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Paris

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INTRODUCTION

Parissky.jpg

A Paris, vous trouverez une grande diversité de ressources de soins. La contraception est très facilement accessible. Vous n'avez pas besoin d'ordonnance pour obtenir une contraception hormonale, et certaines pharmacies n'acceptent pas les ordonnances étrangères, mais vous n'aurez en général pas de problème pour vous procurer des contraceptifs. La contraception d'urgence (pilule du lendemain) est disponible en pharmacie sans ordonnance. Il n'y a pas de restrictions d'âge et de nombreuses marques sont disponibles, y compris ellaOne

Concernant les menstruations, vous trouverez des serviettes hygiéniques, tampons (même des 100% coton) et coupes menstruelles, comme DivaCup et Lunette.

Pour les femmes enceintes, la France offre 16 semaines de congé maternité avec 100% du salaire. Concernant l'avortement, il est totalement légal jusqu'à 14 semaines de grossesse ou 12 semaines de gestation. Il existe de nombreuses cliniques qui effectuent des avortements, et il est même possible que la procédure soit remboursée par l'Etat.

Contraception

Pilule contraceptive achetée en France (8€ pour 3 mois)

Note : il existe de nombreux moyens de contraception, comme les DIU (dispositifs intra-utérins ou stérilets), les contraceptions orales, les patchs, les injections, les préservatifs, etc. Pour une liste complète, cliquez ici.

Lois et stigmatisation sociale

En France, vous aurez besoin d'une ordonnance pour accéder à une contraception hormonale. Selon certains témoignages, les pharmacies françaises accepteraient les ordonnances étrangères. Selon d'autres, ce ne serait pas le cas. Tout dépend donc de la pharmacie où vous allez. Si vous parlez français, cela augmentera vos chances de pouvoir utiliser une ordonnance étrangère. Les préservatifs, quant à eux, sont très faciles à trouver et utilisés; on estime que la France est le troisième pays du monde qui utilise des préservatifs couramment.[1]

Voici un témoignage personnel sur l'acquisition d'une contraception en France.

Que prendre et où le trouver

  • Pour une liste d'options de contraception en France, cliquez [1].
  • Si vous n'avez pas encore d'ordonnance pour un contraception, vous pourrez vous en procurer facilement en allant voir un gynécologue/obstétricien, un médecin généraliste ou une sage-femme. Si vous avez une ordonnance étrangère, vous devrez la prendre avec vous ainsi que la boîte vide de votre contraceptif, si possible, chez un pharmacien pour un renouvellement. Vous pouvez dire: “Pourriez-vous me dépanner avant que j’obtienne une nouvelle ordonnance?”. Le pharmacien vous donnera peut-être une réserve pour 1 à 3 mois, surtout si vous promettez d'aller voir un médecin ou une sage-femme bientôt.
  • En France, vous avez le choix entre de nombreuses pilules contraceptives, dont des pilules triphasiques, des pilules progestatives, et des pilules combinées. Les marques disponibles proviennent de nombreux pays, comme la France, l'Allemagne, les Etats-Unis, le Royaume-Uni et le Chili. Certaines des marques que vous trouverez sont 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.
  • Vous pourrez vous faire poser un implant contraceptif. Le seul sur le marché est Nexplanon.
  • Vous vouvez obtenir un contraceptif injectable, comme Depo-Prodasone, Depo-Provera SAS 150mg/ml et Noristerat.
  • Vous pouvez vous faire poser un DIU (stérilet). Vous aurez le choix entre un stérilet en cuivre ou horonal (Mirena ou Jaydess).

Coûts

Sans assurance Française (sécurité sociale dite 'sécu'), la plupart des marques de pilule vous coûteront de 2 à 15 euros pour un mois. Si vous avez la Sécu, certaines marques sont partiellement couvertes, ainsi que Depo-Provera et les diaphragmes. Le patch, l'anneau (comme Nuvaring), les spermicides et les capsules cervicales ne sont pas couverts par la Sécu, vous devrez donc les payer à 100%. .[2]

Contraception d'urgence (pilule du lendemain)

Notes importantes: La contraception d'urgence peut prévenir une grossesse jusqu'à 3 jours (72h) et parfois 5 jours (120h) après un rapport non protégé. Prenez le contraceptif d'urgence le plus tôt possible après le rapport non protégé. Si vous n'avez pas accès à la contraception d'urgence, les contraceptifs oraux peuvent être utilisés en remplacement, mais souvenez-vous de ce qui suit: 1- Seulement quelques contraceptifs peuvent être utilisés comme contraceptifs d'urgence, 2- Des contraceptifs différents nécessitent des dosages et des horaires différents pour pouvoir fonctionner en tant que contraceptifs d'urgence, 3- Vous devez uniquement utiliser les 21 premières pilules dans les packs de 28 pilules, 4- Ces contraceptifs seront probablement moins efficaces qu'une véritable contraception d'urgence. Pour des informations générales sur la contraception d'urgence, cliquez ici et ici. Les stérilets en cuivre peuvent aussi prévenir une grossesse jusqu'à 5 jours après un rapport non protégé.

Lois et stigmatisation sociale

En France, vous pouvez vous procurer une contraception d'urgence (pilule du lendemain) sans ordonnance. Il n'y a pas de restriction d'âge. Si vous avez moins de 18 ans, les pharmaciens sont obligés de vous fournir une contraception d'urgence gratuitement (il suffit de leur dire votre âge). Ils ne peuvent pas refuser de vous la donner. Ils peuvent néanmoins vous poser des questions afin de vérifier si la contraception d'urgence convient à votre situation.

Que prendre et où le trouver

Vous pouvez obtenir de la contraception d'urgence dans les pharmacies et plannings familiaux. Il y a également des sites Français où vous pourrez acheter de la contraception d'urgence en ligne.

  • Si vous souhaitez une contraception d'urgence (pilule du lendemain), pour pouvez vous procurer ellaOne (prendre 1 comprimé dans les 120h suivant le rapport non protégé). C'est actuellement le contraceptif d'urgence considéré comme le plus efficace.[3]
  • D'autres marques de contraception d'urgence que vous pouvez trouver en France sont Levonorgestrel Biogaran 1500 (disponible en pharmacie sans ordonnance; prendre un comprimé dans les 120h suivant le rapport non protégé) et NorLevo 1,5mg (disponible en pharmacie sans ordonnance; prendre un comprimé dans les 120h suivant le rapport non protégé).
  • Si vous ne pouvez pas avoir accès à une contraception d'urgence, vous pouvez utiliser un contraceptif oral habituel en tant que contraception d'urgence. Pour les pilules progestatives, vous pouvez utiliser Microval (prendre 50 comprimés dans les 120h suivant le rapport non protégé). Vous pouvez aussi utiliser les pilules combinées (progestérone et oestrogènes) en tant que contraception d'urgence, mais souvenez-vous que, dans les paquets de 28 comprimés, seulement les 21 premiers comprimés doivent être utilisés. Par exemple, vous pouvez prendre Ovral (prendre deux comprimés dans les 120h suivant le rapport non protégé, puis 2 comprimés 12 heures après). Vous pouvez aussi utiliser Minidril ou Nordette (pour chacune de ces marques, prendre 4 comprimés dans les 120h suivant le rapport non protégé, puis 4 comprimés 12 heures après).[4]
  • Si vous avez un DIU (stérilet), il peut aussi prévenir une grossesse après un rapport non protégé. Vous trouverez plus de détails dans la section "Contraception" de cette page.

Coûts

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 at any pharmacy.

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. [5] 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.[6]

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

  • "There are a number of centre de dépistage and they are all anonymous. They are also all TOTALLY FREE OF CHARGE and no carte vitale is needed. I would recommend using a Red Cross centre as they have one located right in the middle of Paris (metro: Palais Royale Musee du Louvre) and most of the people working there speak English. Not being able to speak French is NOT a problem. If you don’t speak French, they can, and will, happily ask you the questions in English. After choosing your centre you can either call them to make an appointment (they will only ask you for your surname) or you can decide to go sans RDV (without an appointment). However, sans RDV is only available on Wednesday’s between 3 pm and 6 pm and as you don’t have an appointment you will have to wait…possibly for a long time. If you decide to book an appointment you will be seen very quickly, therefore I would definitely recommend booking before. Also, you generally have to book around two weeks in advance so be prepared for a small wait!" -- Read more on this blog post about getting tested in paris
  • Figuier HIV Testing Centre: 2, rue du Figuier — métro : Saint Paul, from Monday to Friday, from 1:30 pm to 6:30 pm; by appointment at other times
  • MGEN Centre de Santé: 178 rue Vaugirard, 75015 Paris, France, 15ème, 08 20 01 28 28
  • Clinique du Mont-Louis: 11ème, Père Lachaise, 8-10 rue de la Folie Regnault, 75011 Paris, France, Phone number 08 26 30 56 56
  • La Maison du Don: Saint-Georges, 9ème, 55 rue de Châteaudun, 75009 Paris, France, Phone number 01 55 31 60 60
  • Institut Fournier : 14ème, 25 boulevard Saint-Jacques 75014 Paris, France, Phone number 01 40 78 26 00, to know the opening hours, click [2]
  • Any médecin généraliste(general practitioner) can also give you a prescription for testing of STDs. You will then have to go to a analysis lab (which are common and easy to find) to do the actual test. Results will be communicated to you a few days after. If you are enrolled in the Sécurité sociale, testing for most of the STD is covered at about 99%, as well as the GP appointment, provided you choose one conventionné secteur 1.

Support

  • SOS Hepatites: This is a hepatitis group that is a member of the World Hepatitis Alliance. Phone : +33 1 43 67 26 40
  • 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

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 d'urine 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."[7] 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.[8]

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. 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.

Usage

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. 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

In France, in any matter concerning women health, sexuality, birth control, you can go to a midwife, a primary care physician or an ob/gyn.

Costs

The price of a consultation to a midwife or a primary care physician is 23€ and an ob/gyn 28€. Those are the prices edicted by the health care. You may add sometimes (often in Paris) a variable amount (it can be around 70-80€ for an ob/gyn)

Pregnancy

Laws & Social Stigmas

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

What to Get & Where to Get It

The usual medical follow up of a pregnancy is : - 1 consult during the first trimester - 1 consult/month during the rest of a pregnancy

You can do all of these exams with a midwife, an ob/gyn or a primary care physician.

- 3 ultrasound (12 weeks, 22 weeks, 32 weeks) that you can do with a midwife specialised, or an md specialised.

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 given the option 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.[9]

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. 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."[10]

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.[11]

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.[12]. 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. 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."[13]

In February 2017, a law was passed which criminalises websites promoting anti-abortion propaganda and exerting pressure on woman seeking information regarding abortion. This is now referred to as "délit d'entrave à l'IVG".[14]

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.

Costs

Under France's social security, abortions (medical or surgical) are 100% covered, if the practitioner's prices are Secteur 1 “tarif conventionné.” 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

  • Centre LGBT, Paris
  • Human Rights Watch - Paris Office
  • La France Gaie et Lesbienne: This is an LGBTQ website with a directory of queer associations in France, Belgium and Switzerland.
  • Women in War: "a non-profit organization and think-tank focusing on the role of gender in armed conflict." Established in Paris in 2008 by international feminist academics.
  • Planning Familial (in French) a militant organisation set up in 1956 to promote the right to abortion and now more generally promotes the right to sexual education
  • Gyn&co (in French) a list of feminist and LGBTQI-friendly caregivers (OB, GP, midwives…)

References