{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:55:10Z","timestamp":1790823310210,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Perspect Sexual Reproductive"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In France, abortion is available without restriction as to reason until 14\u2009weeks of pregnancy. Beyond this limit, medical authorization is required and \u201cmedical termination of pregnancy\u201d is permitted for fetal malformation or serious danger to the woman's health, including from \u201cpsychosocial distress.\u201d Little is known about how professionals interpret psychosocial distress criteria and which women are deemed eligible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is based on 6\u2009months of ethnographic fieldwork (2021\u20132022) in two French university hospital maternity wards. Data collection included observations of abortion care, 12 multidisciplinary team meetings, and interviews with 25 healthcare professionals (gynecologists, general practitioners, psychiatrists, psychologists, social workers, and midwives). Analysis of case files from 27 past medical termination of pregnancy requests provided additional data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Healthcare professionals pathologized reproductive nonconformity by constructing certain women as unfit for motherhood based on intersecting marginalization\u2014class, racialization, age, disability, and family structure. Approval depended on intersecting characteristics distancing women from the \u201cgood mother\u201d norm: poverty, violent relationships, incarceration, substance use, and psychiatric diagnosis. Professionals medicalized social inequality while regulating abortion seekers' emotions and behaviors. Gynecologists invoked fetal interests to refuse requests and conditioned approval on long\u2010acting contraception or sterilization. Professional hierarchies shaped decisions, with gynecologists dominating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Medical gatekeeping of second\u2010 and third\u2010trimester abortion care reinforces reproductive stratification by granting access primarily to marginalized women judged incapable of motherhood while subjecting them to contraceptive coercion. Physicians construct reproductive legitimacy through collective practices, transforming social and political issues into medical problems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psrh.70095","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:56:04Z","timestamp":1790819764000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unfit Mothers Only: Medical Gatekeeping of Second\u2010 and Third\u2010Trimester Abortion in France"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7347-0945","authenticated-orcid":false,"given":"Rapha\u00ebl","family":"Perrin","sequence":"first","affiliation":[{"name":"Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), Inserm  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Center for Reproductive Rights \u201cThe World's Abortion Laws \u201d 2024 https:\/\/reproductiverights.org\/the\u2010worlds\u2010abortion\u2010laws\/."},{"key":"e_1_2_11_3_1","unstructured":"J.Chaput \u201cLes interruptions m\u00e9dicales de grossesse : des avortements pas comme les autres ? Contours et acc\u00e8s \u00e0 l\u2019IMG en France au d\u00e9but du XXIe si\u00e8cle[doctoral dissertation] \u201d(Universit\u00e9 Paris 1 Panth\u00e9on\u2010Sorbonne forthcoming 2026)."},{"key":"e_1_2_11_4_1","volume-title":"Conceiving the New World Order: The Global Politics of Reproduction","author":"Colen S.","year":"1995"},{"key":"e_1_2_11_5_1","volume-title":"Conceiving the New World Order: The Global Politics of Reproduction","author":"Ginsburg F. D.","year":"1995"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10999949.2017.1389634"},{"key":"e_1_2_11_7_1","volume-title":"Killing the Black Body: Race, Reproduction, and the Meaning of Liberty","author":"Roberts D.","year":"1997"},{"key":"e_1_2_11_8_1","volume-title":"Reproduction and Society","author":"Solinger R.","year":"2014"},{"key":"e_1_2_11_9_1","volume-title":"Reproduction and Society","author":"Kallianes V.","year":"2014"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/13505068241262122"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1525\/9780520963207"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2018.1450973"},{"issue":"3","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1080\/09612025.2019.1695354","article-title":"\u2018The Objectionable Injectable\u2019: Recovering the Lost History of the WLM Through the Campaign Against Depo\u2010Provera","volume":"29","author":"Lambert C.","year":"2020","journal-title":"Women's History Review"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2022.2048408"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1360780420909139"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470.2012.675046"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1515\/9781400827503"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0306312711426596"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3917\/rfas.232.0107","article-title":"Au tribunal des femmes enceintes. Enqu\u00eate sur les pratiques d'interruption m\u00e9dicale de grossesse pour d\u00e9tresse psychosociale","volume":"2","author":"Perrin R.","year":"2023","journal-title":"Revue Fran\u00e7aise des Affaires Sociales"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2022-201712"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691050902842741"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022146516669970"},{"key":"e_1_2_11_23_1","unstructured":"C.Mahiou \u201cInterruption m\u00e9dicale de grossesse pour motif psychosocial: analyse r\u00e9trospective des demandes dans un centre de diagnostic pr\u00e9natal \u00e0 Marseille entre 2007 et 2021\u201d (dissertation Facult\u00e9 des sciences m\u00e9dicales et param\u00e9dicales de Marseille 2022)."},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1086\/227049"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.4000\/books.editionsehess.1794"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.04.007"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/01639625.2013.800423"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1363\/48e8516"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.3478"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112704"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625180902745130"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.07.006"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0891243215590101"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2020.02.009"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2017.1293707"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.12.009"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112531"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14193"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.05.009"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14699"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.7.1089"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.VV-D-18-00128"},{"key":"e_1_2_11_43_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12910-025-01207-3","article-title":"How to Deal With the Criterion of Severe Mental Distress for Late Termination of Pregnancy? A Scoping Literature Review and a Content Analysis of Clinical Ethics Consultations","volume":"26","author":"Wetterauer C.","year":"2025","journal-title":"BMC Medical Ethics"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-4446.70057"},{"key":"e_1_2_11_45_1","volume-title":"Professional Dominance: The Social Structure of Medical Care","author":"Freidson E.","year":"1970"}],"container-title":["Perspectives on Sexual and Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psrh.70095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/psrh.70095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psrh.70095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:56:07Z","timestamp":1790819767000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/psrh.70095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":44,"alternative-id":["10.1111\/psrh.70095"],"URL":"https:\/\/doi.org\/10.1111\/psrh.70095","archive":["Portico"],"relation":{},"ISSN":["1538-6341","1931-2393"],"issn-type":[{"value":"1538-6341","type":"print"},{"value":"1931-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2025-11-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"psrh.70095"}}