Contraceptive use in France in 2012 and 2022: a descriptive analysis of two repeated nationwide cross-sectional studies.

BACKGROUND

A decrease in oral contraceptive use, newly available methods, and the emerging role of midwives suggested meaningful changes in contraception use in France. With two repeated cross-sectional studies, we aimed to describe contraception use in France in 2012 and 2022, in the total population and across age groups.

METHODS

Using the French National Health Data System (SNDS) covering 99% of the population, we identified reimbursed contraceptive use in women 15-49 years in January 2012 and 2022: combined oral contraceptives (COC), progestogen-only pill (POP), injectable progestogen, copper intrauterine device (Cu-IUD), levonorgestrel-releasing intrauterine devices (LNG-IUD), implants, sterilization. Number of users, socio-demographic characteristics and healthcare providers were assessed. Sales data accounted for non-reimbursed OC.

FINDINGS: Amid stable prevalence of contraception use (6.67 million users in 01/2012 and 6.73 in 01/2022, or 47%-46% of women aged 15-49 years), COC use decreased by a third from 54% (n = 3,602,803) to 35% of users (n = 2,370,205) while remaining the most popular method. POP and Cu-IUD use doubled, up to 19% (n = 1,293,073) and 21% of users (n = 1,428,837) users, respectively. IUD and POP have become leading methods in women 30-39 years, concerning 44% of users (n = 951,649) and 20% of users (n = 428,138) of users, respectively, while 50% of women ≥40 years (n = 1,051,066) used IUD. From <0.5% in 2012 (n = 16,154), midwives prescriptions reached 13% (n = 859,819) of total prescriptions in 2022. Social disparities in IUD use grew.

INTERPRETATION: Our findings displayed profound changes over ten years towards more hormone-free contraceptive methods.

FUNDING: The French National Health Insurance Fund (Cnam) and the French National Agency for Medicines and Health Products Safety (ANSM) via the Scientific Interest Group EPI-PHARE.