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Hum. Reprod. Advance Access originally published online on June 28, 2007
Human Reproduction 2007 22(9):2422-2427; doi:10.1093/humrep/dem184
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Contraceptive failure rates in France: results from a population-based survey

C. Moreau1,2,3,4,6, J. Trussell1,5, G. Rodriguez1, N. Bajos2,3,4 and J. Bouyer2,3,4

1 Office of Population Research, Princeton University, Wallace Hall, Princeton, NJ 08544, USA 2 Institut National de la Santé et de la Recherche Médicale, Unit 822 Epidemiology, Demography and Social Sciences, Le Kremlin-Bicêtre, F-94276, France 3 Institut National d'Etudes Démographiques, Paris, France 4 Univ Paris-Sud, Faculté de Médecine, Le Kremlin-Bicêtre, F-94276, France 5 The Hull York Medical School, Hull, UK

6 Corresponding address. Tel: +1-609-258-6968; Fax: +1-609-258-1039; E-mail: cmoreau{at}princeton.edu

BACKGROUND: Despite the widespread use of highly effective contraceptive methods in France, one in every three pregnancies is unintended, of which 65% occur while using contraceptives. In the USA, 49% of pregnancies are unintended, half of which result from contraceptive failure. This study provides estimates of method-specific failure rates among French women.

METHODS: We use data from the 2000 Cocon Study, a population-based cohort, comprising a representative sample of 1689 women aged 18–44 years who described their contraceptive history. Piecewise-constant hazards models were used to estimate method-specific contraceptive failure rates during the first 5 years of contraceptive use. A random effect was introduced to take into account the fact that some women contribute more than 1 contraceptive episode. These same models were used to assess the effects of socio-demographic characteristics on the probability of contraceptive failure among pill, intrauterine device (IUD) and condom users.

RESULTS: Overall, 2.9% of women experienced a contraceptive failure in the first year of use and 8.4% in the first 5 years of use. The IUD had the lowest first year failure rate (1.1%), followed by the pill (2.4%), the condom (3.6%), fertility awareness methods (periodic abstinence or safe period by temperature) (7.7%), withdrawal (10.1%) and spermicides (21.7%). These failure rates varied little by user characteristics.

CONCLUSIONS: Lower failure rates among French women compared with those reported for US women suggest differences in contraceptive practices which need to be further explored.

Key words: contraceptive failure/contraceptive efficacy/population-based survey/France

Submitted on April 27, 2007; resubmitted on May 17, 2007; accepted on May 25, 2007.


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