Current Knowledge Among Primary Care Resident Physicians in Using Emergency Contraception

Abstract

Background Emergency contraception is used after unprotected intercourse in an attempt to prevent an unwanted pregnancy. Emergency contraception has been largely under-utilized in this country. Potential reasons for under-utilization of this form of pregnancy prevention could include lack of patient knowledge, lack of physician knowledge, and reluctance to prescribe based on abortion belief. The purpose of this survey was to determine physician knowledge, opinion, and experience with emergency contraception. Methods Primary care specialty housestaff physicians at the University of Kentucky were surveyed regarding postcoital contraception (40.5% response rate, 81 out of 200). Specialties surveyed included family practice (FP), internal medicine (IM), pediatrics (PD), and obstetrics and gynecology (OG) with their year of training being included. The attending faculty in Obstetrics and Gynecology were also surveyed as a control (69% response rate, 9 out of 13). The scored survey included questions on knowledge and use of emergency contraception. An opinion question whether or not they believed emergency contraception was a form of abortion was asked, but not scored. Results Overall (including attending physicians), 29.6% of responders have prescribed emergency contraception, 7.4% counsel their patients in the availability and proper usage, and 36.2% believe it to be a form of abortion. Specifically, 18.3 % of resident housestaff have prescribed emergency contraception, 5.6% had counseled their patients on use, and 38.0% believe it to be a form of abortion. Believing emergency contraception to be a form of abortion did not appear to effect either prescribing or counseling of emergency contraception. The average score on the survey was significantly different based on specialty of training (p Conclusions We have demonstrated that residents in training have a limited knowledge base regarding emergency contraception. The knowledge and utilization of this form of pregnancy prevention is dependent on specialty, with obstetrics and gynecology residents demonstrating a superior knowledge compared to other specialties. Unfortunately, this knowledge does not appear to increase with year of training suggesting that there is a lack of education during the years of training. We have also demonstrated that believing emergency contraception to be a form of abortion is not a deterrent to prescribing or counseling about this form of treatment. We believe our results demonstrate the need for improved education on postcoital contraception, especially in non-reproductive specialties.