Contraception use among sexually active women wanting to avoid pregnancy
by Tia Carpino
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Highlights
- Over the 2019-to-2020 period, 4 in 5 (79.9%) sexually active women aged 15 to 49 wanting to avoid pregnancy reported that they and their partner used contraception the last time they had sex (in the past 12 months).
- Overall contraception use among women wanting to avoid pregnancy
varied by certain characteristics. For example:
- Contraception use declined with age (from 89.6% among 15-to-24-year-old women to 74.0% among 35-to-49-year-old women).
- Compared with women in the rest of Canada, contraception use was higher among women in Quebec (85.0%), whereas it was lower among women in Alberta (74.3%).
- Recent (72.6%) and established (74.6%) immigrant women were less likely to report using contraception than non-immigrant women (81.4%).
- Women who were never married and not living common law were most likely to report using contraception the last time they had sex, at 87.7%.
- About 4 in 5 (79.7%) women aged 25 to 49 with a postsecondary certificate, diploma or degree reported using contraception the last time they had sex, compared with 72.1% of those with a high school diploma or equivalency certificate and less than two-thirds (64.6%) of those with no certificate, diploma or degree.
- Condoms (33.0%) were the most commonly used method of contraception, followed by the birth control pill (22.3%), vasectomy or tubal sterilization (15.8%), and intrauterine device (13.5%). Traditional methods (4.3%), other methods (2.4%), and other hormonal methods (2.1%) were less commonly used. Like overall contraception use, the use of different methods of contraception varied among different groups of women and their partners.
Introduction
Over half of a century has passed since the Criminal Law Amendment Act, 1968-69 decriminalized contraception in Canada. This pivotal milestone has supported women in having greater autonomy over whether (and when) or not to conceive. Still, pregnancy may occur due to incorrect and/or inconsistent use of contraception, failure of a particular contraceptive method (despite correct and consistent use), or not using any contraceptive method at all (Black et al., 2015).
Access to sexual and reproductive health care, including contraception, can facilitate decision-making regarding whether (and when) to have children.Note Recent research suggests that, in Canada, about a third of people aged 15 to 49 do not intend to have children (Statistics Canada, 2023). Further, the fertility rate has generally experienced a decline for over 15 years, reaching a new low in 2023 (Statistics Canada, 2024). The fact that people in Canada are delaying conception, having fewer children, or are choosing not to have children altogether highlights the critical need for effective contraception.
Sexual and reproductive health and rights are linked to gender equality, as reflected in a number of domestic and international agreements and frameworks, such as the Convention on the Elimination of Discrimination against Women, the 2030 Agenda for Sustainable Development and Canada’s Gender Results Framework—the Government of Canada’s vision for gender equality. Indeed, access to contraception can support women’s economic empowerment through educational attainment and labour market participation (Institute for Women’s Policy Research, 2019; United Nations Population Fund, 2023). It is in this context that the current study examines the prevalence of contraception use from the perspective of women wanting to avoid pregnancy.
Previous data and analysis have advanced our understanding of the prevalence of contraception use among women in Canada who are not trying to conceive. According to data from the Canadian Community Health Survey (CCHS), over the 2015-to-2016 period, about 1 in 4 (24.4%) sexually active women aged 15 to 49 who were not trying to conceive reported not using contraception the last time they had sex (Statistics Canada, 2019).Note Research has also highlighted that overall contraception use and the use of different methods varies according to certain characteristics, such as age, marital status, household income, and place of residence (e.g., Black et al., 2009; Contraception Access Research Team [CART], 2017; Dunn et al., 2019; Netherly et al., 2019).
In an effort to provide updated insights, this study uses data from the 2019 and 2020Note cycles of the CCHS to examine the proportion of women aged 15 to 49 who strongly agreed or agreed that it was important for them to avoid getting pregnant right now (referred to in this study as “wanting to avoid pregnancy”)Note who reported that they and a male partnerNote (hereafter referred to as “partner”) used contraception the last time they had sex in the past 12 months, as well as the methods of contraception used. Women who were currently pregnant, who did not have sex in the past 12 months with a man, or whose last sexual partner was not a man were excluded from this study. Where possible, results are disaggregated by various characteristics to shed light on contraception use among diverse groups of women wanting to avoid pregnancy.
Results
Overall contraception use
One in five women wanting to avoid pregnancy report that they and their partner did not use contraception the last time they had sex
In Canada, there were approximately 4.5 million sexually active women aged 15 to 49 wanting to avoid pregnancy over the 2019-to-2020 period. Of them, 79.9% reported that they and their partner used contraception the last time they had sex (in the past 12 months). Put differently, 1 in 5 (20.1%) reported not using contraception.
Nine in ten young women report that they and their partner used contraception the last time they had sex
The extent to which women wanting to avoid pregnancy reported that they and their partner used contraception the last time they had sex varied among different groups of women. For example, the proportion of women who reported using contraception declined with age: 9 in 10 (89.6%) women aged 15 to 24 reported that they and their partner used contraception, compared with 84.2% of 25-to-34-year-old women and 74.0% of those aged 35 to 49 (Table 1).
Among young women (i.e., aged 15 to 24) wanting to avoid pregnancy, 95.8% of 15-to-17-year-olds reported that they and their partner used contraception the last time they had sex, which was higher than among their 20-to-24-year-old counterparts (88.9%).Note
| Characteristic | Percent | 95% confidence interval | |
|---|---|---|---|
| from | to | ||
Source: Statistics Canada, Canadian Community Health Survey, 2019 and 2020. |
|||
| Age group | |||
| 15 to 24 Table 1 Note † | 89.6 | 84.3 | 93.5 |
| 25 to 34 | 84.2 Table 1 Note * | 81.6 | 86.6 |
| 35 to 49 | 74.0 Table 1 Note * | 71.7 | 76.1 |
| Province | |||
| Newfoundland and Labrador | 75.9 | 67.4 | 83.1 |
| Prince Edward Island | 80.7 | 72.8 | 87.1 |
| Nova Scotia | 77.0 | 66.6 | 85.5 |
| New Brunswick | 77.5 | 64.1 | 87.7 |
| Quebec | 85.0 Table 1 Note * | 80.5 | 88.8 |
| Ontario | 78.3 | 76.0 | 80.4 |
| Manitoba | 81.7 | 76.4 | 86.2 |
| Saskatchewan | 78.9 | 69.8 | 86.3 |
| Alberta | 74.3 Table 1 Note * | 68.2 | 79.8 |
| British Columbia | 81.7 | 78.3 | 84.8 |
| Rurality status | |||
| Rural areas | 79.8 | 76.7 | 82.7 |
| Small or medium population centres | 80.0 | 77.3 | 82.5 |
| Large urban population centres Table 1 Note † | 79.8 | 77.6 | 81.9 |
| Indigenous identity | |||
| Indigenous Table 1 Note 1 | 84.3 | 79.1 | 88.5 |
| Non-Indigenous Table 1 Note † | 81.4 | 79.5 | 83.2 |
| Immigrant status and period of immigration | |||
| Recent immigrants | 72.6 Table 1 Note * | 64.4 | 79.9 |
| Established immigrants | 74.6 Table 1 Note * | 69.7 | 79.0 |
| Non-permanent residents | 82.5 | 73.0 | 89.8 |
| Non-immigrants Table 1 Note † | 81.4 | 79.6 | 83.1 |
| Marital status | |||
| Married Table 1 Note † | 73.7 | 71.2 | 76.2 |
| Living common law | 82.9 Table 1 Note * | 79.2 | 86.1 |
| Separated, divorced or widowed and not living common law | 76.7 | 71.4 | 81.4 |
| Never married and not living common law | 87.7 Table 1 Note * | 84.4 | 90.5 |
| Household income quintile | |||
| Quintile 1 (lowest) | 78.1 | 74.3 | 81.6 |
| Quintile 2 | 80.9 | 76.6 | 84.8 |
| Quintile 3 | 77.3 | 73.0 | 81.2 |
| Quintile 4 | 82.1 | 79.0 | 84.9 |
| Quintile 5 (highest) Table 1 Note † | 80.9 | 77.7 | 83.7 |
| Highest certificate, diploma or degree (ages 25 to 49 only) | |||
| No certificate, diploma or degree | 64.6 Table 1 Note * | 50.4 | 77.0 |
| High school diploma or equivalency certificate | 72.1 Table 1 Note * | 66.5 | 77.2 |
| Postsecondary certificate, diploma or degree Table 1 Note † | 79.7 | 78.0 | 81.4 |
| Currently attending school (ages 15 to 24 only) | |||
| Yes Table 1 Note † | 90.6 | 82.9 | 95.6 |
| No | 87.5 | 79.6 | 93.2 |
Compared with the rest of Canada, contraception use is higher among women in Quebec, whereas it is lower in Alberta
Contraception use among women wanting to avoid pregnancy did not vary according to rurality status, that is, whether a woman lived in a rural area, small or medium population centre, or large urban population centre.Note However, some differences were observed according to the province of residence. Specifically, women in Quebec (85.0%) were more likely than those in the rest of CanadaNote to report that they and their partner used contraception the last time they had sex, whereas women in Alberta (74.3%) were less likely.
Contraception use is highest among women who were never married and not living common law
Almost 9 in 10 (87.7%) women wanting to avoid pregnancy who were never married and not living common law reported that they and their partner used contraception the last time they had sex, which was higher than the proportions observed among married women (73.7%), women who were separated, divorced or widowed (76.7%), and women who were living common law (82.9%).
A gap was also observed between married women and women who were living common law, with the former less likely to report using contraception than the latter (73.7% vs. 82.9%, respectively). Notably, while this pattern was observed outside of Quebec, married women (81.6%) and women who were living common law (84.7%) in Quebec were equally likely to report using contraception. This finding points to different cultural norms in Quebec versus the rest of Canada regarding common-law unions, particularly norms related to married versus common-law unions as a setting for having children (Statistics Canada, 2022).
Women with a postsecondary certificate, diploma or degree are most likely to report using contraception
Among women aged 25 to 49 wanting to avoid pregnancy, about 4 in 5 (79.7%) women with a postsecondary certificate, diploma or degree reported that they and their partner used contraception the last time they had sex, which was higher than the proportions observed among women with a high school diploma or equivalency certificate (72.1%) and among women with no certificate, diploma or degree (64.6%).
Contraception use varies according to immigrant status
The proportion of women who reported that they and their partner used contraception the last time they had sex also varied by immigrant status. Recent (72.6%) and established (74.6%) immigrant women were less likely than non-immigrant women (81.4%) to report that they and their partner used contraception the last time they had sex.
The lower prevalence of contraception use among immigrant women and their partners could be due to a number of factors that may not be directly measured using CCHS data, including religious beliefs, as well as cultural norms and attitudes, such as those related to sexual and reproductive health and gender.Note Further research would be needed to interrogate what factors—and their interplay—could be contributing to this finding.
Methods of contraception
In addition to examining contraception use at an aggregate level, it is also useful to examine the different methods of contraception used. It is well established that different methods of contraception vary according to the extent to which their typical use prevents pregnancy, with certain methods (e.g., intrauterine device [IUD], vasectomy or tubal sterilization, hormonal implant) more effective than others (e.g., withdrawal; Fisher & Black, 2007; Canadian Contraception Consensus, 2015). Such an analysis, then, allows for an understanding of whether some groups of women wanting to avoid pregnancy are more likely to report that they and their partner used methods that are less effective at preventing pregnancy.
What’s more, different methods of contraception may be more or less accessible due to a number of factors. For example, the high costs associated with certain methods of contraception may serve as a significant barrier to their uptake for certain groups, including among youth (Di Meglio et al., 2020). A hormonal IUD can cost up to $500 per unit, while oral birth control pills may cost up to $300 per year (Government of Canada, 2024). As such, an examination of whether the use of different methods of contraception varies among diverse groups of women and their partners can highlight potential barriers that may exist to accessing certain methods of contraception.
Women wanting to avoid pregnancy are most likely to report that they and their partner used a condom the last time they had sex
One in three (33.0%) women wanting to avoid pregnancy reported that they and their partner used a condom the last time they had sex (Chart 1).Note This was followed by the birth control pill, with just over 1 in 5 (22.3%) reporting that they used the birth control pill as a method of contraception the last time they had sex. This aligns with previous research (e.g., Black et al., 2009) that has found that condoms are, overall, the most commonly used method of contraception among women in Canada who are not trying to conceive, followed by the birth control pill.
Chart 1 start
Data table for Chart 1
| Method of contraception | Percent | 95% confidence interval | |
|---|---|---|---|
| from | to | ||
| Note: In order to increase sample size for disaggregation, data were taken from 2019 and 2020 for respondents in Newfoundland and Labrador, Prince Edward Island, Ontario, Manitoba and British Columbia where the sexual behaviours content was included in both years. For the remaining five provinces, data were taken only from the 2020 reference period.
Source: Statistics Canada, Canadian Community Health Survey, 2019 and 2020. |
|||
| Condom | 33.0 | 31.4 | 34.8 |
| Vasectomy or tubal sterilization |
15.8 | 14.5 | 17.2 |
| Birth control pill | 22.3 | 20.8 | 23.9 |
| IUD | 13.5 | 12.2 | 14.9 |
| Other hormonal methods | 2.1 | 1.7 | 2.8 |
| Traditional methods | 4.3 | 3.7 | 5.0 |
| Other methods | 2.4 | 1.9 | 3.1 |
Chart 1 end
More than 1 in 6 (15.8%) women wanting to avoid pregnancy reported that they and their partner used a vasectomy or tubal sterilization as a method of contraception the last time they had sex, while 13.5% reported using an IUD. Less commonly used methods of contraception include traditional methodsNote (4.3%), other methodsNote (2.4%), and other hormonal methodsNote (2.1%).
Start of text boxDual use of certain methods of contraception with a condom
The use of a condom in combination with other methods of contraception aids not only in the prevention of pregnancy, but also in providing protection against sexually transmitted infections (Black et al., 2009). Among women wanting to avoid pregnancy who reported using the birth control pill as a method of contraception the last time they had sex, 1 in 3 (33.1%) reported that they and their partner also used a condom (Chart 2).
The use of a condom among women who reported using the birth control pill as a method of contraception the last time they had sex declined with age (from 55.8% among 15-to-24-year-old women to 15.3% among 35-to-49-year-old women). Among young women, 42.1% of those aged 20 to 24 who reported using the birth control pill the last time they had sex also reported using a condom, which was significantly lower than the proportions of 15-to-17-year-old (81.4%) and 18-to-19-year-old (66.8%) women who reported the same.
Chart 2 start
Data table for Chart 2
| Method of contraception | Percent | 95% confidence interval | |
|---|---|---|---|
| from | to | ||
Source: Statistics Canada, Canadian Community Health Survey, 2019 and 2020. |
|||
| Vasectomy or tubal sterilization | 2.4 E use with caution | 1.6 | 3.6 |
| Birth control pill | 33.1 | 29.4 | 37.0 |
| IUD | 11.0 | 8.2 | 14.3 |
| Other hormonal methods | 25.0 E use with caution | 15.3 | 37.0 |
| Traditional methods | 23.5 E use with caution | 16.2 | 32.2 |
| Other methods | 23.9 E use with caution | 13.8 | 36.9 |
Chart 2 end
Among women wanting to avoid pregnancy who reported using other hormonal methods, other methods, or traditional methods the last time they had sex, about 1 in 4 also reported using a condom. Condom use was less frequently reported by women who used an IUD (11.0%) and by those who reported using a vasectomy or tubal sterilization (2.4%) as a method of contraception the last time they had sex.
About half of young women report using a condom or the birth control pill the last time they had sex
As was observed for overall contraception use, the methods of contraception that women wanting to avoid pregnancy reported they and their partner used the last time they had sex varied according to different characteristics. For example, the use of condoms and the birth control pill declined with age: 53.9% of women aged 15 to 24 reported that they and their partner used a condom, while the same was true for less than one-quarter (24.3%) of those aged 35 to 49 (Table 2). Further, 1 in 2 (50.3%) 15-to-24-year-old women reported using the birth control pill as a method of contraception the last time they had sex, which was almost five times greater than the proportion of 35-to-49-year-old women (10.6%) who reported the same.
Among young women, further disaggregation revealed that the use of condoms was higher among 15-to-17-year-olds, compared with 20-to-24-year-olds (74.0% vs. 46.9%, respectively; data not shown).
| Characteristic Table 2 Note 1 | Condom | Birth control pill | IUD | Vasectomy or tubal sterilization | Traditional methods | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Percent | 95% confidence interval | Percent | 95% confidence interval | Percent | 95% confidence interval | Percent | 95% confidence interval | Percent | 95% confidence interval | ||||||
| from | to | from | to | from | to | from | to | from | to | ||||||
Due to small sample sizes and/or large coefficients of variations, disaggregation of other hormonal methods and other methods by characteristics was not possible. Source: Statistics Canada, Canadian Community Health Survey, 2019 and 2020. |
|||||||||||||||
| Age group | |||||||||||||||
| 15 to 24 Table 2 Note † | 53.9 | 48.4 | 59.4 | 50.3 | 45.1 | 55.6 | 10.6 | 7.8 | 14.0 | F too unreliable to be published | ... not applicable | ... not applicable | 4.0 E use with caution | 2.7 | 5.7 |
| 25 to 34 | 36.4 Table 2 Note * | 33.0 | 40.0 | 26.7 Table 2 Note * | 23.7 | 29.8 | 17.8 Table 2 Note * | 15.0 | 21.0 | 7.5 | 5.5 | 9.8 | 4.8 | 3.7 | 6.2 |
| 35 to 49 | 24.3 Table 2 Note * | 22.2 | 26.5 | 10.6 Table 2 Note * | 9.1 | 12.4 | 11.5 | 9.9 | 13.3 | 26.1 | 24.0 | 28.3 | 4.1 | 3.2 | 5.2 |
| Geographic region | |||||||||||||||
| Atlantic provinces | 26.0 Table 2 Note * | 20.7 | 31.9 | 23.7 | 18.5 | 29.6 | 14.2 E use with caution | 9.6 | 20.0 | 18.3 | 14.0 | 23.3 | 3.6 E use with caution | 1.7 | 6.6 |
| Quebec | 27.5 Table 2 Note * | 23.2 | 32.1 | 24.7 | 20.3 | 29.6 | 16.9 | 12.7 | 21.8 | 18.8 Table 2 Note * | 15.3 | 22.6 | 2.6 E use with cautionTable 2 Note * | 1.4 | 4.3 |
| Ontario | 37.6 Table 2 Note * | 35.1 | 40.3 | 21.3 | 19.2 | 23.5 | 10.6 Table 2 Note * | 8.9 | 12.4 | 13.8 Table 2 Note * | 12.3 | 15.4 | 4.4 | 3.4 | 5.5 |
| Prairie provinces | 32.3 | 28.4 | 36.5 | 20.7 | 17.6 | 24.1 | 12.1 | 9.4 | 15.2 | 18.2 | 14.5 | 22.4 | 5.6 E use with caution | 3.8 | 8.1 |
| British Columbia | 34.0 | 29.8 | 38.4 | 22.4 | 18.9 | 26.3 | 17.4 Table 2 Note * | 14.4 | 20.7 | 11.9 Table 2 Note * | 9.5 | 14.7 | 5.6 E use with caution | 4.0 | 7.7 |
| Rurality status | |||||||||||||||
| Rural areas | 28.1 Table 2 Note * | 24.2 | 32.3 | 22.0 | 18.7 | 25.6 | 10.6 Table 2 Note * | 8.1 | 13.5 | 24.8 Table 2 Note * | 21.3 | 28.6 | 3.2 E use with cautionTable 2 Note * | 1.9 | 4.8 |
| Small or medium population centres | 29.0 Table 2 Note * | 25.9 | 32.3 | 23.4 | 20.4 | 26.5 | 13.1 | 10.5 | 16.1 | 21.8 Table 2 Note * | 18.9 | 24.8 | 3.0 E use with cautionTable 2 Note * | 2.1 | 4.1 |
| Large urban population centres Table 2 Note † | 35.5 | 33.1 | 37.9 | 22.0 | 20.0 | 24.2 | 14.3 | 12.4 | 16.2 | 11.8 | 10.2 | 13.5 | 5.0 | 4.1 | 6.1 |
| Indigenous identity | |||||||||||||||
| Indigenous Table 2 Note 2 | 28.6 | 21.7 | 36.4 | 24.9 | 18.7 | 32.0 | 10.6 E use with caution | 6.8 | 15.5 | 20.7 E use with caution | 14.6 | 28.1 | 4.8 E use with caution | 2.4 | 8.4 |
| Non-Indigenous Table 2 Note † | 30.6 | 28.6 | 32.6 | 24.6 | 22.7 | 26.7 | 14.7 | 13.0 | 16.6 | 18.8 | 17.2 | 20.5 | 3.4 | 2.7 | 4.1 |
| Immigrant status | |||||||||||||||
| Immigrants | 39.7 Table 2 Note * | 35.5 | 44.0 | 14.6 Table 2 Note * | 11.3 | 18.3 | 10.5 Table 2 Note * | 8.1 | 13.2 | 7.1 E use with cautionTable 2 Note * | 4.7 | 10.2 | 7.5 Table 2 Note * | 5.5 | 9.9 |
| Non-immigrants Table 2 Note † | 30.4 | 28.4 | 32.4 | 24.7 | 22.8 | 26.6 | 14.5 | 12.8 | 16.3 | 18.9 | 17.4 | 20.6 | 3.4 | 2.8 | 4.2 |
| Marital status | |||||||||||||||
| Married Table 2 Note † | 26.3 | 23.9 | 28.8 | 11.9 | 10.1 | 13.9 | 9.9 | 8.5 | 11.4 | 22.9 | 20.6 | 25.4 | 4.4 | 3.4 | 5.7 |
| Living common law | 24.2 | 20.0 | 28.9 | 20.4 Table 2 Note * | 16.6 | 24.6 | 20.0 Table 2 Note * | 15.9 | 24.6 | 17.5 Table 2 Note * | 14.2 | 21.2 | 3.6 E use with caution | 2.4 | 5.1 |
| Separated, divorced or widowed and not living common law | 28.9 | 23.3 | 35.1 | 17.8 E use with cautionTable 2 Note * | 12.7 | 24.0 | 14.2 Table 2 Note * | 10.4 | 18.8 | 18.3 | 13.6 | 23.9 | 5.0 E use with caution | 2.5 | 8.9 |
| Never married and not living common law | 49.3 Table 2 Note * | 45.7 | 53.0 | 39.8 Table 2 Note * | 36.3 | 43.3 | 14.6 Table 2 Note * | 11.9 | 17.6 | 3.7 Table 2 Note * | 2.8 | 4.9 | 4.6 | 3.4 | 6.0 |
| Household income quintile | |||||||||||||||
| Quintile 1 (lowest) | 36.9 Table 2 Note * | 32.8 | 41.1 | 20.7 | 17.1 | 24.7 | 12.7 | 9.6 | 16.4 | 9.6 Table 2 Note * | 7.5 | 12.1 | 5.8 E use with cautionTable 2 Note * | 3.9 | 8.1 |
| Quintile 2 | 34.5 | 30.0 | 39.2 | 19.6 | 15.9 | 23.7 | 16.2 | 12.9 | 20.1 | 13.2 Table 2 Note * | 10.6 | 16.3 | 5.9 Table 2 Note * | 4.3 | 7.8 |
| Quintile 3 | 31.0 | 27.6 | 34.7 | 21.0 | 17.9 | 24.3 | 11.9 | 9.3 | 14.8 | 19.8 | 16.6 | 23.3 | 3.8 E use with caution | 2.6 | 5.5 |
| Quintile 4 | 32.8 | 28.8 | 37.0 | 25.5 | 21.8 | 29.4 | 13.2 | 10.6 | 16.1 | 18.0 | 14.8 | 21.7 | 3.1 E use with caution | 2.1 | 4.5 |
| Quintile 5 (highest) Table 2 Note † | 29.7 | 25.8 | 33.8 | 24.8 | 21.2 | 28.8 | 13.3 | 10.3 | 16.8 | 18.5 | 15.4 | 21.9 | 2.9 E use with caution | 1.9 | 4.2 |
| Highest certificate, diploma or degree (ages 25 to 49 only) | |||||||||||||||
| No certificate, diploma or degree | 20.1 E use with cautionTable 2 Note * | 12.4 | 29.8 | 11.5 E use with caution | 4.9 | 21.9 | 6.9 E use with cautionTable 2 Note * | 3.2 | 12.7 | 17.3 E use with caution | 11.1 | 25.3 | F too unreliable to be published | ... not applicable | ... not applicable |
| High school diploma or equivalency certificate | 24.8 Table 2 Note * | 20.2 | 29.8 | 14.6 | 11.1 | 18.6 | 12.5 E use with caution | 8.4 | 17.6 | 17.4 | 13.9 | 21.4 | 6.4 E use with caution | 3.7 | 10.1 |
| Postsecondary certificate, diploma or degree Table 2 Note † | 30.3 | 28.2 | 32.5 | 17.7 | 15.9 | 19.6 | 14.6 | 12.9 | 16.4 | 19.0 | 17.3 | 20.8 | 3.9 | 3.2 | 4.7 |
| Currently attending school (ages 15 to 24 only) | |||||||||||||||
| Yes Table 2 Note † | 57.5 | 50.3 | 64.4 | 56.5 | 49.5 | 63.4 | 9.4 E use with caution | 6.2 | 13.6 | F too unreliable to be published | ... not applicable | ... not applicable | 3.0 E use with caution | 1.6 | 5.1 |
| No | 47.0 Table 2 Note * | 39.1 | 55.0 | 38.1 Table 2 Note * | 30.7 | 45.9 | 13.0 E use with caution | 8.2 | 19.2 | F too unreliable to be published | ... not applicable | ... not applicable | 6.0 E use with caution | 3.5 | 9.6 |
For young women wanting to avoid pregnancy, condoms and the birth control pill were the most commonly used methods of contraception the last time they had sex, as was also the case for 25-to-34-year-old women. For 35-to-49-year-old women, however, a vasectomy or tubal sterilization was the most commonly used method of contraception, with over 1 in 4 (26.1%) reporting that they and their partner used this method of contraception the last time they had sex. This could be due to the fact that older women may be more likely than their younger counterparts to have already had children if they wanted to and/or to know if they want to conceive in the future. As such, they may be more inclined to opt for a more permanent method of contraception.
It is also worth noting that 25-to-34-year-old women were more likely than both their younger and older counterparts to report using an IUD the last time they had sex, with close to 1 in 5 (17.8%) reporting that they used this method of contraception (compared with around 1 in 10 of those aged 15 to 24 and 25 to 34).
Women in large urban population centres are more likely than those in rural areas to report using a condom or IUD the last time they had sex
The methods of contraception used by women and their partners also varied according to rurality status and geographic region.Note Women living in large urban population centres were more likely than their counterparts living in rural areas to report that they and their partner used a condom or IUD the last time they had sex. At the same time, they were also more likely to report using traditional methods of contraception. Conversely, about 1 in 4 (24.8%) women living in rural areas reported that they used a vasectomy or tubal sterilization as a method of contraception the last time they had sex, which was more than double that among women living in large urban population centres (11.8%).
Compared with women in the rest of Canada, women in Ontario (37.6%) were more likely to report that they and their partner used a condom the last time they had sex, whereas women in Quebec (27.5%) and in the Atlantic provinces (26.0%) were less likely. Women in British Columbia (17.4%) were more likely than women in the rest of Canada to report using an IUD the last time they had sex, whereas women in Ontario (10.6%) were less likely. The proportion of women who reported that they and their partner used a vasectomy or tubal sterilization as a method of contraception the last time they had sex was lower in Ontario (13.8%) and British Columbia (11.9%), compared with women in the rest of Canada, while it was higher in Quebec (18.8%). Use of the birth control pill did not vary according to geographic region.
Immigrant women are more likely than their non-immigrant counterparts to report using a condom or traditional methods of contraception, but less likely to report using other methods
About 2 in 5 (39.7%) immigrant womenNote reported that they and their partner used a condom the last time they had sex, compared with 3 in 10 (30.4%) non-immigrant women. Immigrant women were also more than twice as likely as their non-immigrant counterparts to report that they and their partner used traditional methods of contraception (7.5% vs. 3.4%, respectively).
Conversely, immigrant women were less likely than non-immigrant women to report using the birth control pill (14.6% vs. 24.7%, respectively) or an IUD (10.5% vs. 14.5%). Non-immigrant women (18.9%) were also more than twice as likely as immigrant women (7.1%) to report that they and their partner used a vasectomy or tubal sterilization as a method of contraception the last time they had sex.
Use of a condom or the birth control pill is highest among women who were never married and not living common law and lowest among married women
Women who were never married and not living common law were most likely to report that they and their partner used a condom or the birth control pill the last time they had sex, whereas married women were least likely. Specifically, about half (49.3%) of women who were never married and not living common law reported using a condom, compared with, for example, 26.3% of their married counterparts. Further, 2 in 5 (39.8%) women who were never married and not living common law reported using the birth control pill, which was more than three times greater than the proportion observed among married women (11.9%). Married women were also the least likely to report using an IUD, with 1 in 10 (9.9%) reporting that they used this method of contraception the last time they had sex.
On the other hand, married women were more than six times more likely than women who were never married and not living common law to report that they and their partner used a vasectomy or tubal sterilization as a method of contraception the last time they had sex (22.9% vs. 3.7%, respectively). The use of traditional methods of contraception did not vary according to marital status.
Women in the lowest household income quintile are more likely than those in the highest household income quintile to report using traditional methods of contraception or a condom
The use of traditional methods of contraception (which entail no costs) and condoms (which are relatively cheaper than certain methods of contraception) varied according to household income quintile. Women in the lowest household income quintile (i.e., women with the lowest household income) were twice as likely as those in the highest household income quintile to report that they and their partner used traditional methods of contraception the last time they had sex (5.8% vs. 2.9%, respectively). In addition, close to two-fifths (36.9%) of women in the lowest household income quintile reported that they and their partner used a condom, which was significantly higher than the 3 in 10 (29.7%) women in the highest household income quintile who reported the same. No differences were observed with respect to the use of the birth control pill or an IUD according to household income quintile.
Women with a postsecondary certificate, diploma or degree are more likely than those with lower educational attainment to report using a condom the last time they had sex
Condom use among women and their partners increased with educational attainment. Among women aged 25 to 49, 1 in 5 (20.1%) women with no certificate, diploma or degree reported that they and their partner used a condom the last time they had sex, while the same was true for one-quarter (24.8%) of women with a high school diploma or equivalency certificate and 3 in 10 (30.3%) women with a postsecondary certificate, diploma or degree. In addition, the proportion of women with a postsecondary certificate, diploma or degree (14.6%) who reported using an IUD the last time they had sex was double that among women with no certificate, diploma or degree (6.9%).
Among young women (i.e., those aged 15 to 24), those who were not currently attending school were less likely than those who were currently attending school to report that a condom or the birth control pill was used the last time they had sex. One possible explanation for this could be condom distribution in some high schools and colleges and universities and/or the fact that some educational institutions may have a nurse or health clinic that can facilitate access to these methods of contraception.
Conclusion
Access to sexual and reproductive health care, including contraception, is key to advancing gender equality. Indeed, access to contraception can facilitate women’s educational attainment and labour force participation, and, in turn, economic empowerment. This underscores the importance of producing updated statistics related to contraception use from the perspective of women wanting to avoid pregnancy.
Overall, this study revealed that, over the 2019-to-2020 period, the majority of women wanting to avoid pregnancy reported that they and their partner used contraception the last time they had sex. Still, 1 in 5 women reported that they and their partner did not use contraception, and certain groups of women were less likely to report using contraception than others. Specifically, older women, immigrant women, married women, and women with no postsecondary certificate, diploma or degree were less likely to report that they and their partner used contraception the last time they had sex. This study also observed that the use of different methods of contraception varied according to certain characteristics.
There are a number of reasons why women wanting to avoid pregnancy and their partners may not use certain methods of contraception or any method at all, such as being in a monogamous relationship, pressure from their partner and/or society, cost, preference, a lack of information about (different methods of) contraception, religion or culture, among others. However, the current study could not directly assess this due to the fact that the 2019 and 2020 cycles of the CCHS did not ask respondents to indicate their reasons for not using various methods of contraception. It should be noted that the forthcoming Canadian Sexual and Reproductive Health Survey will measure different factors (e.g., cost, lack of social support or worried about the reaction of others) making it difficult for women to get birth control.
It is important to highlight some of the limitations of this study. The analysis presented in this article is descriptive in nature and did not examine the relationship(s) between contraception use and different factors. Nonetheless, the information garnered through this study may help tailor interventions aimed at increasing contraception use among women wanting to avoid pregnancy and their partners. Additionally, it was not possible to ascertain whether a woman is able to conceive or not (e.g., if they or their partner experience challenges with fertility, if they are menopausal, etc.).
It should also be noted that the current study focused on contraception use among a specific group of women, that is, non-pregnant women aged 15 to 49 who reported that they wanted to avoid pregnancy and who had sex with a man in the past 12 months. As such, this study does not shed light on contraception use among other groups of women and girls, such as those younger than 15,Note nor the use of contraception among women (including older women and women who last had sex with a woman) for purposes other than pregnancy prevention, including the prevention of sexually transmitted infections or for other medical reasons.
Caution should be taken when comparing the findings of this study to other data and analysis on this topic for three important reasons. First, this study measures pregnancy avoidance, rather than pregnancy intention, whereas some data and analysis in the Canadian context (e.g., Black et al., 2009; CART, 2017; Statistics Canada, 2019) have focused on the latter. For example, data from the 2015 and 2016 cycles of the CCHS focus on the non-use of contraception among women not trying to conceive, that is, they indicated that they were not trying to get pregnant (Statistics Canada, 2019). In this study, women were included if they indicated that it was important for them to avoid getting pregnant right now. Second, the sample used in this study may not be directly comparable to the samples used in other research. For example, some studies (e.g., Dunn et al., 2019, Netherly et al., 2019) excluded women from their sample who reported that they were sterilized. Finally, the way in which contraception use is measured across different studies varies (i.e., whether contraception was used the last time they had sex, during the past six or 12 months, etc.). With these considerations in mind, the findings of this study may not be directly comparable to the findings of other research in this area.
With the impending roll-out of the Pharmacare Act, the knowledge garnered through this study can usefully inform the efforts of both decision-makers and service providers alike. It can also inform the ways in which people and organizations provide information about sexual and reproductive health, including contraception, to ensure that women and their partners are equipped with the information needed to help them decide if and when to conceive.
Note to readers
In this study, data on women are measured using the “sex at birth” variable. Sex at birth refers to sex assigned at birth. Sex at birth is typically assigned based on a person's reproductive system and other physical characteristics. Although sex at birth and gender refer to two different concepts, the terminology related to gender is used throughout this article to make it easier for readers.
Data source, methods and definitions
Data source
This study uses data from the annual component of the 2019 and 2020 Canadian Community Health Survey (CCHS). The CCHS, a cross-sectional survey that collects information related to health status, health care utilization, and health determinants, also collects information about various characteristics, including sex at birth, gender of person, age, Indigenous identity, immigrant status, and geography.
The CCHS covers the population 12 years of age and over living in the ten provinces. Excluded from the survey's coverage are: persons living on reserves and other Indigenous settlements in the provinces; full-time members of the Canadian Forces; youth aged 12 to 17 living in foster homes; the institutionalized population; and persons living in the Quebec health regions of Nunavik and Terres-Cries-de-la-Baie-James. Altogether, these exclusions represent less than 3% of the target population.
The most recent cycle of the CCHS that included the content on sexual behaviours for all provinces was in 2020. In the preceding year (i.e., in 2019), five provinces (Newfoundland and Labrador, Prince Edward Island, Ontario, Manitoba, and British Columbia) had opted to include the sexual behaviour module as part of their allotted optional content. In order to maximize data availability for this study, the most recent data from 2020 has been combined with the data from 2019 for those five provinces, and survey weights adjusted (divided by two) to account for this combining. As such, the data from this study represent the average population over 2019 and 2020 for these five provinces, whereas it only represents the average population for 2020 for the other provinces.
The COVID-19 pandemic had major impacts on the data collection operations for CCHS 2020. The collection was stopped mid-March, towards the end of the first collection period, and did not resume until September. The second, third and fourth quarterly samples were collected during very short collection periods, each of about five weeks, from September to December. The impossibility of conducting in-person interviews, the shorter collection periods and collection capacity issues resulted in a significant decrease in the response rates. As such, disaggregation by certain characteristics in the current study was not always possible.
Readers may refer to the documentation for the 2019 and 2020 cycles of the CCHS for more detailed information about these cycles.
Methods
This study focuses on women aged 15 to 49 who reported that they had sexNote with a man in the past 12 months. The analysis was restricted to women wanting to avoid pregnancy, that is, they strongly agreed or agreed that it was important for them to avoid getting pregnant right now.Note Women who were currently pregnant, who did not have sex in the past 12 months with a man, or whose last sexual partner was not a man were excluded from this study. The sample size for estimating the number of women wanting to avoid pregnancy was 7,195.
Overall contraception use was measured using the following two questions: “Did you or your partner use a condom the last time you had sex?” and “What other methods of protection did you and your partner use the last time you had sex?” Women were categorized as having used contraception the last time they had sex if they reported using a condom and/or other method of contraception.
In addition to condoms, women could report whether they and their partner used one of the following methods of contraception the last time they had sex: withdrawal or pulling out; vasectomy or tubal sterilization (“tubes tied”); birth control pill; injection (e.g., Depo-ProveraTM); spermicidal foam, jelly, cream, film, suppository; hormonal implant; rhythm method (tracking ovulation cycle); contraceptive patch (e.g., Ortho-EvraTM); vaginal contraceptive ring (e.g., Nuva-ringTM); or IUD (e.g., MirenaTM), coil, loop. Women could select more than one of these other methods of contraception. Emergency contraception (e.g., the “morning after pill”) was not included in the list of contraceptive methods.
To ensure adequate sample sizes for disaggregation, some methods of contraception were grouped together. “Traditional methods” include withdrawal or pulling out and the rhythm method (i.e., tracking ovulation cycle). “Other hormonal methods” include injection, hormonal implant, contraceptive patch, and vaginal contraceptive ring. “Other methods” include spermicidal foam, jelly, cream, film, suppository, and “other.”
Dual use was measured by examining whether women reported using a particular method of contraception (e.g., birth control pill) in combination with a condom the last time they had sex.
Definitions
Established immigrant: Person who first obtained landed immigrant or permanent resident status in Canada more than five years prior to the survey.
Household income quintile: The household income quintile is based on income received by all household members, from all sources, before taxes and deductions, during the 12 months ending December 31 of the year preceding the interview. This total household income is adjusted by a low-income cut-off (relative to the household size and geographic location of the household) which represents the threshold at which a family would typically spend a larger portion of its income than the average family on the necessities of food, shelter and clothing. This adjusted income is divided into five quintiles at the national level (excluding the territories).
Immigrant: Person who is, or who has ever been, a landed immigrant or permanent resident. Such a person has been granted the right to live in Canada permanently by immigration authorities. Immigrants who have obtained Canadian citizenship by naturalization are included in this group. Non-permanent residents are excluded from this category.
Indigenous: Person who identifies as First Nations (North American Indian), Métis and/or Inuk (Inuit).
Large urban population centre: Population centres with a population of 100,00 or more. For additional information, readers may refer to Population Centre and Rural Area Classification 2016.
Non-immigrant: Person who reported having been born in Canada.
Non-permanent resident: Person from another country with a usual place of residence in Canada and who has a work or study permit or who has claimed refugee status (asylum claimant). Family members living with work or study permit holders are also included, unless these family members are already Canadian citizens or landed immigrants or permanent residents.
Recent immigrant: Person who first obtained landed immigrant or permanent resident status in Canada in the five years preceding the survey.
Rural area: All territory lying outside population centres. For additional information, readers may refer to Population Centre and Rural Area Classification 2016.
Small or medium population centre: Small population centres are defined as population centres with a population between 1,000 and 29,999, while medium population centres have a population between 30,000 and 99,999. For additional information, readers may refer to Population Centre and Rural Area Classification 2016.
References
Black, A., Yang, Q., Wen, S. W., Lalonde, A. B., Guilbert, E., & Fisher, W. (2009). Contraceptive use among Canadian women of reproductive age: Results of a national survey. Journal of Obstetrics and Gynaecology Canada, 31(7), 627-640. https://doi.org/10.1016/S1701-2163(16)34242-6
Canadian Contraception Consensus. (2015). Chapter 1: Contraception in Canada. Journal of Obstetrics and Gynaecology Canada, 37(10), S5-S12. https://doi.org/10.1016/S1701-2163(16)39370-7
Contraception Access Research Team (CART). (2017). British Columbia 2015 Sexual Health Indicators: Rates and determinants among 14 to 49 year old females. https://med-fom-cart-grac.sites.olt.ubc.ca/files/2020/12/2015-BC-Sexual-Health-Indicators-CART-CSHS_2017-06-15.pdf
Di Meglio, G., Yeates, J., & Seidman, G. (2020). Can youth get the contraception they want? Results of a pilot study in the province of Quebec. Paediatrics & Child Health, 25(3), 160-165. https://doi.org/10.1093/pch/pxz059
Dunn, S., Xiong, A. Q., Nuernberger, K., & Norman, W. V. (2019). Non-use of contraception by Canadian youth aged 15 to 24: Findings from the 2009-2010 Canadian Community Health Survey. Journal of Obstetrics and Gynaecology Canada, 41(1), 29-37. https://doi.org/10.1016/j.jogc.2018.05.021
Fisher, W. A., & Black, A. (2007). Contraception in Canada: A review of method choices, characteristics, adherence and approaches to counselling. Canadian Medical Association Journal, 176(7), 953–961. https://doi.org/10.1503/cmaj.060851
Government of Canada. (2024). Budget 2024 – Lifting Up Every Generation. https://www.budget.canada.ca/2024/report-rapport/chap2-en.html
Institute for Women’s Policy Research. (2019). The Economic Effects of Contraceptive Access: A Review of the Evidence. https://iwpr.org/wp-content/uploads/2020/07/B381_Contraception-Access_Final.pdf
Netherly, E., Schummers, L., Maginley, K. S., Dunn, S., & Norman, W. V. (2019). Household income and contraceptive methods among female youth: A cross-sectional study using the Canadian Community Health Survey (2019-2010 and 2013-2014). CMAJ Open, 7(4), E646-E653. https://doi.org/10.9778/cmajo.20190087
Statistics Canada. (2019). Table 13-10-0382-01 - Population that did not use contraception among sexually active population not trying to conceive, by sex and other characteristics [Data table]. https://doi.org/10.25318/1310038201-eng
Statistics Canada. (2022). State of the union: Canada leads the G7 with nearly one-quarter of couples living common law, driven by Quebec. The Daily. https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713b-eng.htm
Statistics Canada. (2023). Family Matters: To have kids or not to have kids: That is the question! Infographics. Statistics Canada Catalogue no. 11-627-M. https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627-m2023006-eng.htm
Statistics Canada. (2024). Births and stillbirths, 2023. The Daily. https://www150.statcan.gc.ca/n1/daily-quotidien/240925/dq240925c-eng.htm
United Nations Population Fund. (2023). Sexual and reproductive health and rights: a key pillar to addressing poverty from a gender perspective. https://www.unwomen.org/sites/default/files/2023-11/unfpa_observer_paper_unfpa.pdf
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