Temporal trends in contraceptive use in British Columbia, Canada between 2001 and 2021: A descriptive analysis

Alice J Mei; Abigail Shore; Helena Abreu do Valle; Celeste Leigh Pearce; Rafael Meza; Regina Renner; Gillian E Hanley

doi:10.1016/j.contraception.2026.111487

Temporal trends in contraceptive use in British Columbia, Canada between 2001 and 2021: A descriptive analysis

Contraception. 2026 May 20:111487. doi: 10.1016/j.contraception.2026.111487. Online ahead of print.

Authors

Alice J Mei¹, Abigail Shore², Helena Abreu do Valle³, Celeste Leigh Pearce⁴, Rafael Meza⁵, Regina Renner⁶, Gillian E Hanley⁷

Affiliations

¹ Ovarian Cancer Research Centre, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: alicemei@student.ubc.ca.
² Ovarian Cancer Research Centre, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: abbyshor@student.ubc.ca.
³ Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: helena.valle@alumni.ubc.ca.
⁴ Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States. Electronic address: lpearce@umich.edu.
⁵ Department of Population Health Sciences, BC Cancer Research Institute, BC Cancer Agency, Vancouver, British Columbia, Canada. Electronic address: rmeza@bccrc.ca.
⁶ Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: regina.renner@ubc.ca.
⁷ Ovarian Cancer Research Centre, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: gillian.hanley@ubc.ca.

PMID: 42167641
DOI: 10.1016/j.contraception.2026.111487

Abstract

Objectives: This study reports trends in reversible and permanent contraceptive use among females aged 15-44 in British Columbia (BC), Canada, from 2001 to 2021.

Study design: Using a retrospective, population-based design, we analyzed data from BC Pharmanet, healthcare visits, and hospital records for females (as registered by the provincial insurance program), aged 15-44 in BC. Contraceptive options included short-acting reversible contraceptives (combined oral contraceptives [COC], progestin-only pills, vaginal rings, transdermal contraceptives), long-acting reversible contraceptives (levonorgestrel intrauterine devices [LNG-IUD], copper intrauterine devices), and permanent contraception (tubal ligation, bilateral salpingectomy). We measured IUD use in incident (number of insertions per year) and prevalent use (number of estimated users per year).

Results: From 2001 to 2021, the incident and prevalent use of the LNG-IUD in women aged 15-44 living in BC increased from 0.0% to 1.9%, and from 0.0% to 11.7%. The incidence of COC use decreased from 20.5% to 14.4%. Tubal ligation incidence declined from 0.4% to 0.0%, and bilateral salpingectomy incidence increased from 0.0% to 0.2%. Overall, these permanent contraception methods decreased from 0.4% to 0.3%. Younger age groups increasingly opted for LNG-IUDs, as illustrated by a median age decrease from 33.3 to 30.1 from 2001 to 2021.

Conclusions: We observed pronounced shifts away from the use of COC towards the LNG-IUD, which was larger in younger age groups. Despite a pronounced move away from tubal ligation and toward bilateral salpingectomy for permanent contraception, there were fewer seeking permanent contraception.

Implications: In British Columbia from 2001 to 2021, contraceptive use shifted away from short-acting reversible methods toward long-acting reversible methods, suggesting a change to more effective methods for reducing unintended pregnancies. While bilateral salpingectomy rates increased and tubal ligation rates decreased (reflecting the recommendations to perform bilateral salpingectomy for ovarian cancer risk reduction), female permanent contraception rates decreased overall.

Keywords: Bilateral salpingectomy; Canada; Intrauterine device; Oral contraceptive; Permanent contraception; Population-based.