Abstract
AbastractObjective: to discern the profile of the Spanish Emergency Contraceptive users (EC). Design: systematic review of contraceptive use in the Spanish population. Data Source: Spanish and international databases, between January 2006 - March 2011. Keywords: Contraceptives, Postcoital pills, emergency contraception, levonorgestrel, data collection. Study selection: original papers, letters to the editor in which stated aims were the description, prediction or measurement of variables related to EC use. Twenty-two papers were retrieved and fourteen were finally selected, all of which were descriptive. Data extraction: manuscripts were evaluated by two independent reviewers. Results: Women requesting EC have ages between 21-24 years, mostly single and university students; declare that they have not previously used EC, and attend an Emergency department, at weekends and within 48 hours following unprotected sexual intercourse. The reason is condom rupture. None of the studies reviewed measured alcohol and other drug consumption, the number of sexual partners, nor any of the studies performed a comparison with a group not using EC. Conclusions: lack of homogeneity and comprehensiveness of studied variables resulted in a limited profile of Spanish EC users. Further studies are needed with a more comprehensive approach if sexual health interventions are to be carried out in possible users.
Highlights
Throughout the world, unplanned pregnancy is a considerable social and public health issue
Studies performed outside Spain report on the use of other drugs among Emergency Contraceptive users (EC) users and observe an association between consumption of alcohol and tobacco, number of sexual partners and use of EC, while in the reviewed studies these variables were not investigated . [25,26,27,28] Nor was any study found where comparisons were made with women who had not taken EC, which would have allowed clarification of the characteristics that differentiate these women and the factors related to the use of EC
In the United States and the United Kingdom, some qualitative studies have been carried out which provide an insight into the discourse of women on the free dispensation of EC in pharmacies or advance supply of 5 units of the drug . [29,30,31,32] This research suggests that free dispensation increases access to EC that is highly valued by the women as it reduces waiting times, increasing efficacy as the drug is always administered within 72 hours of unprotected coitus
Summary
Throughout the world, unplanned pregnancy is a considerable social and public health issue. The majority of cases are unwanted pregnancies and many of these cases result in abortion. Pregnancies in girls between 14 and 17 years rose from 4‰ in 1990 to almost 12‰ in 2006(1) This may have been due to two factors. The rate of abortion or voluntary pregnancy termination (VPT) represents an estimate of the number of unwanted pregnancies. On analysing the incidence of this rate in Spain, we see moderate values with respect to other European countries [3]. It should be pointed out that Spain is one of the countries that have seen the greatest increase in recourse to abortion in recent decades, rising from 7.14 VPT per 1,000 women in the year 2000, to 11.41 in 2009. The abortions are mainly in the 20-29 age group, and among those who have sophomore-10h-grade [4]
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