From Pill Dominance to Diversification: The Czech Contraceptive Transition

Jirina Kocourková , Department od Demography and Geodemography, Faculty of Science
Jitka Slabá, Charles University - Faculty of Science

In the 1990s, Czechia experienced the fastest increase in hormonal contraceptive use among Eastern European countries, accompanied by a rapid decline in abortion rates. The widespread adoption of effective contraception enabled women to postpone childbearing without rising levels of unintended pregnancies, making Czechia unique both regionally and globally. However, after reaching a peak of almost 50% of users in 2007, hormonal contraceptive use declined to around 30% by 2021, without a compensatory rise in IUD use. This downward trend occurred alongside continued fertility postponement and a slow decline in abortion rates, suggesting a transformation in fertility control. Using data from the GGS II (Wave 1), this study examines recent contraceptive behaviour and its determinants. Results show that pill use has declined across all age groups, particularly among higher-educated women, while condom and withdrawal use have increased. Compared with 2008, the prevalence of hormonal contraception halved, and withdrawal use doubled among the youngest women. Logistic regression confirms that women with lower education remain more likely to use hormonal contraception, indicating a reversal of the traditional educational gradient known from the 1990s and 2000s. These findings align with Western European evidence of a reconfiguration of social inequalities, where better-educated women are the first to abandon hormonal methods in response to perceived health risks and the diffusion of natural health lifestyles. The study also highlights the growing influence of social media in shaping contraceptive choices and the need to reassess fertility control strategies in the context of delayed childbearing and persistently low fertility.

See extended abstract

 Presented in Session P8. Demographic Trends, History, Data and Methods