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There are many types of contraceptive methods available in France. All contraceptives are obtained by medical prescription after a visit to a family planning specialist, a gynecologist or a midwife. An exception to this is emergency contraception, which does not require a prescription and can be obtained directly in a pharmacy.
In the context of a pro-natalist narrative after World War I, contraception and abortion were heavily reprimanded in France. A law from 1920 defined abortion as a crime, subject to prison or the death penalty. This law was applicable to both the person performing the abortion and the person having the abortion. This law also forbade the "propaganda of any birth control methods" [1]
The Catholic church was heavily against any methods of contraception and with France being predominantly Christian, access to contraception took a long time to be accepted. In 1968, Pope Paul VI, took a position against any form of family planning and birth control. This marked a split for a lot of Christians at the time who believed there was too much interference from the Church in their private life and body autonomy. Furthermore, it highlighted the gap between the Church's official line and the reality of a need for better access to family planning.
The legalization of birth control occurred in France in 1967, when the Neuwirth Law lifted the ban on birth control methods on December 28, 1967, including oral contraception. It legalized the free prescription of the contraceptive pill. [2]
In 1973, the Movement for the Freedom of Abortion and Contraception (MLAC) was created. [2] From 1974 onwards, the pill has been reimbursed by the social security system in France.
In 1999, the morning-after pill (or emergency contraception pill) was available in pharmacies without prescription. Two years later in 2001, the Aubry law on abortion in France and contraception was adopted. [3] The statutory period for abortion is fixed to 12 weeks and not only 10. Minors can be accompanied by an adult of their choice to obtain an abortion.
In 2022 France began to introduce free birth control to women between the ages of 18 and 25 years in order to reduce the number of unwanted pregnancies in the age group. [4] The French government will provide access to birth control pills, intrauterine devices, contraceptive patches and injectable birth control. [5]
In 2023 France announced free access to male condoms for people aged between 18 and 25 years old. Pharmacies will provide free packets of 6, 12 or 24 condoms. This measure is part of a broader plan from the French Ministry for Health to have access to better sexual health. Female condoms however are not free. [6]
In France, a prescription is required to obtain hormonal birth control.
In France, there are various means of contraception.
The pill is the most well-known and the most-used means of contraception in France. There are different pills. A visit to a gynecologist is required for a prescription and to see which type of pill is most suitable. While it is the most used means of contraception, it is important to note that, in France, fewer women are using the pill. [9] This is due to the debate related to the risks of 3rd and 4th generation pills, [10] and also to the development of alternative and less restrictive means of birth control.
The contraceptive implant is a small stick put in place under the skin. The implant contains the same hormones as contraceptive pills. These hormones are diffused directly into the blood and suppress ovulation. The advantages are that it is easy to put in place, efficient and discreet. It is possible to keep the same implant for three years. In France, contraceptive implants have been available since 2001. [11] The implant can be bought in pharmacies, costs €106.76 and is reimbursed up to 65% by Social Security. The implant, its insertion and removal are free for women under 18 years old in the planning centers of public hospitals.
The patch can be used for four consecutive weeks and should be applied on the stomach, the shoulders or the lower back. It should never be applied near a breast. A box of patches can be bought in pharmacies with a prescription, and costs around €15 but is not reimbursed by the Social Security. [12]
Condoms are also used in France. There are two kinds of condoms: male and female. It is easy to find male condoms in France in pharmacies, convenience stores, café/tobacco shops, or vending machines. [13]
Spermicides are substances in the form of gel or capsules inserted in the vagina, which inactivate or destroy the spermatozoa. In France, spermicides are available without prescription but they are not reimbursed by Social Security. [14]
There are also intrauterine devices (IUD): There are copper IUDs or hormonal IUDs. The insertion of an IUD is done by a gynecologist or a midwife. The intrauterine Device (IUD) must first be prescribed by a doctor or midwife. The price depends on the type of IUD: for the copper IUD, it is around €30 and for the hormonal IUD, it costs €125,15. Both are reimbursed up to 65% by Social Security. [15]
Injectable progestin is a synthetic progestin (medroxyprogesterone) injected intramuscularly every three months. It is effective for 12 weeks. Each dose costs €3,44 and it is reimbursed up to 65% by Social Security. [16]
Diaphragms are generally made of latex or silicone. They slide into the vagina, in contact with the cervix, to prevent the passage of sperm to the inside of the uterus. They can be inserted in advance and are reusable. [17]
The vaginal ring is a flexible porous plastic ring that contains a combination of estrogen and progestin. The advantage compared to the pill is that it does not need to be remembered daily. It costs €16 and is available in pharmacies with a prescription, but it is not reimbursed by Social Security. [18]
Sterilization can be a female (tubal ligation) or a male sterilization (vasectomy). It is definitive. The intervention can be only operated after a reflection period of four months after the first consultation. [19]
Natural methods are another means of contraception, without hormones: Ogino method, temperature method, Billings method, withdrawal. Natural methods are free but they can be imprecise and not always reliable. [20]
There are also two kinds of emergency contraception. The morning after pill must be taken within 72 hours of unprotected sex and is available in pharmacies. The intrauterine device (IUD) may also be used as an emergency contraception up to five days after unprotected intercourse to prevent pregnancy.
A copper intrauterine device (IUD), also known as an intrauterine coil or copper coil or non-hormonal IUD, is a type of intrauterine device which contains copper. It is used for birth control and emergency contraception within five days of unprotected sex. It is one of the most effective forms of birth control with a one-year failure rate around 0.7%. The device is placed in the uterus and lasts up to twelve years. It may be used by women of all ages regardless of whether or not they have had children. Following removal, fertility quickly returns.
Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy.
Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand names Plan B One-Step and Julie, among others, it is useful within 72 hours of unprotected sex. The more time that has passed since sex, the less effective the medication becomes, and it does not work after pregnancy (implantation) has occurred. Levonorgestrel works by preventing ovulation or fertilization from occurring. It decreases the chances of pregnancy by 57–93%. In an intrauterine device (IUD), such as Mirena among others, it is effective for the long-term prevention of pregnancy. A levonorgestrel-releasing implant is also available in some countries.
A contraceptive patch, also known as "the patch", is a transdermal patch applied to the skin that releases synthetic oestrogen and progestogen hormones to prevent pregnancy. They have been shown to be as effective as the combined oral contraceptive pill with perfect use, and the patch may be more effective in typical use.
A hormonal intrauterine device (IUD), also known as an intrauterine system (IUS) with progestogen and sold under the brand name Mirena among others, is an intrauterine device that releases a progestogenic hormonal agent such as levonorgestrel into the uterus. It is used for birth control, heavy menstrual periods, and to prevent excessive build of the lining of the uterus in those on estrogen replacement therapy. It is one of the most effective forms of birth control with a one-year failure rate around 0.2%. The device is placed in the uterus and lasts three to eight years. Fertility often returns quickly following removal.
Vaginal rings are polymeric drug delivery devices designed to provide controlled release of drugs for intravaginal administration over extended periods of time. The ring is inserted into the vagina and provides contraception protection. Vaginal rings come in one size that fits most women.
Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original hormonal method—the combined oral contraceptive pill—was first marketed as a contraceptive in 1960. In the ensuing decades, many other delivery methods have been developed, although the oral and injectable methods are by far the most popular. Hormonal contraception is highly effective: when taken on the prescribed schedule, users of steroid hormone methods experience pregnancy rates of less than 1% per year. Perfect-use pregnancy rates for most hormonal contraceptives are usually around the 0.3% rate or less. Currently available methods can only be used by women; the development of a male hormonal contraceptive is an active research area.
Controversy over the beginning of pregnancy occurs in different contexts, particularly as it is discussed within the debate of abortion in the United States. Because an abortion is defined as ending an established pregnancy, rather than as destroying a fertilized egg, depending on when pregnancy is considered to begin, some methods of birth control as well as some methods of infertility treatment might be classified as causing abortions.
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Contraceptive security is an individual's ability to reliably choose, obtain, and use quality contraceptives for family planning and the prevention of sexually transmitted diseases. The term refers primarily to efforts undertaken in low and middle-income countries to ensure contraceptive availability as an integral part of family planning programs. Even though there is a consistent increase in the use of contraceptives in low, middle, and high-income countries, the actual contraceptive use varies in different regions of the world. The World Health Organization recognizes the importance of contraception and describes all choices regarding family planning as human rights. Subsidized products, particularly condoms and oral contraceptives, may be provided to increase accessibility for low-income people. Measures taken to provide contraceptive security may include strengthening contraceptive supply chains, forming contraceptive security committees, product quality assurance, promoting supportive policy environments, and examining financing options.
Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include injections, intrauterine devices (IUDs), and subdermal contraceptive implants. They are the most effective reversible methods of contraception because their efficacy is not reliant on patient compliance. The typical use failure rates of IUDs and implants, less than 1% per year, are about the same as perfect use failure rates.
Progestogen-only contraception relies on progestogens alone to achieve contraception. It is one of the two major types of hormonal contraception, with the other major type being combined hormonal contraceptive methods. There are several progestogen only contraceptive methods:
A contraceptive implant is an implantable medical device used for the purpose of birth control. The implant may depend on the timed release of hormones to hinder ovulation or sperm development, the ability of copper to act as a natural spermicide within the uterus, or it may work using a non-hormonal, physical blocking mechanism. As with other contraceptives, a contraceptive implant is designed to prevent pregnancy, but it does not protect against sexually transmitted infections.
Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unintended pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only became available in the 20th century. Planning, making available, and using human birth control is called family planning. Some cultures limit or discourage access to birth control because they consider it to be morally, religiously, or politically undesirable.
An intrauterine device (IUD), also known as intrauterine contraceptive device or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth control (LARC). One study found that female family planning providers choose LARC methods more often (41.7%) than the general public (12.1%). Among birth control methods, IUDs, along with other contraceptive implants, result in the greatest satisfaction among users.
Birth control in the United States is available in many forms. Some of the forms available at drugstores and some retail stores are male condoms, female condoms, sponges, spermicides, and over-the-counter emergency contraception. Forms available at pharmacies with a doctor's prescription or at doctor's offices are oral contraceptive pills, patches, vaginal rings, diaphragms, shots/injections, cervical caps, implantable rods, and intrauterine devices (IUDs). Sterilization procedures, including tubal ligations and vasectomies, are also performed.
Reproductive coercion is a collection of behaviors that interfere with decision-making related to reproductive health. These behaviors are meant to maintain power and control related to reproductive health by a current, former, or hopeful intimate or romantic partner, but they can also be perpetrated by parents or in-laws. Coercive behaviors infringe on individuals' reproductive rights and reduce their reproductive autonomy.
Women's reproductive health in the United States refers to the set of physical, mental, and social issues related to the health of women in the United States. It includes the rights of women in the United States to adequate sexual health, available contraception methods, and treatment for sexually transmitted diseases. The prevalence of women's health issues in American culture is inspired by second-wave feminism in the United States. As a result of this movement, women of the United States began to question the largely male-dominated health care system and demanded a right to information on issues regarding their physiology and anatomy. The U.S. government has made significant strides to propose solutions, like creating the Women's Health Initiative through the Office of Research on Women's Health in 1991. However, many issues still exist related to the accessibility of reproductive healthcare as well as the stigma and controversy attached to sexual health, contraception, and sexually transmitted diseases.
Contraceptive rights in New Zealand are extensive. There are many options available to women seeking contraception. There are also options for men. Government funding keeps the cost of most types of contraception low in most cases. Family planning options in New Zealand are generally in keeping with the United Nations stance towards sexual and reproductive rights although the country has received criticism in some aspects.
Menstrual suppression refers to the practice of using hormonal management to stop or reduce menstrual bleeding. In contrast to surgical options for this purpose, such as hysterectomy or endometrial ablation, hormonal methods to manipulate menstruation are reversible.