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Abstract
Objectives: To describe the trends in contraceptive provision in general practice in the Netherlands from 1971-1996 and to investigate whether there has been a difference in contraceptive prevalence according to socioeconomic status.
Subjects and setting: Patients in four general practices in and around Nijmegen, the Netherlands, from 1971 to 1996 totalling 83,616 female patient years and 82,237 male patient years.
Method: Data on contraceptive provision were obtained from the Nijmegen Continuous Morbidity Registration Project. This project has been running since 1971 in the study general practices. Trends in first prescription of oral contraceptives, insertion of the intra-uterine device (IUD) and referral for male and female sterilisation were described for the different socioeconomic status groups. Trends in repeat oral contraceptive prescription, prevalence of IUD use and sterilisation prevalence were also described.
Results: Oral contraceptives were the main contraceptive provided throughout the time period studied. Oral contraceptive prescription rates peaked in the mid-1970s before declining. Increases in sterilisation referral and IUD insertion rates then followed. The high socioeconomic status (SES) group has consistently had the lowest rates of first and repeat prescriptions of oral contraceptives. In the 1970s the highest incidence and prevalence of sterilisation was in the low SES group, whereas by the 1980s it was seen in the high SES group. Until the late 1980s, IUD insertion rates and prevalence were consistently lower in the low SES group. By 1996 prevalence in all three groups was similar.
Conclusion: Trends in contraceptive use appear to have been dictated primarily by trends in oral contraceptive use. Differences according to SES emerged; these varied from those observed in other countries. Eur J Gen Pract 1999;5:54-8.