Le Guen M, Agius R, Panjo H, Moreau C
Centre de recherche en Démographie, Université catholique de Louvain, 1 Place Montesquieu, L2.08.03, 1348 Louvain-la-Neuve, Belgique; Institut National d'Études Démographiques, 9, Cours des Humanités, 93300 Aubervilliers, France.
Soins primaires et prévention, Centre de Recherche en Épidémiologie et Santé des populations, U1018, Inserm, 94807 Villejuif, France.
Rev Epidemiol Sante Publique. 2020 Nov;68(6):347-355. doi: 10.1016/j.respe.2020.10.003. Epub 2020 Nov 6.
In December 2012, a media controversy about negative side-effects of oral contraceptives on women's health, also called "pill scare", broke out in France. While several analyses highlighted a change in women's contraceptive practices following this media controversy, no analysis has been conducted to determine the possible changes in their choices of health professionals and its repercussions on their contraceptive use.
Our study is based on data from three population-based cross-sectional surveys conducted in 2010, 2013 and 2016 (Fecond 2010, Fecond 2013 and Baromètre Santé 2016) that collected information on women's contraceptive practices and the specialties of the health professionals having prescribed the methods they were using.
Between 2010 and 2016, women went to a gynecologist or a midwife more often than to a general practitioner for prescription of a reversible contraceptive method. However, their changes in visiting prescribers did not explain the changes in their contraceptive practices observed over the period. In 2016, access to health professional remained largely dependent on women's socio-demographic characteristics: older ones and those from a more privileged social background or living in urban areas were more likely to consult a gynecologist for prescription of their contraceptive method. On the other hand, consultations of midwives for contraceptive prescription were more frequent among women with children and among those who relied on public health insurance alone.
Following the "pill scare" that occurred in France in December 2012, the decision by some women to use the IUD instead of the pill led them to change health professionals, and also led practitioners to change their prescribing practices.
2012年12月，法国爆发了一场关于口服避孕药对女性健康产生负面副作用的媒体争议，即所谓的“避孕药恐慌”。尽管多项分析强调了这场媒体争议后女性避孕方式的变化，但尚未进行任何分析来确定她们在选择医疗保健专业人员方面可能发生的变化及其对避孕使用的影响。
我们的研究基于2010年、2013年和2016年进行的三项基于人群的横断面调查（2010年生育调查、2013年生育调查和2016年健康晴雨表调查）的数据，这些调查收集了有关女性避孕方式以及为她们开具所用避孕方法的医疗保健专业人员专业的信息。
2010年至2016年期间，女性在开具可逆性避孕方法处方时，去看妇科医生或助产士的次数比去看全科医生的次数更多。然而，她们在就诊医生方面的变化并不能解释同期观察到的她们避孕方式的变化。2016年，获得医疗保健专业人员的服务在很大程度上仍取决于女性的社会人口特征：年龄较大的女性、社会背景更优越或居住在城市地区的女性更有可能咨询妇科医生以获取避孕方法的处方。另一方面，有孩子的女性以及仅依靠公共医疗保险的女性更频繁地咨询助产士以获取避孕处方。
2012年12月法国发生“避孕药恐慌”后，一些女性决定使用宫内节育器而非避孕药，这导致她们更换了医疗保健专业人员，也促使从业者改变了他们开具处方的做法。
