Making contraception free across the province would cost the Quebec government approximately $22 million, according to calculations by l’Institut de recherche et d’informations socioéconomiques (IRIS) in a report published Thursday, which examines the economic and demographic impacts of free contraception in Quebec.
This takes into account the costs involved, but also the resulting savings, particularly in relation to unplanned pregnancies. If Quebec were to make contraception free—excluding condoms, the hormonal patch, and other less common methods—it would reduce unplanned pregnancies by about a quarter.
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The IRIS report highlights that unplanned pregnancies pose greater risks to women and the fetus. They are also sources of financial hardship and deteriorating physical and mental health.
“By implementing free contraception, we are acknowledging that contraception is a public health issue that affects the entire population—the women who use it, the men who benefit from it, and society as a whole, which must live with the consequences of unplanned pregnancies,” argues the study’s author and IRIS researcher, Eve-Lyne Couturier.
She expects that more women will adopt effective methods of contraception if they are free. The implant and the IUD, for example, cost a few hundred dollars and are nearly 100 per cent effective.
In a table comparing the projected usage rates of the most popular contraceptives, it is noted that between the first and fifth years of the implementation of free contraception in Quebec, there would be a 7.5 percentage point decrease in the use of the birth control pill, a 3.9 percentage point decrease in “unintended abstinence,” while there would be an 8.6 percentage point increase in IUD use, a 5 percentage point increase in copper IUD use, and a 2 percentage point increase in implant use.
It is estimated that between 39 per cent and 45 per cent of unplanned pregnancies are voluntarily terminated. In Quebec, an abortion costs between $500 and $1,000, says Couturier. One of the benefits of free contraception is reducing the number of unplanned pregnancies, and consequently, the number of abortions.
“According to international research on programs that made contraception free, women generally choose more effective, long-acting methods, such as the IUD, the implant, and, to a lesser extent, the injection. And this helps reduce the number of unplanned pregnancies, since protection is more effective,” she explains.
Couturier notes that the first year of implementing free contraception would be more expensive because many women—who are currently deterred by the high costs of long-acting methods—would switch to a different method. In subsequent years, the cost would be lower. For example, in the fifth year of implementation, it would cost the government $10.6 million, according to IRIS.
The $22 million cost also excludes free condoms, for which an additional $4 to $5 million per year would be required. However, providing free condoms would have long-term benefits (and cost savings for the government) since it would lead to a reduction in sexually transmitted and blood-borne infections (STBBIs).
“This has public health implications for the healthcare system, for the quality of life of people living with these infections, and for those around them who live with infected individuals,” emphasizes Couturier.
In 2024, the federal government launched a drug insurance program that covers contraceptives, among other things. So far, British Columbia, Prince Edward Island, Manitoba, and the Yukon have signed an agreement with the federal government.
“So, funding is also available,” Couturier points out. “We’ve seen [Christine] Fréchette’s government make agreements on infrastructure and public transit. We’re urging them to make other agreements, this time on contraception and medications. It would benefit society as a whole.”
Currently, in Quebec, the public health plan provides free contraceptives to people under 18, to those 25 and under who are full-time students without private insurance if they still live with their parents, as well as to those receiving last-resort financial assistance. IRIS notes, however, that this population represents a minority of people who would like to use contraception and that not everyone is aware of this information.
Furthermore, the report emphasizes the need for a comprehensive sex education strategy and sexual health services that are well distributed throughout the province.
“If we want a genuine sexual health policy, reducing the cost barrier to accessing contraception is a step in the right direction, but it’s not enough,” says Couturier. “We also need to improve knowledge of contraceptive methods, and making sexual health a topic that can be debated in the public sphere—one where people can ask questions and discuss it with their sexual partners […] or friends—is also a driver of gender equality. To do that, we need the necessary information; otherwise, what are we even talking about?”
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The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.
–This report by La Presse Canadienne was translated by CityNews
