Trends and determinants of use of long acting reversible contraception use among young women in France Results from three national surveys conducted between 2000 and 2010

Capsule:
Long-acting reversible contraceptive use remains low among young women with little progress in the last decade, pointing to the failure of family planning policies in altering contraceptive norms in France.

Authors:
Caroline Moreau, M.D., Ph.D., Aline Bohet, Danielle Hassoun, M.D., Michel Teboul, M.D., the FECOND working group, Nathalie Bajos, Ph.D.

Volume 100, Issue 2, Pages 451-458, August 2013

Abstract:

Objective:
To investigate trends and determinants in the use of long-acting reversible contraceptives (LARCs), including intrauterine devices and implants, over the last decade among young women in France.

Design:
Data drawn from three cross-sectional national probability surveys.

Setting:
Not applicable.

Patient(s):
A total of 1,204 women, ages 15 to 29, who are at potential risk of an unintended pregnancy in 2000; 1,921 in 2005; and 1,281 in 2010.

Intervention(s):
None.

Main Outcome Measure(s):
Logistic regression models were used to explore trends in LARC use since 2000 and to examine determinants of LARC use in 2010.

Result(s):
A minority of women were using LARC methods, with a significant increase between 2000 and 2010, from 4.6% to 6.4%. The odds of LARC use in 2010 were higher among women 20 to 29 years, parous women, women with a history of unintended pregnancy, women in difficult financial situations, smokers, and women in the care of a gynecologist.

Conclusion(s):
This study shows that little progress has been made in LARC use among young women in France, despite these methods being widely available and reimbursed by the national health system.

  • Amanda N. Kallen

    Thank you to Dr. Moreau and colleagues for this interesting paper. Unfortunately, it seems based on your results that poor utilization of LARC is not a problem limited to our practice in the US. I did have two questions about your results. One, any ideas as to why the association between positive smoking status and LARC use? And second, are there any programs like CHOICE that are being initiated in France to address these issues? It would be interesting to compare data on the efficacy of such programs in the context of our different healthcare delivery systems.

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