Which Country Has the Best Access to Contraception in the World?

Questions around contraception, family planning and safe-sex are a feature of day-to-day life for most adults, irrespective of nationality, culture or gender.

As science and technology progress, there are more contraceptive options available than ever before, and still more are in development. Hormonal male contraception clinical trials began in the U.S. in the 1970s and articles in medical journals and the popular press periodically promise that this next advance is just around the corner. It is clear that contraception is still the subject of research and study, and just as medicine has room to advance, so do the policies of governments and the attitudes of citizens around the world.

Some countries boast a free healthcare system but in others, contraception can be prohibitively expensive or difficult to access for a large part of the population. Many nations provide a range of contraceptive options, such as the combined pill, the condom, the IUS and the IUD. But others have been slow to recognise the need for universal or subsidised contraceptive care, and both access and education are limited.

Our team researched 11 countries around the world on issues such as sexual health, contraception costs and contraceptive responsibility, to create an interactive contraception map which highlights different national approaches towards family planning. The results were sometimes surprising...

Top of our ranking amongst the 11 countries we researched is the United Kingdom, where access to safe contraception is universal and most birth control options can be obtained for free. The research shows that 10% of women in the UK have been using the same form of birth control for more than 20 years, which suggests they are pretty satisfied with the effectiveness of their chosen product.

In second place was Spain, where the government has made all kinds of contraception available to women, from the implant to the pill, and condoms are widely sold and affordable.

Brazil took third place, as our research showed birth control was affordable for everyone. The country’s hard work to promote condoms to men who have sex with men is also admirable, making Brazil one of the leading nations in the fight to reduce HIV and AIDS.

India, the USA and Brazil were the first countries on our list to introduce the contraceptive pill, with all three making it available as early as 1960. The pill revolutionised the way women approached sex, meaning they could now enjoy relationships more freely without the fear of unwanted pregnancy. In the UK, women are lucky enough to receive the pill for free on the NHS, but in other countries, this foil-wrapped game-changer can actually be very costly. In Japan, for example, health insurance doesn’t cover contraception and women in Japan pay around £20 for a sheet of contraceptive pills.

1. Contraceptive Injections: Contraceptive injections, such as Depo-Provera, are a hormonal method administered every three months. They release progestin to prevent ovulation and thicken cervical mucus, providing reliable contraception. It is convenient for individuals who prefer long-acting methods without requiring daily or frequent administration.
2. Contraceptive Patch: The contraceptive patch is a hormonal method that delivers oestrogen and progestin through the skin. It is applied once a week for three weeks, followed by a patch-free week. The Evra patch, a discreet and user-friendly contraceptive option, functions by inhibiting ovulation, thickening cervical mucus, and thinning the uterine lining. It provides an effective means of birth control while offering convenience and ease of use.
3. Vaginal Ring: The vaginal ring is a flexible, hormonal contraceptive inserted into the vagina. It releases oestrogen and progestin, similar to the combination pill, to prevent pregnancy. The ring is left in place for three weeks and then removed for a week to allow for withdrawal bleeding. It offers a convenient and low-maintenance method.

Dating back as far as 1855 in the UK, originally made of rubber but more recently latex or polyurethane, the condom is one of the most common forms of birth control in many of the countries we researched. Just over 30% of those interviewed in the UK and the US name them as their typical method of contraception. In most nations, condoms cost a few pounds at the most and are readily available.

However, there are concerns that sexually active middle-aged and older people, who aren’t the subject of safe sex and family planning campaigns, are using condoms less. Consequently, there has been a worrying increase in STIs among that demographic.

Contraceptive diaphragms and caps are barrier methods that offer an additional contraception option. They provide a physical barrier to prevent sperm from reaching the cervix. These devices should be fitted by a healthcare professional and used with spermicide for optimal effectiveness. While they are reversible and can be used as needed, it's important to note that they don't protect against STIs.

• Diaphragms are about 94% effective against pregnancy with perfect use and 88% effective with real-life use.
• When used with spermicide, diaphragms are 88% effective. When used without spermicide, that number drops down to 80%.
• In comparison, condoms are 98% effective with perfect use and 87% effective with typical use.
• The Pill and IUDs are more than 99% effective with perfect use.
• With typical use, diaphragms prevent pregnancy 87% of the time.
• When used correctly with spermicide, a diaphragm is 92 to 96% effective at preventing pregnancy.
• In real-world use, about 16 women out of every 100 who use a diaphragm a year become pregnant. This is because people forget to use it or don’t put it in properly (84% effective).

In general, diaphragms may offer some level of birth control, but their effectiveness is lower compared to other methods such as contraceptive pills and IUDs. However, they can be a good option for women who prefer non-hormonal birth control or who cannot use other methods for medical reasons.

The IUD, or copper coil, essentially allows women to forget about birth control for as long as ten years; although, like the contraceptive pill, the IUD doesn’t provide protection from STIs. Perhaps unsurprisingly, it’s popular with women in long-term, committed relationships. In 2015, a UN report on contraception around the world stated that:

“Long-acting or permanent methods, such as sterilisation, implants and the IUD, are more common in Asia and Northern America.”

While an IUD is an effective long-term means of family planning, it does require a visit to a clinic or sexual health professional for the fitting. The procedure is free in Britain, as well as Brazil and Spain, but can cost as much as £700 in the US, depending on your insurance.

What type of contraception suits you best, barrier or hormonal?

You might opt for barrier birth control, such as condoms or the cervical cap, which stop sperm reaching the egg altogether. If that’s not for you, hormonal contraception like the pill or IUS alter your body’s chemicals so you can enjoy sex without the risk of pregnancy. With so many possibilities, you’re sure to find one that fits your lifestyle.

Could the progesterone injection work for you?

This birth control method increases hormone levels in your bloodstream, keeping you protected from pregnancy for 12 weeks. The injection stops your ovaries from releasing their monthly egg and thins the lining of your uterus, making it less likely for a fertilised egg to settle there.

When should I take emergency contraceptive pills?

Emergency contraceptive pills should be taken as soon as possible after unprotected sex or contraceptive failure to maximise their effectiveness. The timing is crucial, and it's recommended to take the pill within 3 days (Levonelle) or 5 days (ellaOne) of the incident.

The sooner you take it, the more effective it will be in preventing pregnancy. Starting Morning after Pill contraception within 120 hours is considered the window of maximum effectiveness.

If you have any concerns or need more information about emergency contraception, it is advisable to consult with our ZAVA team who can provide personalised guidance based on your specific situation.

In summary, access to contraception plays a vital role in reproductive health and family planning. In this article, we explored various aspects of contraception, including the availability and effectiveness of different methods. It has highlighted countries that excel in providing comprehensive access to contraception and emphasised the importance of informed decision-making.

When it comes to selecting and obtaining contraception, it is crucial to consult with healthcare professionals or trusted sources. Seeking guidance from a legal and reliable online pharmacy, such as ZAVA, can provide valuable support.

Our online pharmacy offers personalised advice, ensures access to genuine medications, and prioritises patient safety and privacy. By consulting with experts in reproductive health, individuals can make informed choices, find the most suitable contraceptive methods, and prioritise their overall well-being.