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.