The Effect of Access to Emergency Contraceptive Pills on Women's Use of Highly Effective Contraceptives: Results From a French National Cohort Study

摘要

We examined changes in contraceptive behaviors after emergency contraception (EC) pill use. A nationally representative cohort of 2863 French women was studied to identify 272 instances of EC pill use. In 71% of the cases, we found no changes in contraceptive practices from the time of EC pill use to 6 months later: 41% of women continued use of highly effective methods and 30% continued less effective methods. Only 8.4% switched from highly effective to less effective methods.Improved access to emergency contraception (EC) pills has been shown to increase their use. EC pills contain progestin alone or in combination with estrogen; they can be taken up to 5 days after an act of unprotected intercourse to prevent pregnancy. In France, the 1999 introduction of a dedicated EC pill available without a prescription resulted in a 72% increase in use. Critics of increasing availability of EC pills have expressed concerns that easier access could have a negative effect on use of highly effective contraceptives, such as hormonal methods, an intrauterine device, or sterilization. We used longitudinal data to examine changes in women's contraceptive practices in the 6 months following EC pill use in a representative cohort of French women.