien vers un portail dédié aux protections périodiques naturelles (coupes menstruelles, culottes menstruelles, etc.))
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OVERVIEW

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In France, you will find a wealth of health care resources. Contraception (birth control) is widely accessible. You do need a prescription to obtain hormonal birth control, and some pharmacies will reject foreign prescriptions, but you'll generally find little issue purchasing contraceptives. Emergency contraception (the morning after pill) is available at pharmacies with no prescription required. There are no age restrictions and a variety of brands are available, including ellaOne.

Regarding menstrual needs, you can find pads, tampons (including 100% cotton) and menstrual cups in France, such as DivaCup and Lunette. Note that tampons tend to often have no applicators and, if they do have applicators, they may be cardboard applicators.

For pregnant women, France offers 16 weeks of maternity leave with 100% wage coverage. Those 16 weeks are split : 6 weeks before birth and 10 weeks after the date of presumed birth when you declared your pregnancy. You can also have the benefits of 2 weeks before the maternity leave if you have problems. Regarding abortion services, abortion is fully legal for 14 weeks of pregnancy/12 weeks of gestation. There are many clinics that provide abortions, and it's possible to even have your abortion covered by the state.

For any question about sexuality, contraception, menstruation, STD, relationship, violences,... anyone can call the following phone number : (+33) 0800 08 11 11. It's free and anonymous and is run nationwide by the Mouvement Français pour le Planning Familial (Planned Parenthood).

Contraception (Birth Control)

 
Birth control pills purchased in France (€8 for a 3-month supply)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In France, you need a prescription to obtain hormonal birth control. According to some accounts, French pharmacies accept foreign prescriptions. Other accounts have stated that French pharmacies do not accept foreign prescriptions, so this ultimately seems to be a case-by-case basis. If you speak some French, this may increase your chances of successfully using a foreign prescription. Meanwhile, condoms are widely available and commonly used; it's estimated that France has the third most prevalent condom use of all countries in the world.[1]

Here is a personal testimonial about getting birth control in France.

What to Get & Where to Get It

  • If you don't yet have a prescription for birth control, it can be easily obtained by visiting an ob/gyn even your local physician or a physician midwife can deliver your prescription. If you have a foreign prescription, you should bring your prescription and an empty packet, if possible, to a pharmacist for refill. You can say, “Pourriez-vous me dépanner avant que j’obtienne une nouvelle ordonnance?” They may sell you a 1-3 month supply, especially if you promise to go to a doctor soon.
  • In France, you can find many types of birth control pills, including phasic pills, progestagen-only and combined pills. The brands available come from many countries, including France, Germany, USA, UK and Chile. Some brands you can find are Adépal, Cerazette, Cilest, Cycleane 30, Cycleane-20, Diane, Diane-35, Effiprev, Exluton, Harmonet, Jasmine, Jasminelle, Jasminellecontinu, Levonorgestrel, Ludeal Gé, Meliane, Melodia, Mercilon, Microval, Milli-Anovlar, Milligynon, Minesse, Minidril, Miniphase, Minulet, Moneva, Nordette, Ogyline, Ortho Novum 1/35, Phaeva, Planor, Qlaira, Tetragynon, Tri-Minulet, Triella, Trinordiol, Trinordiol 21, Varnoline, Yasmine and Yaz.
  • You can get the contraceptive implant. The only one in the market is Nexplanon.
  • You can get the contraceptive injectable/shot, including Depo-Prodasone, Depo-Provera SAS 150mg/ml and Noristerat.
  • You can get an IUD. You can have copper IUD or hormonal IUD (Mirena or Jaydess).

Costs

Without French insurance (Sécu), most brands of the pill will cost between 2 and 15 euro for a month's supply. If you have Sécu, some pill brands are partially covered, along with Depo-Provera and diaphragms. The patch, rings (like Nuvaring), spermicide and cervical caps are not covered by Sécu, so you'll need to pay 100%.[2]

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here. Copper IUDs can also prevent pregnancy up to 5 days after unprotected sex.

Laws & Social Stigmas

In France, you can obtain emergency contraception (the morning after pill: "pilule du lendemain") without a prescription. There are no age restrictions. If you are under 18 years old, pharmacists must give you the emergency contraception for free (just tell him/her your age). Pharmacists cannot refuse to sell the emergency contraception to you. They can just ask you some questions to check that the emergency contraception fits your situation.

What to Get & Where to Get It

You can obtain EC in pharmacies and family planning centers. There are also some French websites where you can buy EC online.

  • If you want emergency contraception (the morning after pill in France). You can purchase ellaOne (take 1 pill within 120 hours after unprotected sex). It's currently considered the most effective EC available.[3]
  • Other dedicated emergency contraception brands that you can find in France are Levonorgestrel Biogaran 1500 (available from a pharmacist without a prescription; take 1 pill within 120 hours after unprotected sex) and NorLevo 1.5mg (available from a pharmacist without a prescription; take 1 pill within 120 hours after unprotected sex). You can also take Anthia (available from a pharmacist without a prescription; take 2 pills within 120 hours after unprotected sex).[4]
  • If you can't access emergency contraception, you can use oral contraceptives as EC. For progestin-only pills, you can take Microval (take 50 pills within 120 hours after unprotected sex). You can also used combined progestin-estrogen pills as replacement EC but remember that, in 28-day packs, only the first 21 pills can be used. To do this, you can take Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Minidril or Nordette (for either of these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). [5]
  • If you get an IUD, it can also prevent pregnancy after unprotected sex. You should visit the "Contraception (Birth Control)" section for details.

Costs

LNG: € 6,75 (as of 2013); UPA: € 18,88 (as of 2015). If you have a prescription, 65% of EC costs are reimbursed. You can typically get EC for free at family planning clinics or if you're under 18.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Note about PEP: in France, PEP is given at most within 48 hours. If you've been exposed, go to the Emergency service of the nearest public hospital to get it. It is fully covered but the social security. In case of problems, call Sida Info Service (0800 840 800, free call from landline).

Laws & Social Stigmas

In France, there are no travel restrictions related to HIV status. You can enter the country without presenting medical certificates. If you take a test ad learn that you're HIV positive, and if you're a foreigner, you will not be deported. French hospitals are required to treat anyone in need, and high-quality specialized treatment centers can be found at university hospitals. [6] Furthermore, in Paris, there appears to be very little social stigma attached to STI testing. It is seen as a normal and healthy choice made by responsible adults.

Regarding HPV, according to the HPV Information Centre, it's estimated that 4.7% of French women are infected with HPV-16/18. Furthermore, 75.6% of invasive cervical cancer cases in France are attributed to HPV 16 or HPV 18. Fortunately, the country has a nationwide vaccination program.[7]

In French, AIDS is "SIDA" (Syndrome d'immunodéficience acquise), HIV is "VIH" (Virus de l'immunodéficience humaine) and HIV-positive person is "séropositif" (male) or "séropositive" (female).

Testing Facilities

For local recommendations, visit the city pages, like the Paris page.

Support

  • SOS Hepatites: This is a hepatitis group that is a member of the World Hepatitis Alliance. T: +33 143 672 640. Address: 190 Bd de Charonne. 75020, Paris, France.
  • AIDES National: This is a national AIDS organization that provides social support, legal support, needle exchange, etc. Address: Tour Essor, 14, rue Scandicci, 93508 Pantin, Phone: +33 1 4183 4646.
  • Sida Info Service : Counselling hotline, Phone: +33 1 4183 4277
  • Act Up-Paris: This is the Paris branch of the HIV/AIDS activist group. Address: B. P. 287, 75525 Paris cedex 11, Phone: +33 1 4806 1389
  • Positifs: This is a website for people with HIV/AIDS and an association formed in 1989. Website is in French and English.
  • Sidaction: A French group of businesses, researchers, and doctors who raise funds for HIV research, prevention programs and organizations
  • Site du C.R.I.P.S.: This French-language site has a list of worldwide events related to HIV/AIDS, hepatitis, etc.

Costs

Free and anonymous testing places are available in big enough cities. In other areas, or for quicker results, any doctor can fill up a prescription for a test that can be taken at a local lab. In this latter case, both the visit to the doctor and the tests are 65% covered by the social security.

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • If you have a yeast infection, you can ask the pharmacist for Fluconazole.
  • The word for "(UTI) urinary traction infection" in French is: "IVU (Infection des voies urinaires)." For a female urine sample, you can say "Prélèvement ďurine chez la femme."
  • In France, there is a PrEP program in place. According to PrEPWatch, "In January 2016, full reimbursement by France’s health system became available for Truvada as PrEP, along with counselling and follow-up. Daily PrEP can now be prescribed for anyone assessed as needing it or intermittent PrEP is available for MSM, as studied in the IPERGAY trial."[8] For more information on PrEP access in France, click here.
  • In France, there has been a national HPV vaccination program since 2007. It targets young people, ages 11-14.[9]

Costs

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here, and to learn more about natural periodic protection in general, click here.

Laws & Social Stigmas

What to Get & Where to Get It

You can buy pads, tampons and menstrual cups in France. For pads and tampons, you'll find them in grocery stores, chain store markets and in some pharmacies. You can find 100% cotton tampons in health food stores, but they're more expensive. If you're looking for menstrual cups, they are available in many pharmacies and stores in Paris and other French cities. You can also buy DivaCups at Boutique Bio, Raniana or Vivre-Mieux.com. For LadyCups, check out LadyTeen, LadyCup.fr, and CTOOBIO. For Lunette, check out Lunacopine. For the Meluna brand, check here Meluna.

Usage

You can easily find tampons and menstrual pads in french supermarkets and pharmacies. Even though tampons without applicators are much more common, you can easily find tampons with cardboard or plastic applicators. If you use cups, there is a crowd-sourced database of cupsafe places: Clean Your Cup. Cupsafe places are places like pubs, restaurants, museums, libraries, universities, whose toilets are equiped with a tap on the inside to rinse the cup freely.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

You can either do a gynecological exam (and pap test) with a "gynécologue"(gynecologist), with a "médecin généraliste" (physician), or with a "sage-femme" (midwife). And you can consult a "centre de planning familial", a family planning and advisory centre for advice and support.

To find a respectful and non-judging gynecologist, you can use this website that allows to locate them in France and/or by city, and to know the price they apply : https://gynandco.wordpress.com/trouver-une-soignante-2/trouver-une-soignante/

Costs

The consultation cost is 28 € with a gynecologist and 23 € with a midwife. A pap smear test costs 15,40E. Most of tests and consultations are partially covered if you have the french health insurance (= "sécurité sociale") (70%) and a private health insurance.

in some non profit associations, like The Planning familial, consultations and test are free if you are a minor (under 18), or for adults women without health insurance (migrants for example).

Pregnancy

Laws & Social Stigmas

In France, women receive 16 weeks of maternity leave with 100% wage coverage.

What to Get & Where to Get It

Costs

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

The Mouvement Français pour le Planning Familial (Planned Parenthood) with the help of the government is running a national phone number : (+33) 0800 08 11 11. The call is free and anonymous and counselors will answer you about abortion procedures, your questions and will provide you with address of healthcare facilities they know are good abortion providers. [10]

PLEASE BE CAREFUL : Several french websites which look officials and offer a counseling phone number are run by anti-choice organization. They will give women fake information and try their best to scare the women so they don't abort. They might also call you back on your phone or your parents to talk to you again. A few of them : ivg.net, ecouteivg.org, avortementivg.com.. [11]

Laws & Social Stigmas

In France, abortion, or "“Interruption Volontaire de Grossesse” (IVG), is legal for up to 14 weeks after pregnancy (i.e. week 12 of gestation, week 14 after first day of last menstrual period). During this period, all reasons for an abortion are accepted, including to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, risk of fetal impairment, economic or social reasons, or available on request. However, there are certain protocols to follow. Before a voluntary abortion, women are offered counseling. If they are non-emancipated minors, they are required to seek counseling. During this consultation, women will meet with a person who "has satisfied qualified training as a marriage counselor or any other qualified person in a facility for information, consultation, or family counseling, a center for planning or family education, a social service, or another approved organization." Once the consultation is complete, women will receive a certificate of counseling. If minors wish to keep this consultation confidential or not share this information with their parents, they may choose any adult to serve as a referral.[12]

As stated in the law, "If, after the consultations provided for in articles L. 2212-3 and L. 2212-4, the woman renews her request for a termination of pregnancy, the physician must request a written confirmation from her".[13] There is no mandatory reflexion time anymore between the 1st appointment and the written confirmation of consent[14]

In terms of facilities and physicians, physicians are not required to perform voluntary abortions. However, if they refuse to offer services, they must inform prospective patients of facilities/physicians that will perform abortions. Note that abortions may only take place in health facilities, public hospitals or private hospitals. The only exception is if an agreement has been made between the practitioner or a center for family education, family planning or a health center, and legal facilities will be determined by the State Council.[15] Since 2016, midwife are allowed to provide medical abortion.

French abortion laws were significantly liberalized in 2014. In the past, abortions were only permitted when continuing the pregnancy would put “her in a situation of distress.” With the changes, women could access abortions on request.[16]. In 2016, the one week "reflexion period" was abolished. Under present law, only those women who have sought counseling are required to wait two days before they confirm their wish for an abortion. However, some hospitals will require a letter from a physician or family counselor before making an appointment. This is not legal, but widely required.

As detailed in a UN Report, "The most recent development in French abortion law was occasioned by the activities of a small number of anti-abortion protesters. In the early 1990s, they began a campaign of harassment of clinics where abortions were performed and of persons performing abortions. They blockaded and invaded a number of hospitals and tried to discourage individual physicians from performing abortions. To respond to such attacks, the Government in late 1992 enacted legislation establishing new criminal penalties in the Penal Code to combat disruptive activities. Under these provisions, persons who prevent or attempt to prevent a voluntary termination of pregnancy by disrupting access to or the free movement of persons into and out of clinics or hospitals by threatening or engaging in any act of intimidation against medical and non-medical personnel are subject to fines and imprisonment ("Délit d'entrave à l'IVG" / illegal interference to abortion). The provisions also apply to acts directed towards abortion counselling and requests for abortion and allow organizations established to protect the right to contraception and abortion to join as a party in suits brought against such obstruction."[17] Since 2016, the law against illegal interference ("Délit d'entrave à l'IVG") was extended to wesbites which appears to be run by healthcare facilities or government but give fake information to women and try to prevent them to access abortion service. [18]

What to Get & Where to Get It

If you are seeking an abortion in France, you can first visit a doctor (gynecologist or GP) or, better yet, go to a family planning center (CPEF). They will give you a counseling session (which is optional if you're an adult) and a medical certificate. Some clinics will ask for a two day "reflexion" period before you actually get the abortion (the law is somewhat unclear about this) but the one week reflexion period was abolished in January 2016. They can usually speed up the process if you're close to the 12 week gestation deadline. When looking for information in French regarding IVG, make sure you consult official governmental websites ending with .gouv.fr as there are many anti-abortion websites being promoted on search engines which divulge false information. http://www.ivg.social-sante.gouv.fr/ is the main official website which lists all the places where you can go if you want to get an abortion or are thinking about getting one. From what we have heard and given the militant history of these places, if you're in Paris then the main Planning Familial HQ (10, rue Vivienne, 75002 PARIS, 01 42 60 93 20) and the clinique les Bluets (Hôpital Les Bluets - Trousseau, 6, rue Lasson,75012 PARIS) are two good places but there are plenty of others. You usually don't need an appointment. There is also a free and anonymous helpline 0 800 08 11 11 set up by the government and operated by the Planning Familial.

In order to obtain an abortion, women have to make two appointments. If the woman is a non-emanciped minor (under 18), the consent of the parent is not required : she can have a abortion without her parents or legal represent knowing about it. The minor will, however, have to come with a person above 18 to the appointments (who can be a friend, other member of family or even a volunteer from Planning Familial/Planned Parenthood).[19] [20]

During the 1st appointment with a doctor or a midwife, the healthcare provider will explain the procedure, give a prescription to do a ultrasound to date the pregnancy as well as other medical acts if they are necessary. The healthcare provider will then give the patient a certificate of the first medical appointment. If the healthcare provider do not provide abortion service, he is obliged to give the name of a healthcare provider who offer abortion services. Women will also be offered a counseling appointment with a qualified counselor. If the woman is under 18, the counseling appointment is mandatory. [21]

Once the required medical examinations are done, the woman can go to the second appointment. She can make the appointment as soon as she wants, as there is no mandatory reflexion time anymore [22]. According to the state of the pregnancy and what the woman want, she will choose the type of abortion she will have : medical abortion (with "abortion pills") and surgical abortion ("in-clinic"). Then the woman will sign her written consent to undergo abortion and the healthcare provider will give her the second certificate of medical appointment. If the woman chooses the medical abortion (possible up to 7 week of gestation/9 weeks pregnancy), she may take the first pill during the secon appointment. This pill will stop the pregnancy but will not induce bleeding. The woman will be given the second pills she will have to take two days later (she can take them at home or at a healthcare facilities).

If she chooses the surgical abortion (possible up to 12 weeks of gestation/14 weeks of pregnancy), she will have to make an appointment to a healthcare facilities that offer surgical abortion. The surgical abortion method uses vacuum aspiration technic. The woman will undergo general or local anesthetic and the operation will last only a few minutes. The patient will be at the healthcare facility for a few hours in total. [23] [24]

After the medical or surgical abortion, the patient has to make one last appointment 14 to 21 days later to check that the pregnancy is completly over. She will be offered a psychosocial consultation if she wants. [25]

Costs

Under France's social security, abortions (medical or surgical) as well as the required examination (ultrasound, blood test...) are 100% covered, if the practitioner's prices are Secteur 1 “tarif conventionné.”[26] The recommended follow-up visits, which typically happen 3 weeks after the abortion, are also covered.


[27]

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

Costs

Other French Pages by city

Rennes

List of Additional Resources

References