Contraception in France
Nearly all women wishing to avoid pregnancy in France use a means of contraception. The pill is the most widely used method, but practices are becoming more diverse.
All women of childbearing age who are neither sterile nor pregnant, have heterosexual relations and do not wish to become pregnant are concerned by contraception. In France this is the caes of over seven in ten women aged 15 to 49, and almost all of them use a contraceptive method. Only 3% use no method at all.
Le paysage contraceptif en évolution
Depuis 2000, le paysage contraceptif a connu plusieurs évolutions notables en France. La loi Aubry du 4 juillet 2001 a notamment permis aux mineures de recourir au médecin de leur choix sans autorisation parentale ; elle a aussi légalisé la stérilisation à visée contraceptive. De nouvelles méthodes hormonales de contraception comme l’implant, le patch et l’anneau vaginal sont devenues disponibles ces dernières années.
L’enquête Fecond, réalisée en 2010 et reconduite en 2013 par l’Inserm et l’Ined, permet d’examiner les dernières tendances en matière de contraception, les méthodes utilisées selon l’âge des femmes et leur milieu social et les pratiques des professionnels de santé. L’enquête montre un recul de la contraception orale, accéléré par la crise des pilules de 3e et 4e générations.
Methods of contraception used in France in 2013 by women’s age (Population & Societies, 511, Figure 2)
The pill is losing ground
France is among countries where pill use is highest. Legalized in 1967 by the Neuwirth Law and reimbursed by France’s universal health insurance system since 1964, the pill long symbolized women’s “sexual liberation”: control over their own fertility.
And the pill is still the most-used contraceptive method in France, but it is not as far ahead of other methods as it used to be. The 2012-2013 pill scare surrounding new-generation birth control pills led a considerable proportion of women to abandon oral contraception. The polemic around third- and fourth-generation pills and the risk of deep vein thrombosis has accelerated an unprecedented fall in pill use that began in the 2000s.
Between 2010 and 2013 in France, oral contraception use fell from 50% to 41% of women aged 15-49 concerned by contraception, a decrease entirely explained by the fall in use of new-generation pills from 19% to 10% in three years. Few women turned to second-generation pills following the scare; their use rose by only one point in three years, from 22% to 23%, a finding that suggests a general disaffection for oral contraception. The decrease is particularly marked among young women under 30. Young women aged 25-29 have turned instead to the IUD or condoms.
Changes in contraceptive methods used in France from 2010 to 2013 by women’s age (Population & Societies, 511)
Practices are diversifying
Women in France are turning increasingly to methods other than the pill. The IUD is the second-most widespread method now. But it is still often prescribed only to women who have already had children or are over age 30. Conversely, young women at the start of sexual life more often use condoms, which also offer protection against sexually transmitted diseases. Condoms—combined with the pill in some cases—are the third-most preferred method, but they are not reimbursed by the health insurance system. The proportion of women for whom condoms are the preferred birth control method declines with age.
Access to contraception may be unequal
The cost of some methods not reimbursed by the health insurance system may represent an obstacle for women in financial difficulty. Such women and women with little or no education are more likely not to use any contraceptive method. Following the new-generation pill scare, women managers—the main pill users—turned to the IUD, some to th so-called natural methods (rhythm, withdrawal). Women manual workers, already less likely to be pill users, did not modify their practices.
Overall, financially secure women went from using new versions of oral contraception to earlier versions while financially insecure women, particularly those born in Sub-Saharan Africa, turned to natural methods, much less effective than medical methods.
N. Bajos, M. Rouzaud-Cornabas, Henri Panjo, Aline Bohet, Caroline Moreau and the Fécond team, May 2014, “The French Pill Scare: Towards a New Contraceptive Model?” Population & Societies, 511
Contact : Nathalie Bajos
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