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The French pill scare and the reshaping of social inequalities in access to medical contraceptives

机译:法国药丸吓跑和再培养了医学避孕药的社会不平等

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摘要

While the consequences of various "pill scares" have been relatively well-documented in the public health literature revealing a drop in pill use and a rise in unplanned pregnancies and abortion rates, researchers rarely considered that these controversies would affect women contraceptive practices differently according to their social background. Indeed, social differentiations in reaction to "pill scares" could contribute to reinforce the social gradient in the use of contraceptive methods and choice of visiting the health professionals who prescribe them. These could contribute to an increase in health inequalities on access to contraceptive methods. Using data from three state nationally representative cross-sectional surveys conducted in France in 2010, 2013 and 2016, we studied the changes in women's contraceptive uses around the French "pill scare" that occurred in 2012–2013. We focused on the changes in the use of all contraceptives available under medical prescription (called medical contraceptives) on one hand, and on each specific method (pill, IUD, implant, patch or vaginal ring, and female sterilization) on the other hand according to the women's social background. We saw a social gradient in contraceptives changes. The decline in the use of contraceptive methods available under medical prescription was particularly marked for women from lower and higher classes in which we observe a decrease in pill use between 2010 and 2013, whereas it was observed only between 2013 and 2016 among middle class women. Moreover, while some women from upper class shifted from pill to IUD between 2010 and 2013, this was not the case for their less privileged counterparts. As a consequence, it seems that the French "pill scare" led to the reshaping of social inequalities in access to medical contraceptives.
机译:虽然各种“药丸围巾”的后果在公共卫生文献中呈现出露出药丸用途的下降,但在计划生育的怀孕和流产率上升,研究人员很少认为这些争议会根据诸如此外的矛盾措施他们的社会背景。实际上,对“药丸恐惧”的社会分歧可以有助于加强在使用避孕方法方面的社会梯度和参观规定的卫生专业人员的选择。这些可能有助于增加避孕方法的健康不平等。在2010年,2013年和2016年,使用来自法国的三国国家代表横断面调查的数据,我们研究了2012 - 2013年发生的法国“丸吓人”周围女性避孕药的变化。我们专注于在一方面使用医疗处方(叫做医疗避孕药)的所有避孕药的变化,另一方面对每只特定方法(药丸,IUD,植入物,贴片或阴道环)另行对妇女的社会背景。我们在避孕药中看到了社会渐变。在医疗处方提供的避孕方法的下降尤其标记为低级和较高阶级的妇女,其中我们观察到2010年至2013年之间的药丸使用减少,而仅在2013年和2016年间中产阶级妇女之间观察到。此外,虽然来自2010年至2013年的上层阶级的一些女性从避孕药转移到IUD,但这并非如此特权的对应物。因此,似乎法国“药丸吓唬”导致了对获得医疗避孕药的社会不平等的重塑。

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