Despite Canada’s universal health insurance, we do not have universal coverage of #contraception.
More effective methods like ‘the Pill’ can cost 15-40$
per month. Condoms are usually the cheapest, around $1 each, but are less effective in real-life conditions (85%). /3
What we found: For low-income (household income <$80k/yr) female youth (15-24y), lower rates of the pill, dual methods (condoms and a second method) and more use of condoms-only or no method– when compared to high-income youth. /4
Even after controlling for other factors (like age, marital status, student status, etc), being from a low-income household was still associated with a 15% decrease for ‘the pill’ and a 30% increase in using condoms. /5
Equitable access to #contraception is something that should be a key part of Canada's health care system. Eliminating cost barriers to contraception access through #UniversalSubsidy and @pharmacare2020 would lead to improved health and lower govt costs. /6
Other interesting findings: Roughly 3 out of 20 youth were not using any method – despite saying it was important for them to avoid a pregnancy.
In Quebec, where a private or public drug plan is govt mandated, we still found an income-based difference in contraception use. /7
Injectables (DMPA) were used by 2.5% of the study group. But, DMPA was more common in the low-income group (3%) vs the high income group (1.5%). Also, the rate of DMPA use was even higher, 10%, in the northern territories. /8
We also stratified by whether youth said they had a family doctor: 18% of female youth without a family doctor were using NO contraception method compared to 12% of those youth who did have a doctor. @CanPaedSociety /9
Further research can help identify and target strategies to address all barriers to improve access the full range of contraception options for all Canadians. /10
1/ A recent analysis and commentary directly critiques our study (Nethery et al, 2021) on planned home and birth center birth in Washington State in @greenjrnl. Some thoughts after reading ajog.org/article/S0002-… in @AJOG_thegray (long thread)
2/ ‘An immutable truth’ could have also been titled “The vast majority of US home births were ‘low risk'; Low-risk home births had better outcomes than high risk home births”. And, let's improve hospital-based care + access to hospital-midwives for high risk people.
3/ They studied 'high risk' v. 'low risk' home births using US birth certificate data.
2/ Saying “[high risk people] have no place in planned home births” in my mind, is akin to ‘telling people what to do with their bodies’ - and not useful in promoting safe, respectful maternity care.
3/ We can strongly and clearly recommend hospital birth with specific risks, but ‘telling women/birthing people what to do with their bodies’ is patriarchical - as is forced pregnancy.