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ONS General Household Survey - Contraception and sterilisation

  • Last modified date:
    8 February 2007

The GHS first included questions on contraception in 1983 when they were addressed to women aged 18-49, and to women aged 16-17 who were or had been married. Since 1986, the questions have been asked of all women aged 16-49.

Summary of main findings (from 1998 GHS)

In 1998, as in 1995 and 1993, nearly three-quarters of women aged 16-49 (72%) used at least one form of contraception. The most common methods for avoiding pregnancy used by women in this age range included:

  • the contraceptive pill (used by 24% of women);
  • surgical sterilisation either of the woman or her partner (23% of women);
  • the male condom (used by partners of 18% of women);

28% of women questioned in 1998 were not using any form of contraception, and of these:

  • half were not in a sexual relationship (14% of all women aged 16-49)
  • almost a quarter were pregnant or wanting to conceive (6% of all women in the age group).

Trends in contraceptive use

Trends in the use of contraceptive methods by women aged 16-49 have been monitored since 1986 when questions about contraception were first addressed to all women as young as 16.

Between 1986 and 1998:

  • the proportion of women using some form of contraception has ranged from 69% to 73%. Although differences between individual years are statistically significant, changes have been small and no very clear trend emerges from the data;
  • the contraceptive pill, surgical sterilisation and the male condom have remained the three most commonly used methods of contraception.

Between 1989 and 1993, the percentage of women using the pill increased from 22% to 25% since when it has remained at roughly the same level.

  • The percentage of women aged 35-39 using the pill increased between 1986 and 1995, but this trend was not continued in 1998;
  • There was a statistically significant decrease between 1995 and 1998, from 29% to 24% in the percentage of women aged 30-34 claiming to use the pill as their usual form of contraception;
  • In other age groups none of the changes between 1995 and 1998 was statistically significant.

Among all women aged 16-49, the prevalence of sterilisation as a method of contraception has changed little since 1986, with levels of usage remaining at or around a quarter of women or their partners. However, this broadly stable picture conceals some important opposing trends within different age groups:

  • use of sterilisation, of self or partner, declined amongst women aged 30-44, particularly among women in their thirties, and increased among women in their late forties, although the key periods of change varied between age groups;

Between 1986 and 1995, the proportion of women whose partners used the condom increased from 13% to 18%. There was no further change to this figure between 1995 and the most recent survey in 1998. Trends in condom use vary with age:

  • among women under 30, the main trend between 1986 and 1998 has been the steady increase in the use of the condom. Apparent decreases in the use of this method by women in this age group, for example such as that reported by women aged 18-19 between 1995 and 1998, were not statistically significant;
  • the only age group in which a statistically significant change has occurred since 1995 is women aged 45-49, only 10% of whom, compared with 14% in 1995, said the condom was a usual method of contraception. This continues a long term downward trend since 1986, when 16% of women in this age group reported that their partner used the condom.

Current use of contraception and marital status

A third of women who were widowed, divorced or separated and nearly two-fifths of single women said that they had no current sexual relationship. Among the rest, 22% of widowed, divorced or separated women (48% of all women in this marital status), 17% of married or cohabiting women and 12% of single women (45% of all single women) said they used no form of contraception.

Of the three most commonly forms of contraception:

  • single women were more likely to use the pill than any other method (34% did so, compared with 21% using the condom and 2% surgical sterilisation);
  • just under a third of women who were married or cohabiting were sterilised or had partners who were sterilised, and roughly equal proportions (around a fifth) used the pill or the condom.

Change to and from the condom

Women were asked about their use of condoms over the two year period prior to interview. Among current users of a contraceptive method:

  • sixteen per cent had used the condom as their main method throughout the two year period, 7% had changed to the condom and were currently using it and 5% had switched from the condom to some other method;
  • women aged 25-39 were more likely than those in other age group to have used the condom as their main method throughout the reference period;
  • younger users of contraception were much more likely than older women to have used the condom at some stage over the past two years;
  • there was no statistically significant difference between the proportion of single women and those who were married or cohabiting who had used condoms throughout the reference period;
  •  however, single women were around three times as likely as their married or cohabiting counterparts to have changed to the condom from some other method (16% compared with 6%);
  • they were also twice as likely to have switched from the condom to some other method during the same time period.

Women not 'at risk' of pregnancy

Absence of a sexual relationship and sterilisation of either a woman or her partner carry no 'risk' (or very low 'risk') of pregnancy. Table 10.9 in the report shows the proportion of women in different groups who had no sexual partner or who depended on sterilisation (or self or partner) to avoid pregnancy. The prevalence of women protected from pregnancy in these ways was greatest among:

  • young women aged 16-19, none of whom were sterilised, and women aged 40-49 nearly half of whom were sterilised or had partners who had been sterilised;
  • single women, most because they had no sexual partner, and women who were widowed, divorced or separated;
  • women with two or more children (about a half);
  • women who said they were not likely to have any (more) children;
  • women with no educational qualifications;
  • and women in manual socio-economic groups.

Protection afforded either by sterilisation or by not having a sexual relationship covered only:

  • about one in six women cohabiting with their partners;
  • about one in five women aged 25-34;
  • and one in five women who said that they were likely to have (more) children;
  • one in three women in non-manual socio-economic groups;
  • less than a third of women with the highest levels of educational attainment: GCE 'A' levels or above;
  • less than a third of women with one child or no children.

Use of the pill and the condom as usual methods of contraception by women 'at risk' of pregnancy

Table 10.10 in the report shows the percentage of women 'at risk' of pregnancy (that is women aged 16-49 who were in a sexual relationship, who were not pregnant or sterilised, and whose partners had not been sterilised) who used the pill, and the condom. Women who reported using both methods appear in both columns, but the proportion to whom this applies is small (4%) and this table can, therefore, be used to give some broad indication of the percentage of 'at risk' women using one or other of these two methods of contraception.

  • all but a tiny proportion of 16-19 years olds 'at risk' of pregnancy used the pill or the male condom as their usual form of contraception, but the percentage of 'at risk' women claiming to use one or other of these methods as their usual form of contraception declined with age. Only around one third of women aged 45-49 said that they did;
  • all but a small percentage of single women 'at risk' of pregnancy, the majority of whom are in the younger age groups, used either the pill or the condom, and, at the other extreme, around two-fifths of women who were divorced or separated did so. Women who were cohabiting were more likely than married women to use one or other of these two methods;
  • a higher percentage of women with no children than of women with children used either the pill or the male condom, and the likelihood of using these two methods declined with the number of children. This is likely to be partly an effect of age, as older women tend to have more children than younger women;
  • a higher proportion of women who said that they were likely to have (more) children than of those who were not likely to, use the pill and the condom;
  • the pill and the condom were most likely to be used by women qualified to GCSE grades A-C or above. Less than half of 'at risk' women with no formal qualifications used one of these two methods.

Use of emergency contraception

The GHS first included questions on emergency (post-coital) contraception in 1993. Ten per cent of women aged 16-49 who were not sterilised and whose partners were not sterilised had used emergency contraception at least once in the two years prior to interview. This represents an increase of three percentage points since 1993. Emergency contraception was most likely to have been used in the past two years by:

  • women under 30;
  • single women, who were twice as likely as other women to have used emergency contraception;
  • women with no children (14%);
  • women with higher levels of educational attainment (12% of those with GCE 'A' levels or above had used this method, compared with 6% of those with no educational qualifications);
  • women who said they definitely or probably would have (more) children (15% compared with 6% of those who said they definitely or probably would not).

There were no significant differences in respect of the use of emergency contraception between women in manual and non-manual socio-economic groups.

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