Use Of Emergency Contraception Research Articles

Young People's Use and Perceptions of Emergency Contraceptives in Sub‐Saharan Africa: Existing Insights and Knowledge Gaps

AbstractDespite growing international attention to the sexual and reproductive health and rights of young people, their uptake of modern contraceptive methods remains low, especially in Sub‐Saharan Africa. This article focuses on young people's use of a relatively new contraceptive method, emergency contraceptives (ECs). Emergency contraceptives can be used after intercourse and have been marketed to be used when other contraceptives fail or after unplanned, unprotected intercourse. This article reviews qualitative evidence from seven studies on young people's experiences with this contraceptive method. Many users of ECs were in their twenties, well‐educated, and either single or in a relationship. Repeated use was found in four of the studies, and ECs may fit within an existing range of post‐coital methods used to prevent pregnancies. While concerns about side effects were reported frequently among non‐users of ECs, other women preferred ECs above other hormonal contraceptive methods. Men were actively involved, for example, as providers of information to their partners, and as purchasers of ECs. Young people's understandings of ECs hence differ from the meanings inscribed to these pills at an international level. Further research on this topic is needed to ensure that young people's (emergency) contraceptive needs are well understood and responded to.

Likelihood of Emergency Contraception Use Among African-American Women at Risk of Adverse Birth Outcomes

Nearly a half million infants in the United States are born preterm or with low birth weight each year. Providing women who have had a prior adverse birth outcome with access to family planning can help reduce the incidence of subsequent high-risk pregnancies and adverse outcomes. One effective option to prevent unintended pregnancy for women with a prior adverse birth outcome who either do not use contraception consistently or whose contraception fails is emergency contraception (EC). The purpose of our study was to understand willingness to use EC among African-American women who recently had an adverse birth outcome. The Healthy Births Healthy Communities (HBHC) Interconceptional Care Project (ICCP) targeted high-risk African-American women from two low-income Chicago neighborhoods who recently had an adverse birth outcome. The aim of HBHC ICCP was to improve participants' future birth outcomes by providing medical and social services and helping women to clarify their reproductive life goals. Information about participants' pregnancy intentions and willingness to use EC was measured in an interview shortly after enrollment into the study. Over 90% of the 131 women in our study either did not want to become pregnant or did not know if they wanted to become pregnant within the next 2 years. These women had 4.4 times higher odds of reporting willingness to use EC as compared to women who reported a desire to become pregnant within the next 2 years (75.6 vs. 50.0%, respectively; AOR: 4.4; 95% CI 1.1, 17.6). EC is an essential part of the reproductive toolkit for women at high risk of adverse birth outcomes who are not intending pregnancy, along with reproductive life planning and use of effective contraception.

Characteristics of young women who demonstrated correct versus incorrect use of emergency contraception

Characteristics of young women who demonstrated correct versus incorrect use of emergency contraception

Impact of Training on General Practitioner's Knowledge, Attitude and Practices Regarding Emergency Contraception in Hyderabad.

To elaborate the impact of family planning training on general practitioners' knowledge, attitude and practices regarding emergency contraception. A cross sectional survey involving 270 general practitioners was conducted in Hyderabad from 1(st) Oct to 31(st) Dec 2010. Participants were divided into two groups on the basis of attending family planning training course after graduation and were interviewed face to face. Data was noted on questionnaire asking their knowledge, attitude and practices regarding emergency contraception. Data was analyzed on SPSS version 11. Student t-test was applied to compare the proportions among two groups. Out of 270 general practitioners, male & female participants were 132 (48.9%) and 138 (51.1%) respectively. Mean experience as private general practitioner was 7.48 + 7.6 years. One third of the participants 84 (31.1%) have attended five days training course on family planning in the past, while 186 (69.9%) did not have any training. Source of training was government institutes 46(17%) and non government organization in 38 (14.1%) cases. Significant positive difference was noted on emergency contraception knowledge, attitude and use in group who attended family planning training. Educational intervention has a positive impact on health care provider's knowledge, attitude and practices of emergency contraception.

Active-Learning Instruction on Emergency Contraception Counseling

To increase pharmacy students' knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception. Approximately 200 third-year pharmacy students participated in the Women's Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students' knowledge scores increased from 86% to 93% (p<0.001). Approximately 25% of the students stated they were confident in counseling patients on emergency contraception before completing the active-learning exercise compared to 58.5% after (p<0.001). The most common barrier to counseling that students identified on the pre- and post-workshop survey was lack of knowledge. Participation in an active-learning exercise significantly increased pharmacy students' knowledge of and confidence in counseling patients regarding emergency contraception and significantly reduced several barriers to counseling identified prior to participation.

Questionnaire for the management of the victim of sexual abuse

Caring for victims of sexual assault demands of the physician a precise physical examination, provision of evidence, psychological support and appropriate treatment. Because the majority of victims of sexual violence are women, we usually encounter these patients in gynecological clinics. If the evidence is collected and stored properly, with special forensic methods we can distinguish between any two persons in the world, except identical twins. Therefore, patient’s history and taking evidence is of utmost importance. In the case of sexual assault, infection with sexually transmitted diseases is possible, so they should be diagnosed and treated in time. The victim should be offered the use of emergency contraception, which is only effective in the first days after sexual assault. To make sure that each step of the examination is completed and all samplings are done in the correct order, it is useful to have a written questionnaire or a routine protocol. We describe stepby- step management procedures for victims of sexual assault, taking into consideration the victim’s history, physical examination, different samplings, and different emergency treatments.

Emergency contraception: an untapped resource among sexually active college students in Osogbo metropolis, Nigeria

Emergency contraception: an untapped resource among sexually active college students in Osogbo metropolis, Nigeria Esther O Asekun-Olarinmoye,1 Wasiu O Adebimpe,1 Adeleye A Adeomi,2 Adenike I Olugbenga-Bello2 1Department of Community Medicine, Osun State University, Osogbo, Nigeria; 2Department of Community Medicine, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria Introduction: Unwanted pregnancies and unsafe abortions result in the death of thousands of women, while millions suffer from permanent or temporary disabilities, problems that the use of emergency contraception can ameliorate. This study was therefore carried out to assess the knowledge, attitude, and practice of emergency contraception (EC) among college students in Osogbo metropolis. Materials and methods: This descriptive cross-sectional study was carried out among 594 college students in Osogbo metropolis in Osun State, Nigeria, using pretested, semistructured questionnaires. Respondents were selected by multistage sampling. Data were analyzed using SPSS software, version 15. Results: The mean age of the respondents was 23.45 &plusmn; 3.63 years. Mean age at first sexual exposure was 19.34 &plusmn; 4.34 years. Awareness about EC was fairly high among the respondents, (403, 67.8%), with categorized scoring of outcome variables showing that 60.8% of respondents had good general knowledge and only 27.9% had a positive attitude towards EC. However, only 66 (29.9%) of the sexually active respondents had ever used EC before the study, while 26 (21.5%) of the 121 sexually active female respondents admitted to having had an abortion. Bivariate analysis revealed that respondents&rsquo; knowledge of, and attitude towards, EC were significantly related to age (P &lt; 0.00000001), respondents&rsquo; course of study (P &lt; 0.00000001), and their level in college (P = 0.0000002), while the use of EC among the sexually active students was significantly related to respondents&rsquo; knowledge of EC (P = 0.017). Conclusion: Fairly high awareness, good general but poor comprehensive knowledge, negative attitudes, and poor use characterized the practice of EC among our study population. There is therefore a need for health-education initiatives about EC, addressing specific areas of poor knowledge and clarification of common misconceptions. Keywords: knowledge, attitude, practice, college students, emergency contraception

Acceptability and use of emergency contraception among married women in Bangalore, India

ObjectiveTo assess knowledge, acceptability, and use of emergency contraceptive pills (ECs) among lower-income married women in Bangalore, India. MethodsEC counseling and supplies were offered to 322 women aged 18–25years participating in a longitudinal reproductive health study. Participants completed interviews at enrollment and were followed for 1year. EC acceptability and use were assessed, and factors associated with use were identified. Results206/320 (64.4%) participants did not desire pregnancy but only 46/321 (14.3%) used an intrauterine device or contraceptive pills. Only 25 (7.8%) had heard of ECs. Overall, 123 (38.2%) participants requested advance provisions of ECs after counseling. Over a year, 37/263 (14.1%) women used ECs, usually within 3days of unprotected sex (33 [89.2%]), and 32 (86.5%) took both pills together or 1day apart. Thirty-six (97.3%) felt glad and 31 (83.8%) were relieved after taking ECs. Twenty-five (67.6%) women who used ECs sought permission from their husbands. The only factor associated with EC use was couples' pregnancy intentions (odds ratio 4.71; 95% confidence interval, 1.43–15.58; P≤0.01). ConclusionIndian women with access to ECs generally used them correctly and found them acceptable. Efforts to expand EC knowledge and access should be coupled with efforts to promote gender equality in the reproductive sphere.

Knowledge and determinants of emergency contraception use among students in tertiary institution in Osun State, Nigeria

Background : Emergency contraception (EC) or postcoital contraception has the potential to reduce the number of unwanted pregnancies and thus the abortion rate. Tertiary institutions' students are a unique group with very high social interaction, but by virtue of their level of education, probably forms a group in any community, which should have an overall higher level of awareness and use of available methods of contraception, including that of EC. Aim: The aim of this study was to assess the knowledge and attitude toward EC, and as well to determine the prevalence of emergency contraceptive use among the students of tertiary institutions in Osun State, Nigeria. Subjects and Methods: A cross-sectional study using the self-administered structured questionnaire on questions relating to the socio-demographic characteristics of the students, sexual relations, knowledge of contraception in general and EC, use and determinants of EC use. Results: A total of 384 of the 400 questionnaire were returned of which male respondents were178/384 (46.4%) while the females were 206/384 (53.6%). Two hundred and seven respondents 207/384 (53.9%) were university students, while 177/384 (46.1%) were polytechnic students. Most respondent 142/376 (37.8%) derived knowledge of EC from friends and family life education from school 186/373 (49.9%). More than half of respondents are in sexual relationships, with only 71/384 (18.5%) showing good knowledge of EC. However, use of EC was 106/384 (27.6%). Conclusion: Most tertiary institutions' students are involved in a sexual relationship, have poor knowledge of EC and use of EC also. Formal family life education, partner approval, and previous use of EC encourage further use. There is a need for carefully designed education programs and promotion of family life education with deliberate awareness on safe sex practices, including EC in existing students' health enlightenment programs on campuses.

A study of knowledge and attitude of nursing students towards emergency contraception

Introduction: Out of 210 million pregnancies in the world each year, 75 million pregnancies are unintended and/or not planned. Most of these unplanned/ unintended pregnancies are not carried to full term, but aborted often in unhygienic conditions leading to serious consequences. Mortality and morbidity related to abortion can be significantly reduced by the use of emergency contraceptive. Materials and methods: A present cross-sectional study was carried out among 140 nursing students of the first and second year studying at Katuri College of Nursing, Guntur, Andhra Pradesh, by a convenient sample method over a period of 4 months from March 2010 to June 2010. Results: In the present study,100% of the respondents were aware about EC. The majority (93.4%) of the respondents were unmarried. Regarding knowledge of nursing students, only 55.71% students give the correct response to ideal clients for EC. Only 51.43% students give the correct response to the methods of EC. Only 57.86% students give the correct response for maximum acceptable time after sex for a woman to take EC.65% students don’t know about common side effect of EC. Regarding attitude of nursing students towards EC, 65% students were of opinion that paramedical staff should dispense EC. Conclusion: This study suggested that participants had overall positive attitude toward EC but there was a lack of knowledge regarding the effectiveness, mechanism of protection from RTI/STDs. So, there is a need to further educate them about EC.

CONHECIMENTO E USO DA CONTRACEPÇÃO DE EMERGÊNCIA NA ADOLESCÊNCIA: CONTRIBUIÇÕES PARA A ENFERMAGEM

Trata-se de estudo descritivo-exploratório com o objetivo de identificar o conhecimento e o uso da contracepção de emergência entre adolescentes. A coleta de dados deu-se por meio de questionário respondidos por 271 adolescentes de uma escola pública de São Paulo em 2010. Os resultados revelam que 87,8% das adolescentes conhecem a pílula e a forma de utilização, 28,8% já usaram a pílula e o uso médio por adolescente foi de três vezes e de forma correta. A contracepção de emergência não foi usada por todas as adolescentes que tiveram a sexarca ou demais relações sexuais sem proteção, o que representa uma lacuna entre o conhecimento e o uso dessa modalidade de contracepção. Cabe ao enfermeiro, como educador atuante em unidades básicas de saúde, escolas e outros espaços sociais, desenvolver estratégias para alcançar esta população e contribuir para o conhecimento, a prevenção da gravidez indesejada e promoção do autocuidado.

Emergency Contraception

Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the "off-label" use of combination oral contraceptives.

Emergency Contraception Considerations and Use Among College Women

Emergency contraception (EC) has been available behind the counter without a prescription since 2006. Evidence has shown increased use of EC among young women, but no recent findings have been published to date of current use. This cross-sectional study surveyed 482 college heterosexually active college women attending a large public university who either visited the college-based health clinic or were enrolled in selected undergraduate classes. Prediction models were created for each outcome, EC consideration and use, using Poisson regression with robust variance estimates. Just over 58% of college women sampled reported ever considering EC, and just under 47% reported actual use. Consideration and actual EC use were highest for students who were nonwhite and who reported more sexual partners. Although female students who did not use condoms were more likely to use EC, there was no difference in EC relative to hormonal contraception use. As EC becomes both better known and more readily available, use is expected to grow. Moving forward, greater attention is needed to the efficacy of EC use on preventing unwanted pregnancies.

Availability of Over-the-Counter Emergency Contraception in 2 Disparate New York City Neighborhoods

We conducted a telephone survey of pharmacies in 2 New York City neighborhoods on same-day availability, type, and cost of over-the-counter emergency contraception. There was no difference in availability of over-the-counter emergency contraception between Upper East Side and East Harlem pharmacies (93% vs 94%; P = .71). Average cost of medication was less in East Harlem than in the Upper East Side ($45.16 vs $51.64; P < .001). Efforts should accentuate overcoming cost and knowledge barriers associated with the use of emergency contraception.

What Do We Know About Males and Emergency Contraception? A Synthesis of the Literature

Unintended pregnancy rates are high in the United States. It is important to know whether improving males' access to emergency contraceptive pills may help prevent unintended pregnancy, especially in cases of -condom failure. A search of the PubMed, PsycINFO and Cumulative Index of Nursing and Allied Health Literature databases was conducted to identify studies published from January 1980 to April 2011 concerning males and emergency contraception. Forty-three studies met the specified criteria and examined relevant knowledge, attitudes, beliefs, intentions or behaviors, from the perspectives of males, clinicians or pharmacists. The proportion of males who were familiar with emergency contraception ranged from 38% among teenagers to 65-100% among adults. Small proportions reported that they and their partner had used or discussed using emergency contraceptive pills (13-30%) or that they themselves had ever purchased them (11%). Most providers (77-85%) reported general knowledge about emergency contraceptives, but the proportions who knew the time frame within which the pills can be prescribed were smaller (28-63%). Most males approved of emergency contraceptive use following contraceptive failure (74-82%) or unprotected sex (59-65%), or in cases of rape (85-91%), but both pharmacists and college students reported concerns that females might feel pressured to use the method. No study examined clinicians' attitudes and behaviors (e.g., counseling or advance provision) regarding males and emergency contraception. Studies are needed to determine whether male involvement in emergency contraception can reduce rates of unintended pregnancy and to assess health professionals' ability to counsel males about the method.

Ulipristal Acetate: The Newest Emergency Contraceptive

More than 50 percent of pregnancies in the United States are unplanned. Emergency contraception has been shown to possibly reduce the risk of pregnancy by as much as 75 percent. Ulipristal acetate is a selective progesterone receptor modulator that was approved by the U.S. Food and Drug Administration (FDA) for emergency contraceptive use in August 2010. This article reviews information on its mechanism of action, efficacy, safety and implications for women's health nurses.

Determinants of emergency contraceptive use after unprotected intercourse: Who seeks emergency contraception and who seeks abortion?

To compare differences in contraceptive characteristics and the knowledge of emergency contraception (EC) between women who used EC after unprotected intercourse and those who sought abortion. A questionnaire survey. A Hungarian university hospital. Two large clinical groups were enrolled: women who were prescribed EC after unprotected intercourse (n= 952) (EC group) and women who presented for termination of pregnancy who had not taken EC after a contraceptive failure despite being suitable candidates to take EC (n= 577) (control group). Questionnaire evaluation. Knowledge concerning, previous use of, and other factors related to EC use. The EC group experienced a condom failure significantly more often (odds ratio (OR) = 3.07), while the control group reported more failures with the contraceptive pill (OR = 0.69) and with periodic abstinence (OR = 0.09). Use of EC depended on age, education level, place of residence, accurate knowledge of EC (OR = 3.87) and previous EC use (OR = 1.16). Awareness of EC was influenced by information obtained from healthcare providers (OR = 3.63) or by school education (OR = 1.28). Women who use less reliable contraceptive methods should be targeted for health education that stresses the importance of reliable contraception and provides more detailed knowledge on EC and when it should be used.

Family planning 2011: better use of existing methods, new strategies and more informed choices for female contraception

BACKGROUND This paper explores recent developments in female contraception, using them to illustrate how adaptation of existing methods, improved service delivery and understanding contraceptive behaviour might increase contraceptive uptake and correct and consistent use, and how the development of new methods holds some promise for capitalizing on the potential non-contraceptive benefits. METHODS Searches were performed in Medline and other databases. Selection criteria included high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed by the European Society of Human Reproduction and Embryology (ESHRE) Workshop Group. RESULTS The topics discussed include: adapted regimens for combined oral contraceptive pills, non-invasive methods of female sterilization, the need to improve the awareness of pregnancy risk to increase the use of emergency contraception, improvements in the evidence base for the safety and service delivery of intrauterine methods, emphasis on the potential benefits of combined oral contraceptives for women with hirsutism and acne, the potential of female sterilization to prevent ovarian cancer, and the promise of anti-progesterones and new approaches to dual protection. CONCLUSIONS Although great strides have been made in recent years in increasing contraceptive use among women in many countries where contraceptive prevalence is low or there is a high unmet need for contraception, much more can, and needs to, be done.

P112 Texting or talking? Which works better to reduce hazardous drinking by sexual health clinic attendees?

BackgroundHazardous drinking is associated with an increased risk of catching an STI, getting pregnant unintentionally, being sexually assaulted and sexually assaulting someone else. An Alcohol Brief Intervention (ABI), a type...

The Underutilization of Emergency Contraception

Despite the availability of effective contraceptive methods, unintended pregnancy continues to be a significant health problem for women throughout the world. The reasons for unplanned pregnancy include failure to use contraception, incorrect use of contraception, unplanned consensual intercourse, and rape. Emergency contraception was once heralded as a means of reducing the rates of unintended pregnancy, elective abortion, and unwanted childbirth. But more than three decades after the first oral form was introduced, the use of emergency contraception remains suboptimal-even in the United States, where it is available to most women of childbearing age without a prescription. Nurses can help narrow this clinical gap in women's health care by increasing awareness of emergency contraception, correcting common misconceptions about its mechanism of action and potential adverse effects, and facilitating patient access.