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France

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Revision as of 19:51, 26 February 2017 by TikaW (talk | contribs) (Added content on the maternity leave)
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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 pads 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.

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

  • For a list of contraceptive options available in France, click here.
  • If you don't yet have a prescription for birth control, it can be easily obtained by visiting an ob/gyn. 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. We know that Implanon is available. We're not sure about other brands of implants.
  • You can get the contraceptive injectable/shot, including Depo-Prodasone, Depo-Provera SAS 150mg/ml and Noristerat.
  • You can get an IUD. We know Mirena is available, but we don't know which other brands are available.

Costs

Without French insurance (Sécu), most brands of the pill will cost 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.

Laws & Social Stigmas

In France, you can obtain emergency contraception (the morning after pill) without a prescription. There are no age restrictions.

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.

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]

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 4493 1605
  • 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

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.

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. Note that it's much more common to see tampons without applicators, like OB, than tampons with applicators. If you do find tampons with applicators, there will be a good chance that they are cardboard applicators. 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.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

Costs

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.

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 advised to seek 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.[10]

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; he may only accept this confirmation after the expiration of a week following the first request of the woman, except when the term of twelve weeks risks being passed. This confirmation can only occur after the expiration of a delay of two days following the discussion provided for in article L. 2212-4; this delay may be included in that of the week provided for above."[11]

Note that you may be required to get a second doctor's opinion before the abortion is fully authorized.

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.[12]

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, signed by French President François Hollande, women could access abortions on request.[13]

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. 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."[14]

What to Get & Where to Get It

If you are seeking an abortion in France, you should first visit a doctor or gynecologist. They will give you a counseling session (which is optional if you're an adult) and a medical certificate. Then, you'll need a second medical opinion (one week later) from another doctor. They can usually speed up the process if you're close to the 12 week gestation deadline.

Costs

Under France's social security, abortions (medical or surgical) are 100% covered, if the practitioner's prices are Secteur 1 “tarif convetionné.” The recommended follow-up visits, which typically happen 3 weeks after the abortion, are also covered.[15]

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

Costs

List of Additional Resources

References