Contraception In Canada Research Articles

New Options in Contraception

In the last few years, more contraceptive options have been introduced into Canada, expanding choice for our patients. Patients and clinicians have experienced changes in how health care is accessed and delivered. For patients, this includes an increased use of the internet and social media as sources of information. Also included are changes to insurance coverage for contraception, such as provincial coverage for some (British Columbia, Quebec and Manitoba), and private insurance offered through school or an employer. In 2015 the cost of universal coverage of contraception in Canada was $157 million, while the cost to provide health care for unintended pregnancies was $320 million, providing a strong economic argument for this change. For clinicians, the pandemic provided an opportunity for many to switch to increase the use of virtual care options, and toward efficiencies in practice.

Public coverage of Period Products and Contraception in Canada

Public coverage of Period Products and Contraception in Canada

Can youth-engaged research facilitate equitable access to contraception in Canada? The qualitative study protocol for the Ask Us project

IntroductionThere is little to no evidence in Canada on the barriers that youth face when accessing contraception. We seek to identify the contraception access, experiences, beliefs, attitudes, knowledge, and needs...

Regulatory approval time for hormonal contraception in Canada, the United States and the United Kingdom, 2000-2015: a retrospective data analysis.

Access to a wide range of contraceptive methods improves prevention of unintended pregnancy by ensuring the best method fit for each individual. We compared approval times of new hormonal contraceptives by Health Canada, the US Food and Drug Administration (FDA), and the UK Medicines and Healthcare Products Regulatory Agency (MHRA). We obtained dates of applications to Health Canada, the FDA and the MHRA for contraceptive methods approved from January 2000 to January 2015. We used public data sources and direct correspondence, and excluded generic versions of previously approved drugs. The primary outcome of interest was median time to approval for novel hormonal contraceptives. Secondary outcomes included the median time to approval for all hormonal contraceptives and the number of approved hormonal contraceptives comparing countries studied, as well as the median time for approval of novel compared with nonnovel hormonal contraceptives within each country. During this period 16 contraceptives were approved in Canada, 26 in the US and 14 in the UK. Applications for novel contraceptives were initiated later in Canada, and time to approval was longer in Canada than in the US (p = 0.03). The median time to approval for all contraceptives in Canada was 529.5 (interquartile range [IQR] 420.8 to 784.0) days, compared with 396.0 (IQR 308.0 to 594.5) days in the US and 341.0 (IQR 244.8 to 512.2) days in the UK. No subdermal implant contraceptives are approved in Canada. Canadian women wait longer for novel contraceptive methods and have fewer options. Canada could improve population health by addressing the regulatory barriers associated with the unmet need for contraception. Facilitation for approval of a contraceptive implant, and improvement to prolonged novel drug approval times, could support Canadians to plan and space their pregnancies.

Chapter 1 Contraception in Canada.

Chapter 1 Contraception in Canada.

Contraception in Canada: a review of method choices, characteristics, adherence and approaches to counselling.

Contraception is a significant concern for Canadian women of child-bearing age, their partners and their health care providers. In this narrative review we provide information on current trends and recent changes in Canadians' choices of contraceptive methods. We review the characteristics of contraceptive methods available in Canada, with an emphasis on hormonal methods and newer options such as the transdermal contraceptive patch, the vaginal contraceptive ring and the levonorgestrel-releasing intrauterine system. We also discuss adherence to contraception as well as approaches to counselling to promote adherence and to reduce the risk of sexually transmitted infections in the context of contraception.

Identifying Barriers to Emergency Contraception Use Among Young Women from Various Sociocultural Groups in British Columbia, Canada

Despite advances related to the provision of emergency contraception in Canada, particularly the granting of independent prescriptive authority to pharmacists in 2000, little is known about the ways in which women perceive potential barriers to using it. In 2004, an ethnically diverse sample of 52 women living in Greater Vancouver participated in interviews that were analyzed for an assessment of women's knowledge, attitudes and experiences related to emergency contraception, with particular attention to the ways in which ethnicity affected their stories. Participants generally misperceived emergency contraception as an abortifacient, and often mistakenly thought that it has long-term effects on health and fertility. Knowledge gaps regarding reproductive physiology impeded clear understanding of when it is most effective. Participants also reported receiving subtle and sometimes overtly stigmatizing messages from providers when they sought emergency contraception. Asian and South Asian women were particularly concerned about negative interactions with providers; for example, they feared that female providers from their sociocultural community might recognize, chastise or gossip about them. Institutional policies (e.g., a Catholic hospital's refusal to provide the method), coupled with low awareness of pharmacists' prescriptive authority, also created barriers to use. Women's ability to benefit from emergency contraception is hampered by lack of knowledge and conservative cultural or social mores. Serious contextual and structural shifts are required before woman-centered approaches to provision of the method become the norm.

APPLEBY, Brenda Margaret, RESPONSIBLE PARENTHOOD: DECRIMINALIZING CONTRACEPTION IN CANADA

APPLEBY, Brenda Margaret, RESPONSIBLE PARENTHOOD: DECRIMINALIZING CONTRACEPTION IN CANADA. Toronto, Ontario: University of Toronto Press, 1999,301 pp., $24.95 softcover / $60.00 hardcover. Reviewed by: ANNETTE BURFOOT* Brenda Margaret Appleby provides a detailed and well researched investigation into a crucial moment in Canada's modern history: the mid to late 1960s when the exchange of contraceptive information and devices was decriminalized. Appleby's particular focus is on Christian social ethics that we find intertwines with a complex public morality concerning the control of birth. This complexity arises from medical practitioners concerned with the criminalization of their growing involvement in family planning and global pressures that equated low birth rates with social progress. The analysis of the intersection of birth control with the Canadian state has been made before, notably with Angus McLaren and Arlene Tigar McLaren's The Bedroom and the State (second edition, 1997). That this key text had to be updated from its 1980 version to include new reproductive technologies and the rise in paternity suits is testament to the continued centrality of reproduction to state politics. The recent Canadian and US federal elections also pivoted at times around that most sticky of contemporary reproductive issues: abortion. Appleby's careful examination of the period leading up to and including the 1969 Canadian legislative reform complements and extends the McLarens' work (which focuses primarily on the early part of the twentieth century and includes abortion). Appleby builds her case from a careful and thorough analysis of a selection of material from events leading up to the legislative reform, chiefly submissions to the federal government's Standing Committee on Health and Welfare. The submissions include those from the Canadian medical and bar associations, family planning and social welfare representatives, national women's groups, and churches. Some of the more interesting facts to appear in this investigation involve the varying motives of public support for decriminalizing contraception. For example, the Canadian Medical Association comes out in support of the legal reform (Canadian doctors had been dispensing contraceptive advice for years before 1969 and the development of The Pill in 1960 provided doctors with a highly effective contraceptive for the first time). However, it becomes clear from the submissions that the chief reason for supporting legal reform is the fear of physician liability under the old Criminal Code. For Appleby, the most relevant finding from the submissions is that the churches, including the Roman Catholic Church, support the state sanction of birth control as an example of responsible parenthood. Surprisingly, it was the Canadian Catholic Conference that made the argument to distinguish civil and moral law and supported the decriminalization of contraception as a move towards the common good. …