Australia, we need to talk about contraception

Sigrid Firth Blog, Media

The introduction of the contraceptive pill was one of the most significant revolutionary forces in human history. It has changed the way we work, how we plan our families, the nature of our societies and provided greater control for women over their destinies.

Australian women were early adopters of the Pill when it was released in 1961. Since that time, great strides have been made in more effective contraceptive options. Yet as a nation we have not been so quick to adopt these other options.

Of the 208 million pregnancies worldwide each year, roughly 41% are unplanned. The stats are similar in Australia, with just under half of all pregnancies being unplanned. More than 60% of Australian women who have had an unintended pregnancy were using either the Pill or condom at the time of conception. This national data has also been confirmed through a recent file audit of 1,000 Marie Stopes Australia patients that revealed 57% of patients seeking an abortion were using the Pill, condom or short acting injections at the time of conception.

The Pill and the condom are important and valid contraception methods. In fact the condom is still the only form of protection (other than abstinence) against STIs. They do, however, rely on perfect use, which, as we know, is not always guaranteed.

Long acting reversible contraceptives, or LARCs as they are often called, are less user-dependent forms of contraception. They include progesterone-only implants and hormonal and copper IUDs. They are often referred to as a set-and-forget method that last for a number of years and can be 99% effective.

Despite all of this, take up of LARCs in Australia has been slow and this is for a variety of reasons.

Education is critical when it comes to our health care workforce, especially GPs given their privileged and trusted position as health advisors. As health care professionals, we have a responsibility to have better quality conversations with patients about contraception and the variety of options available that suit a woman’s lifestyle. Recent research in Australia suggests that GPs are often not comfortable talking about forms of contraception other than the Pill, that they believe IUDs are more suited to women who have completed their families, and that they did not feel they had the right training and information.

From a community perspective, there is still a lot more work in education needed about contraception, sex and respectful relationships. With more and more young Australians opting for the withdrawal method, we could be facing an increase in unplanned pregnancies if we do not address this knowledge gap.

Parents also have a key role to play in this issue by educating themselves and having honest conversation about sex and contraception with their children. It can often be an awkward conversation but one that needs to be coupled with a good knowledge of modern contraception and an open mind.

On World Contraception Day, it’s a reminder that we need to get better at talking about contraception and educating our community about the many varied forms of birth available today.