Contraception

Contraception is the act of preventing pregnancy using pharmaceutical, procedural or behavioural methods (Bansode 2023). Contraception is primarily used to prevent pregnancy, but some methods are commonly used for other purposes such as menstrual management and treatment of certain health conditions. Other specific methods, such as condoms, can provide protection against sexually transmitted infections. Unless otherwise specified, ‘contraception’ in this topic refers to contraception methods and devices used for any reason, including and beyond pregnancy prevention. 

A review of the literature and stakeholder consultations identified 6 critical data gaps relating to access to contraception in Australia along with a series of priority areas for data development to start addressing these gaps (Table 4). These gaps and priority areas for data development have directly informed the development of the Data Strategies for the 5 Priority Topics.

Table 4: Contraception: critical data gaps and priority areas for data development

Data gap

Priority areas for data development

1. Comprehensive national data on contraception use. Limited capacity to disaggregate information to understand reasons for contraceptive use (including pregnancy prevention, menstrual disorder management, STI prevention)

Monitor contraception use, including by type and reasons for use.

2. Provider capacity and service delivery for contraception, particularly long-acting reversible contraception (LARC)

  1. Monitor the geographic distribution of contraception prescribers and services by method and prescriber or service type.
  2. Monitor the number, proportion, type and distribution of health care providers trained and actively delivering LARC insertion and removal, and permanent contraception services.

3. Health care provider knowledge, training and confidence

  1. Monitor training provided for general practitioners and other health care providers.
  2. Assess health care provider knowledge and prescribing practices, including alignment with contraception and clinical guidelines.

4. User out-of-pocket cost and government expenditure

Monitor out-of-pocket costs and government expenditure on contraception products and services, including PBS-subsidised and private prescriptions, emergency contraception and MBS-subsidised services.

​5. Patient access, autonomy, and quality of contraception care

  1. Monitor patient autonomy and agency in contraception decision-making, access and use. Identify barriers (to provision and uptake) where preferences are unmet.
  2. Monitor access to pain relief during LARC insertion and removal procedures.
  3. Track wait times for LARC insertion and removal procedures, and permanent contraception procedures.
  4. Evaluate the prevalence and impact of reproductive coercion and abuse in relation to contraception, including screening practices, and effects on contraception use.

6. Health literacy

  1. Measure and monitor contraception health literacy.
  2. Measure and monitor access to trustworthy and appropriate (culturally, linguistically, practically) information resources.

Additional data development priorities

The following data gaps were also identified but were considered to be out of scope for data development at this time:

  • reproductive coercion and abuse response protocols and available supports
  • condom sales, and trends in community availability
  • contraception counselling across care settings, and health care provider type
  • length of time using the contraception method, including LARC
  • contraception consultation and procedure wait times in non-hospital care settings.

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