Contraceptives in Europe, accessibility and availability


in Europe, accessibility and availability

Medard M. Lech

School of Public

Health, National Postgraduate Center of Medical


Warsaw, Poland

It is important that couples have ready

access to a vast range of methods of birth control so they can freely exercise

their choice in the matter of procreation. There are two ways to exercise the

freedom of choice; effective contraception or abortion. Abortion due to various

reasons should stay as a last resort method of births control.  In the countries of central and eastern

Europe and in the newly independent states induced abortion was commonly used

as contraceptive method due to lack of modern contraceptives. In these

countries in 1994, 43% of women aged 15-44 years used no contraceptive method,

27% relied on withdrawal and 6% the rhythm method, and in 1996 the

contraceptive prevalence rate was still only 35%. As a consequence of such

situation, the number of induced abortions was usually much higher than in

western European countries. The increase of use modern contraceptives is

strictly correlated with decline of abortion rates, for example the annual

number of abortions in the Czech Republic declined by 65% from 107,100 in 1990

to 37,200 in 1999  as the modern

contraceptives use increased seven folds in the same period of time.

The teenagers abortion and birth rates in

Norway decreased consecutively by 34% and 24% in the period 1999-2000 (in

comparison with the period 1997-1998) only by single implementation of

contraceptive counseling and OC prescription by public health nurses in youth


Prevalence of contraception

in Europe (in women aged 15-49 year) vary from 20-23% in Lithuania, Moldova,

Ukraine to 74-78% in Denmark, France, Norway and Sweden. In some of countries

modern methods of contraception are even less popular (Romania; all method –

57%, but modern methods only – 14%). Total fertility rates all over Europe – in

recent years – have fallen down, and in the most countries have reached the

value of <1.9 (excluding Albania, Iceland, Cyprus, UK and Turkey) and it is difficult to think that this have happened due to decreasing of sexual activity of people living in Europe, it happen due to increase in use of birth control methods, especially in use of modern contraception.  Full range of modern contraceptives is available in the most of

European countries, but in the eastern and central part of  the Continent access to contraceptive

implants is very limited.  Level of the

accessibility of modern contraceptives depends of various factors, in a poorer

settings (especially for adolescents) the price of contraceptive pills packet

may be the barrier difficult to overcome. There is no universal European policy

regarding the reimbursement of contraceptives costs. In some countries – for

youngsters – oral contraceptives are disposed free of charge (f.e. France, UK),

in many other countries (f.e. Poland) is hard to find even one oral

contraceptive brand name on a list of for 

refund  (even partial) from the

government or social security accounts. 

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