10 years evolution of induced abortion practice in Paris region
Bibliographic record
Abstract
Abstract Background In France, induced abortion (IA) has first been authorized in 1975. To improve access to abortion care services, several legislative reforms have been adopted with the most recent consisted of removal of the mandatory cooling off period before abortion, reimbursement of all expense related to abortion and approval for midwives to perform medical abortion. All these changes could affect practice of IA. The objective of the present research was to describe the evolution of abortion practices in Paris region from 2007 to 2017 Methods Exhaustive data from Paris region healthcare insurance system was use to account for all abortions performed among women living in this region Results More than 50,000 abortions are performed in Paris region each year, which represents over one-quarter of national IA. This number decreased from 58,319 in 2007 to 52,080 in 2017 and the abortion rate has decreased over the past decade (19 IA per 1000 reproductive age women in 2007 and 17‰ in 2017). However, there was found territorial disparity with higher rate of abortion in the lower incomes municipalities (22‰ in the poorer Paris region municipality in 2017). This rate remained higher among women aged 18-34 (27.8‰ in 2007 vs 24.6‰ in 20017). Abortion methods have shifted over the years, with increase of medical abortion (47% in 2007 vs 67% in 2017) and decrease of surgical abortion. The analyses have also shown that the average gestational age at the time of abortion decreased with 65% of abortion performed before 9 weeks of amenorrhea in 2007 and 80% in 2017. There rate of abortion performed by liberal practitioners increased from 15% in 2007 to 33% in 2017 Conclusions The measures such as removing the mandatory cooling-off period, increasing number of medical professional involved in abortion have improved access to abortion care services result in much early IA and higher rate of medical abortion. Improved access to contraception might partly explain the decline in IA rate over time Key messages Legislative reforms such as removing the mandatory cooling-off period have improved access to abortion care services. In this last decade, abortion among Paris women are performed much early and there are increasing number of medical professional involved in abortion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".