Availability of contraceptive choice

Abstract

When considering contraceptive choice for women in the UK, a Pandora’s box of social, political and ethical dilemmas is opened. Contraceptive choices should be motivated by a woman’s right to control her fertility. However, increasingly, we are presented with headlines suggesting that the UK is failing in this challenge on a daily basis. Sexual behaviours in all ages of the population have seen a shift towards more liberal practice from the 1980s at the height of public awareness of HIV. There has been an increase in sexually transmitted infections, particularly chlamydia, and rising abortion rates. 1 This is particularly true in the under-18 and over40 age groups, with teenage pregnancy rates now among the highest in Europe. To combat this public health problem, publications including ‘Next Steps’ guidance from the Department of Health and Department for Children, Schools and Families actively promote ‘equitable access to the full range of contraception methods and provision of high quality advice and support’. A key to the success in improving contraceptive choices is through understanding our local and often diverse populations. Although teenagers typically obtain their information from their peers, or more successfully from television campaigns, they are the highest users of local family planning or sexual health clinics. The percentage of women over 40 attending family planning or sexual health clinics is low, suggesting they are either not seeking advice or attending their local GP. Cultural diversity and religious beliefs also contribute signifi cantly to freedom of access and choices. 2