[Medical termination of pregnancy for psychosocial distress: Overview of practices in France]

In France, each year, approximately 150 women request a medical termination of pregnancy due to psychosocial distress. There are no recommendations regarding their assessment process. Subjectivity can play an even greater role than in the case of a somatic pathology, and differing opinions can sometimes cause tension within teams. The primary objective was to describe these patients' access to care and the stages of their care pathway. The secondary objective was to identify decision-making factors.

Online questionnaire survey of the 48 CPDPNs in France.

Of the 48 CPDPNs, 44 (91.7%) responded, 23 (52.3%) reported receiving fewer than 5 requests per year, and 10 (22.7%) reported receiving more than 10. Among the centers that responded to this question, 38/43 (88%) reported receiving patients systematically and 5 centers under certain conditions: gestational age, context of the request, or only upon referral from a psychiatrist. Fifteen centers (34%) have an evaluation protocol. After evaluation, 57% of centers report accepting the majority of requests. The most frequently cited factors in favor of acceptance were pregnancy resulting from rape, severe psychological distress, a history of violence, and the young age of the patient. The factors in favor of refusal were perceived ambivalence, lack of evident distress, and non-compliance with the assessment process.

It seems that not all CPDPNs in France systematically receive women who request a termination of pregnancy due to psychosocial distress. Regardless of the final decision concerning the continuation of the pregnancy, medical, social, and psychological support should be offered. A relevant multidisciplinary protocol could enable equitable treatment of patients.