Emergency Contraception Methods Research Articles

Knowledge and use of emergency contraceptive methods and associated factors among female youth college students in Gondar city, Northwest Ethiopia, 2023

BackgroundProper use of emergency contraception can reduce unintended pregnancy and the risk of abortion. Despite this fact, there is a high rate of unwanted pregnancies among adolescents in Ethiopia. Therefore, determining the level of knowledge and use of Emergency contraceptives (EC) among female youth is important.ObjectiveTo assess Knowledge and use of EC methods and their associated factors among female college students in Gondar City, Northwest Ethiopia, 2023.MethodsInstitution-based cross-sectional study was employed among 814 female college students in Gondar City from April 15 to 28, 2023. A multi-stage sampling technique was applied to select the study participants. A self-administered questionnaire was used to collect the data. Epi-data version 4.6 and STATA Version 16, respectively, were used for data entry and analysis. A logistic regression model was fitted to identify factors associated with the outcome variables. Statistical significance was defined at a p-value < 0.05 and a corresponding 95% confidence interval.ResultIn this study, 46.2% [95% CI (42.78, 49.63%)] of the participants had adequate knowledge about EC and 26.1% [95% CI (22.82–29.74%)] of sexually active participants used EC. Muslim religion [AOR = 1.82: 95% CI (1.07, 3.09)], being single [AOR = 0.34: 95% CI (0.19, 0.63)], no discussion about reproductive health issues with their husband/partner [AOR = 0.43: 95% CI (0.27, 0.69)], year of study; second year [AOR = 1.63: 95% CI (1.03, 2.58)], third year [AOR = 1.80: 95% CI (1.11, 2.94)], and fourth-year students [AOR = 2.91: 95% CI (1.43, 5.96)] were significantly associated with knowledge about EC. While no discussion about reproductive health with their husband/partner [AOR = 0.09: 95% CI (0.04, 0.20)], monthly allowance [AOR = 3.03: 95% CI (1.54, 5.95)], perceive use emergency contraceptives as not a sin [AOR = 2.59: 95% CI (1.20, 5.60], knowledge about EC [AOR = 2.32: 95% CI (1.253, 4.29)] were associated with the use of EC.ConclusionsParticipants’ knowledge and of use EC in the study area was low. Religion, years of study, marital status, monthly allowance, perception and knowledge, and having discussion were associated with the use of EC. School-based health education, and behavioral change communication interventions should be established and/or strengthened to address students in need of EC services.

Emergency contraception access in Fijian community pharmacies: A descriptive study

ObjectiveTo assess pharmacists’ knowledge regarding emergency contraceptive pills (ECPs), their attitudes towards women obtaining ECPs, and ECP counselling and dispensing practices. MethodsAn online cross-sectional survey using Qualtrics was distributed via pharmacy emails and networks to recruit registered pharmacists working in community-based pharmacies. ResultsThere were 22 valid respondents, predominantly female pharmacists (68%), with an average of 7.5 years of registration. All pharmacists knew the correct time frame after unprotected sex for ECPs to be effective, and 73% knew how ECPs worked, but only 50% knew that there were no contraindications. Most pharmacists (86%) knew that ECPs should be available to all women and girls, but only 59% thought that a married woman should not have to get permission from her husband to buy ECPs. Information or education for clients on the correct use of ECPs was mainly provided by pharmacists (59%), mostly through verbal communication (96%). Only 5% of pharmacists had used the emergency contraception methods wheels. ConclusionsThere were gaps in pharmacists’ knowledge regarding ECPs. Biases, judgemental attitudes, and suboptimal practices existed. Implications for public healthTargeted education and training for pharmacists is needed to improve access to ECPs in Fiji.

Determinants of Contraception Among Women Undergoing Cancer Treatment: A Cross-Sectional Study from Zahedan, Iran

Objectives: This study investigates the prevalence of contraceptive use among women receiving cancer treatment in Zahedan, southeast Iran. We evaluated the role of various demographic and socio-cultural factors, fertility intentions, and care providers in contraceptive use. Methods: This cross-sectional study was conducted on 133 women of reproductive age receiving cancer treatment (chemotherapy or radiotherapy) in Zahedan. Patients referred to three medical centers in Zahedan from November 2019 to May 2020 were selected via the convenience sampling method and interviewed using a questionnaire. The data were analyzed in SPSS (version 18) using multinomial logistic regression. Results: It was found that 34.6% (N = 46) of women undergoing cancer treatment were at risk of unintended pregnancy, with 23.3% (N = 31) using the withdrawal method and 11.3% (N = 15) not using any form of contraception. Additionally, 37.0% (N = 49) of women reported inadequate knowledge about emergency contraception methods. Furthermore, 46.6% (N = 62) of women stated that the physician responsible for their cancer treatment had never discussed contraceptives with them. The highest prevalence of traditional contraceptive methods and non-use of contraception was observed among illiterate women, women with primary education, women living in polygamous families, women desiring more than four children, women who did not agree with their husbands on the contraceptive method, women who did not receive any physician consultation, and women living far from health centers. The multinomial logistic regression analysis revealed that the main predictors of contraception use were physician consultation about contraception (OR = 13.64, 95% CI: 2.13-87.32, P = .006) and couple agreement on the contraception method (OR = 9.91, 95% CI: 1.69-58.15, P = .011). Conclusions: Considering that, based on new population policies in Iran, access to free family planning (FP) services has ended and access to contraceptives is limited, women of reproductive age with illnesses—especially those with poor socioeconomic status, those living in polygamous families, and those in less developed regions—should be considered as a vulnerable group by the healthcare system. Furthermore, men should be included in consultation sessions with care providers to improve their participation in FP.

A Comparative Study between Vaginal versus Oral Administration of Levonorgestrel as A Method of Emergency Contraception

A Comparative Study between Vaginal versus Oral Administration of Levonorgestrel as A Method of Emergency Contraception

Unfulfilled and method-specific contraceptive preferences among reproductive-aged contraceptive users in Arizona, Iowa, New Jersey, and Wisconsin.

To identify characteristics associated with unfulfilled contraceptive preferences, document reasons for these unfulfilled preferences, and examine how these unfulfilled preferences vary across specific method users. We draw on secondary baseline data from 4660 reproductive-aged contraceptive users in the Arizona, Iowa, New Jersey, and Wisconsin Surveys of Women (SoWs), state-representative surveys fielded between October 2018 and August 2020 across the four states. This is an observational cross-sectional study, which examined associations between individuals' reproductive health-related experiences and contraceptive preferences, adjusting for sociodemographic characteristics. Our primary outcome of interest is having an unfulfilled contraceptive preference, and a key independent variable is experience of high-quality contraceptive care. We also examine specific contraceptive method preferences according to current method used, as well as reasons for not using a preferred method. Survey respondents who indicated use of any contraceptive method within the last 3 months prior to the survey were eligible for inclusion in this analysis. Overall, 23% reported preferring to use a method other than their current method, ranging from 17% in Iowa to 26% in New Jersey. Young age (18-24), using methods not requiring provider involvement, and not receiving quality contraceptive care were key attributes associated with unfulfilled contraceptive preferences. Those using emergency contraception and fertility awareness-based methods had some of the highest levels of unfulfilled contraceptive preferences, while pills, condoms, partner vasectomy, and IUDs were identified as the most preferred methods. Reasons for not using preferred contraceptive methods fell largely into one of two buckets: system-level or interpersonal/individual reasons. Our findings highlight that avenues for decreasing the gap between contraceptive methods used and those preferred to be used may lie with healthcare providers and funding streams that support the delivery of contraceptive care.

Motivators for emergency contraception: Previous pregnancy and condom rupture

ObjectivesLittle is known about the motivations to apply for emergency contraception (EC). Our first aim was to explore the motivating circumstances to use EC as fast as possible. Our second aim was to explore the contraceptive method of the population seeking EC. Study designThis present retrospective observational study between July 2021 and September 2021 is embedded in the MEEC (Motivation and Epidemiology of Emergency Contraceptive Pill) based on the study cohort of a Hungarian data bank containing follow-up data of 455 women applied for EC telemedicine consultation. Variables assessed were: age, gynecological history (pregnancies, abortions, miscarriages), data of the intercourse (elapsed time, contraceptive method), and data of the menstrual cycle, and relationship status. ResultsOf all patients, 59.3 % reported condom rupture, 29.5 % no protection, and 11.2 % other. Patients using condom applied for EC significantly sooner than those using no protection and using other protective methods. A significantly shorter elapsed time was observed in patients with a history of a previous pregnancy. No significant relationship was seen between the way of protection, previous pregnancies, and surprisingly the time of ovulation despite the obvious intention of avoiding pregnancy. ConclusionsThis is the first study to examine the potential role of epidemiologic factors as motivators for EC on the basis of a large patient cohort. Our study demonstrates the significant role of condom rupture/use and the history of previous pregnancies to be the strongest motivators for EC.

Efficacy of oral levonorgestrel emergency contraception with same day etonogestrel contraceptive implant: A prospective observational study

ObjectiveTo determine a 1-month pregnancy rate point estimate and 95% confidence interval for guideline-supported, same-day initiation of an etonogestrel implant plus oral levonorgestrel emergency contraception. Study designIn this single-arm, prospective observational study, all emergency contraception clients who presented to four Planned Parenthood Association of Utah clinics from February 2021 to March 2023 received information about oral levonorgestrel with same-day etonogestrel implant insertion. Participants were ≤35 years and reported unprotected intercourse within 5 days with negative pregnancy testing. The primary outcome measure was a 1-month home pregnancy test. We calculated the efficacy using a test of proportions with Yates continuity correction. ResultsA total of 160 emergency contraception clients (7.6% of 2106 approached) enrolled and 153 had 1-month pregnancy outcomes. A positive pregnancy test occurred in 2 participants resulting in an overall pregnancy rate of 1.32% (95% confidence interval 0.23%−5.19%). Ultrasound gestational dating assigned conception of the first pregnancy to 8 days before enrollment. For the second pregnancy, ultrasound dating designated conception at 5 days prior to enrollment. Limiting the efficacy rate to the single pregnancy that occurred within 5 days of unprotected intercourse, we report a pregnancy rate of 0.66% (95% confidence interval 0.03%−4.19%). ConclusionsIn this observational study of emergency contraception clients selecting oral levonorgestrel with same-day etonogestrel implant, we identified a pregnancy rate within the established range of oral emergency contraception methods alone. ImplicationsClients presenting for emergency contraception may also desire ongoing highly-effective contraception, yet current clinical guidelines serve as a barrier to same-day method initiation for the etonogestrel implant and other hormonal methods. Improving access to contraceptive method initiation will reduce the ongoing risk of unwanted pregnancy for this population. Clinical Trial RegistrationClinicaltrials.gov NCT04678817; registered 12/16/20

Anticoncepción de emergencia en estudiantes universitarios. ¿Qué tanto usan y conocen este método los jóvenes?

Objective: To determine the level of knowledge that a group of university students have about emergency contraception, in addition to knowing how often they use these methods. Methods: Quantitative, correlational, cross-sectional research. A survey was applied to all the students of the Physiopathology course of the Pharmacy and Bioanalysis Faculty of the Universidad de Los Andes in Mérida-Venezuela. The data collection instrument was validated by Matzumura-Kasano in her research and was used with previous authorization, in addition, a review of the literature was made, inquiring about the most controversial aspects of emergency contraceptives. Results: 87 people surveyed, between 21 and 36 years old, 66 women. Seventy-seven percent actively have sexual intercourse. 59.8 % have never received information on emergency contraception methods. 71.2 % know the ideal time to use postcoital contraceptives. 89.7% consider that emergency contraceptives are not safe and have repercussions on health, 82.8% think that they are not effective in preventing pregnancy and 53% do not know how they work. Conclusion: There is little education about emergency contraceptives among the respondents, most of them do not know how they work. Most of the respondents know the ideal time to use postcoital methods, but consider that they are not safe, have health repercussions and are not effective in preventing pregnancy, which demonstrates the need to inform the population.

Emergency contraception

Emergency contraception is an intervention aimed to prevent an unplanned or unintended pregnancy after unprotected sexual intercourse or where inadequate contraception has been used. It is only recommended for occasional use, and patients should be advised regarding regular and preferably long-term contraception if suitable. The request for emergency contraception is a frequent presentation in general practice. Around 40% of pregnancies worldwide are estimated to be unplanned, and a significant proportion of unplanned pregnancies result in termination, leading to avoidable distress. Therefore, it is paramount that healthcare professionals understand the available methods of emergency contraception. This article will cover the available methods, looking at their indications, use, efficacy, risks, and benefits.

Factors Affecting Knowledge of Emergency Contraception among Addis Ababa University Female Students, Addis Ababa, Ethiopia

Background: The prevalence of unintended pregnancy is very high in Ethiopia and young and adolescents are one of the major groups that are affected by it. The lack of knowledge of emergency contraception methods is one of the contributing factors to the increasing prevalence of unintended pregnancy. In this study, we explored the level of awareness and the factors affecting the knowledge of one of the most vulnerable groups in our society, university students. Objectives: To assess the level of knowledge as well as factors affecting Knowledge of emergency contraception among female students. Methods: An institution-based cross-sectional study was conducted at Addis Ababa University. The sample size calculated was 648. Data was collected by a self-administered questionnaire and data was entered, cleaned, and analyzed using SPSS version 21. Descriptive statistics was performed to get frequency and percentages. Logistic regression and Chi-square analysis were used to identify predictors of the outcome variable. Result: A total of 648 students were included in the study giving a response rate of 100%. Of all the respondents, 111 (17%) were sexually active, 439 (68%) have ever heard about and 158 (24.5%) have ever used emergency contraception methods. Of those respondents who ever heard of emergency contraceptive methods 265 (60%) (95% CI: 58%, 62%) were found to have good knowledge. The study has shown that field of study (AOR, 7.24; 95% CI: 4.103,12.772, P &lt; 0.000) and every use of emergency contraceptive methods (AOR, 2.075; 95% CI: 1.234,3.490, P &lt; 0.006) were significantly associated with having good knowledge of emergency contraceptive methods. Conclusion and recommendation: The level of knowledge about emergency contraception is fair. This study showed, that faculty of study and every use of emergency contraception are found to have a significant association with good knowledge of emergency contraceptive methods. Even though the knowledge of the respondents is fair much has to be done to improve their knowledge of the different methods by preparing a reproductive health education lesson, especially for students in non-medical faculty who may have been unaddressed.

Knowledge about emergency contraceptive methods in university students: systematic review

The study was based on a systematic review of the literature on knowledge and perception of emergency contraception (EC) among college students. 66 articles were examined and 17 were selected for review. It was found that there is a lack of adequate knowledge about AEs, with different studies reporting poor levels of knowledge in the participants. In addition, significant barriers to accessing and using ECs were observed, such as fear of side effects, religious and cultural factors, and access difficulties. The main sources of information about EA were the Internet, friends, and the media. The importance of improving the dissemination of information on AEs using digital platforms, such as Instagram and TikTok, was highlighted. Myths and misunderstandings about ECs were identified, such as the belief that they are abortifacient. The need to provide clear information on the side and adverse effects of ECs was also noted, so that people are better informed when using them. In general, it was concluded that it is necessary to improve the knowledge, perception and access to emergency contraceptive methods in the university student population. It is recommended to promote sexual and reproductive education programs, address cultural and religious myths and barriers, and use digital platforms to effectively disseminate information about EC. However, the lack of uniformity in the forms used in the reviewed studies was noted, making it difficult to compare and analyze the results. The development of standards for the design and validation of forms is suggested in future research.

Counseling Program for Married Women Regarding Emergency Contraceptive Methods

Counseling Program for Married Women Regarding Emergency Contraceptive Methods

“A Lot of My Friends Don't Know How It Works”: Student Activists Describe Gaps in College Students' Emergency Contraception Knowledge

IntroductionDespite the high potential need for emergency contraception (EC) among college students, lack of accurate knowledge may decrease the likelihood of its use in this population. We examined knowledge about EC methods, potential outcomes of use, and access among college students in the United States. MethodsWe recruited college students from a listserv devoted to EC campus activism for an online survey about EC knowledge (N = 150) and conducted 24 follow-up in-depth interviews. We describe the share of respondents that correctly answered each question and provide additional context and insight from interview respondents. ResultsGaps in EC knowledge were noted in our sample of college student EC activists. Awareness of different methods of EC was not universal; 38% of the sample was unaware of ulipristal acetate (ella®) and 61% was unaware of the intrauterine device inserted after intercourse as EC. Many respondents also incorrectly perceived additional barriers to acquiring EC such as minimum age or an ID requirement to purchase EC (64% and 49%, respectively). Interview respondents describe how medical providers, such as student health services and pharmacists, can pose barriers to EC access through either their actions or how college students expect they will act. ConclusionsWe document several gaps in knowledge surrounding EC in college students, even in an activist sample. Additional efforts to inform students about the variety of available EC methods and address mistaken perceptions about barriers to access may allow college students to better meet their needs for EC.

What women should know about emergency contraception - analysis of women's awareness and experiences after its use

Introduction: Emergency contraception is a method of contraception instigated when the other ones have failed or after unprotected sex. Although highly effective, it is subject to the risk of side effects. Aim of the study: The purpose was to assess the women's knowledge regarding emergency contraception methods and to analyze the experience related to the use of levonorgestrel and ulipristal acetate. Materials and methods: The research was done by conducting an anonymous online survey. The study took place in May 2023 and included 214 women over 15 years of age. The results were analyzed in Excel with a consideration of scientific literature. Results: 64.5% of women indicated correctly what emergency contraception is, 13.1% misunderstood its definition. 86% of respondents were unaware that the emergency contraception could be used for up to 120 hours after sex. 45% of women who used emergency contraception had difficulties obtaining a prescription. 35% of those surveyed indicated that they had side effects, the two most commonly reported being nausea and fatigue. Conclusions: Most women know the definition of emergency contraception, however, the vast majority of the respondents failed to specify how soon the emergency contraception shall be implemented after the intercourse. A large percentage of women reported difficulties in obtaining a prescription for emergency hormonal contraceptives. Therefore, the society should be better educated when it comes to emergency contraception and further actions should be implemented to improve its availability.

Emergency contraception: society of family planning clinical recommendation (2023)

Emergency contraception (EC) refers to several contraceptive options that can be used within a few days after unprotected or under protected intercourse or sexual assault to reduce the risk of pregnancy. Current EC options available in the United States include the copper intrauterine device (IUD), levonorgestrel (LNG) 52 mg IUD, oral LNG, and oral ulipristal acetate (UPА).&#x0D; These clinical recommendations review the indications, effectiveness, safety, and side effects of emergency contraceptive methods; considerations for the use of EC by specific patient populations and in specific clinical circumstances and current barriers to emergency contraceptive access. Further research is needed to evaluate the effectiveness of LNG IUDs for emergency contraceptive use; address the effects of repeated use of UPА at different times in the same menstrual cycle; assess the impact on ovulation of initiating or reinitiating different regimens of regular hormonal contraception following UPА use; and elucidate effective emergency contraceptive pill options by body mass indices or weight.

Cost-Effectiveness Analysis of On-Demand, Any Cycle-Day Intrauterine Device Placement [ID: 1337731

INTRODUCTION: Intrauterine devices (IUDs) are a highly effective form of long-acting reversible contraception. In addition to the TCu380A IUD, the 52-mg-levonorgestrel IUD was recently demonstrated as a noninferior emergency contraception (EC) method, which would increase the menstrual cycle days on which an on-demand IUD placement protocol would be safe. Especially, considering up to 46% of patients that are lost to follow up if two-visit IUD placement protocol is used. This analysis aims to determine the cost-effectiveness of IUD provision of on-demand, any cycle-day, even if unable to reasonably exclude pregnancy. METHODS: We developed a decision-analytic model using TreeAge Pro 2022 software (TreeAge Software, Williamstown, MA) beginning with a patient presenting to clinic for IUD placement, either TCu380A or 52-mg-levonorgestrel IUD. Two strategies are modeled: on-demand placement after shared decision-making, even if unable to reasonably exclude pregnancy, and placement at follow-up visit. Our primary outcome is costs over 1 year from start of model. Our secondary outcomes include unplanned pregnancies averted and pregnancy types. RESULTS: Preliminary model analysis of 1,000 women over 1 year indicates on-demand, any cycle-day IUD placement averts 298 unplanned pregnancies compared to two-visit. Ectopic pregnancies, however, would increase to 9.92 from 6.31 per 1,000 women. The preliminary incremental cost-effectiveness ratio for the model is $7,793 in favor of on-demand placement. Sensitivity analysis is forthcoming. CONCLUSION: A preliminary analysis favors the cost effectiveness of on-demand, any cycle-day IUD placement after shared-decision-making counseling. As we gather more data on the effectiveness of IUD as EC, the time frame for placement may extend, which will further support the practice of on-demand placement.

Progestin intrauterine devices versus copper intrauterine devices for emergency contraception.

The copper intrauterine device (Cu-IUD) is a highly effective method of contraception that can also be used for emergency contraception (EC). It is the most effective form of EC, and is more effective than other existing oral regimens also used for EC. The Cu-IUD provides the unique benefit of providing ongoing contraception after it is inserted for EC; however, uptake of this intervention has been limited. Progestin IUDs are a popular method of long-acting, reversible contraception. If these devices were also found to be effective for EC, they would provide a critical additional option for women. These IUDs could not only provide EC and ongoing contraception, but additional non-contraceptive benefits, including a reduction in menstrual bleeding, cancer prevention, and pain management. To examine the safety and effectiveness of progestin-containing IUDs for emergency contraception, compared with copper-containing IUDs, or compared with dedicated oral hormonal methods. We considered all randomized controlled trials and non-randomized studies of interventions that compared outcomes for individuals seeking a levonorgestrel IUD (LNG-IUD) for EC to a Cu-IUD or dedicated oral EC method. We considered full-text studies, conference abstracts, and unpublished data. We considered studies irrespective of their publication status and language of publication. We included studies comparing progestin IUDs with copper-containing IUDs, or oral EC methods for emergency contraception. We systematically searched nine medical databases, two trials registries, and one gray literature site. We downloaded all titles and abstracts retrieved by electronic searching to a reference management database, and removed duplicates. Three review authors independently screened titles, abstracts, and full-text reports to determine studies eligible for inclusion. We followed standard Cochrane methodology to assess risk of bias, and analyze and interpret the data. We used GRADE methodology to assess the certainty of the evidence. We included only one relevant study (711 women); a randomized, controlled, non-inferiority trial comparing LNG-IUDs to Cu-IUDs for EC, with a one-month follow-up. With one study, the evidence was very uncertain for the difference in pregnancy rates, failed insertion rates, expulsion rates, removal rates and the difference in the acceptability of the IUDs. There was also uncertain evidence suggesting the Cu-IUD may slightly increase rates of cramping and the LNG-IUD may slightly increase bleeding and spotting days. AUTHORS' CONCLUSIONS: This review is limited in its ability to provide definitive evidence regarding the LNG-IUD's equivalence, superiority, or inferiority to the Cu-IUD for EC. Only one study was identified in the review, which had possible risks of bias related to randomization and rare outcomes. Additional studies are needed to provide definitive evidence related to the effectiveness of the LNG-IUD for EC.

Assessment of Reproductive Age Women Health Related Behavior Regarding Emergency Contraception Methods

Assessment of Reproductive Age Women Health Related Behavior Regarding Emergency Contraception Methods

Improving access to highly effective emergency contraception: an assessment of barriers and facilitators to integrating the levonorgestrel IUD as emergency contraception using two applications of the Consolidated Framework for Implementation Research.

Emergency contraception prevents unwanted pregnancy after sexual intercourse. New evidence has demonstrated that the levonorgestrel 52 mg IUD is a highly effective method of emergency contraception. However, translating this research finding into clinical practice faces existing barriers to IUD access, including costs and provider training, novel barriers of providing IUDs for emergency contraception at unscheduled appointments. The purpose of this study was to identify barriers and facilitators to the utilization of the levonorgestrel IUD as emergency contraception from client, provider, and health systems perspectives. We conducted English and Spanish-speaking focus groups (n=5) of both contraceptive users (n=22) and providers (n=13) to examine how the levonorgestrel IUD as EC was perceived and understood by these populations and to determine barriers and facilitators of utilization. We used findings from our focus groups to design a high-fidelity in-situ simulation scenario around EC that we pilot tested with clinical teams in three settings (a county health department, a community clinic, and a midwifery clinic), to further explore structural and health systems barriers to care. Simulation scenarios examined health system barriers to the provision of the levonorgestrel IUD as EC. We coded both focus groups and in-clinic simulations using the modified Consolidated Framework for Implementation Research (CFIR). We then applied our findings to the CFIR-Expert Recommendations for Implementing Change (ERIC) Barrier Busting Tool and mapped results to implement recommendations provided by participants. Ultimately, 9 constructs from the CFIR were consistently identified across focus groups and simulations. Main barriers included suboptimal knowledge and acceptability of the intervention itself, appropriately addressing knowledge and education needs among both providers and contraceptive clients, and adequately accounting for structural barriers inherent in the health system. The CFIR-ERIC Barrier Busting Tool identified eight strategies to improve levonorgestrel IUD as EC access: identifying implementation champions, conducting educational meetings, preparing educational toolkits, involving patients and their partners in implementation, conducting a local needs assessment, distributing educational materials, and obtaining patient feedback. To sustainably incorporate the levonorgestrel IUD as EC into clinical practice, education, health systems strengthening, and policy changes will be necessary.

Exploring the Role of Levonorgestrel Intrauterine System (LNG-IUS) as a Method of Emergency Contraception (EC).

Copper T 380-A (CuT380A) intrauterine device (IUD) has been an effective method of emergency contraception (EC). Levonorgestrel intrauterine system (LNG-IUS) has not been approved by the Food and Drug Association for EC till now. There are few studies that provide data regarding the efficacy of LNG-IUS as EC. This systematic review tried to explore the efficacy of LNG-IUS in preventing accidental pregnancies up to five days of unprotected intercourse. A systematic review of the published studies on the use of LNG-IUS as EC was done. All randomized trials, prospective cohorts, retrospective cohorts. and case-control study designs pertaining to this topic were included in this review. Abstracts were retrieved and reviewed by two authors independently. Variables pertaining to socio-demographic parameters, EC use-related variables (reason for use, frequency, time elapsed since coitus), and those associated with sexual habits were selected and recorded. A total of six articles were rendered for the review. High school students and those attending college accounted for 36.8%-51.8% of the study population. Data on the reason for seeking EC showed noncompliance to routine contraception as the most common reason, followed by failure of withdrawal method, breach of barrier contraception, and unplanned intercourse. With a negligible failure rate, LNG-IUS seemed to be a good alternative to the existing copper EC. Considering the plethora of noncontraceptive benefits associated, LNG-IUS can be safely provided as an option of EC in the cafeteria approach within five days of unprotected intercourse.