Fifty years of legal contraception in France: diffusion, medicalization, feminization

Reproductive behaviours in France changed over the course of the eighteenth century: a large share of the many couples seeking to control their family size began using the withdrawal method. The result was that contrary to the situation in neighbouring countries, French birth rates began falling sharply—a cause for considerable concern. The country’s defeat to Prussia in 1871, followed by the massive loss of life during World War I, gave weight to pro-birth discourses calling for the “repopulation” of France. The fear of “French depopulation” reached its apogee on 31 July 1920, when the parliament passed a law prohibiting pro-contraception propaganda and the sale of “anti-conceptional” devices.

By legalizing access to “anti-conceptional” methods, the Neuwirth law paved the way for the diffusion of the pill and IUD in France and for the medicalization of contraception. From “traditional” contraception practiced privately within the couple, the French shifted to a model of medical contraception managed by women themselves. Once illegal and illegitimate, the use of contraceptive methods now follows a set of implicit rules: condom during sexual debut, the pill in a stable relationship, and the IUD once the desired number of children has been reached. Given that this norm prompts women to use a certain contraceptive method for each age and relationship status, it can be said to prevent them from choosing their preferred type of contraception. It also reinforces the notion that contraception is primarily – not to say entirely – the woman’s responsibility.

In 2012, after the media covered a lawsuit brought by a young stroke victim who blamed the new generation oral contraception for her condition, France experienced a “pill scare”. From 2010 to 2013, birth control pill use fell 18%. The trend seems a lasting one, as use of oral contraception continued to fall (by almost 9%) from 2013 to 2016, though it is still the most widely used method in France. The pill scare amounts less to a health crisis than to a change in the social image of oral contraception over the generations: young women are less likely than their elders to think of the pill as liberating. While, on average, women are not more likely now than before to think of it as a constraint, those who did find it so were the first to stop using it. The controversy around birth control pills seems to have galvanized reluctant pill users to change methods. It may therefore have facilitated a new kind of relationship between female contraception users and health care professionals, in which the emphasis is now on informing women patients and taking their preferences into account. Last, the pill scare has provided an opportunity to probe the question of men’s responsibility for contraception. Not only does the French contraceptive norm limit women’s choice of method, but according to that norm, the mental and material burden of managing the couple’s fertility falls primarily on the woman. Though men too have benefited from improved fertility control, it is as if they had no role to play, and there are few specifically male birth control methods [6]. Meanwhile, men who show some interest in using those methods are perceived as suspect [7] given how fully contraception has come to be considered a woman’s affair in France – a radical change in only fifty years’ time.

Methods of contraception used by women aged 18 to 44 in France, 1968 to 2013

Source: Le Guen Mireille, Roux Alexandra, Rouzaud-Cornabas Mylène, Fonquerne Leslie, Thomé Cécile, Ventola Cécile, le Laboratoire junior Contraception&Genre, 2017, « Fifty years of legal contraception in France: diffusion, medicalization, feminization », Population and Societies, 549, p. 1‑4.

Contact: Le laboratoire junior Contraception&Genre (Cité du Genre, HALL, USPC)

Online: December 2017