The medical construction of gestational age and its effects on abortion access

Bibliographic Data

ID4593387
AuthorsRaphaël Perrin (0009-0006-7347-0945, Centre Européen de Sociologie et de Science Politique, corresponding author)
Year2025
Volume382
Pages118377
Publication date2025-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2025.118377
PMID40645035
OpenAlexW4411991418
LanguageEN
Citations received2
References cited44

This article examines how medical practices construct gestational age and affect access to abortion care. While abortion laws typically establish gestational limits, the clinical determination of gestational age remains a medical responsibility, requiring healthcare professionals to interpret and apply these limits through various dating methods and practices. Based on ethnographic observation in three French abortion centers and interviews with 133 healthcare professionals, this study reveals significant variations in dating practices. These variations occur at three levels: the moment chosen for dating (consultation versus procedure day), the method chosen for dating and the measurement rules applied when pregnancies are dated by ultrasound. The study demonstrates that these technical choices result from negotiations and sometimes conflicts among physicians with different dispositions regarding women's reproductive autonomy and fetal interests. Consequently, a woman might be considered eligible for legal abortion in one center but beyond the legal limit in another. This creates a previously undocumented form of inequality in abortion access that operates through seemingly objective medical instruments. The analysis contributes to understanding how healthcare professionals serve as "legal intermediaries" who must interpret the law through technical devices to apply it. It also reveals how medical instruments, while appearing as objective clinical tools, function as political devices that define in practice what abortion and the right to abortion are. These findings have significant implications for reproductive health equity and policy implementation beyond the French context

Abortion · Autonomy · Context (archaeology · Family medicine · Geography · Health care · Medical abortion · Misoprostol · Political science · Pregnancy · Historical and Scientific Studies · Historical Studies on Reproduction, Gender, Health, and Societal Changes · Law · Medicine · Reproductive Health and Contraception

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