Use Of Emergency Contraceptive Pills Research Articles

Evaluation of Emergency Contraceptive Pill Use with Health Management Information Systems Data in Pakistan.

According to the WHO, all clients should have access to a range of contraceptive methods, including at least one short-term, one long-term, one permanent, and one emergency method of contraception. While there are data on the contraceptive method mix available for many low- and middle-income countries, there are limited data on emergency contraception (EC). This is likely due to some surveys not routinely collecting this information, how survey questions are asked, dual method use, and/or low levels of reported use of EC pill (ECP). Even with low reported use in surveys, contraceptive social marketing statistics from DKT International. show a trend in recent years of increasing product sales of ECPs. To understand a more complete scope of ECP use, we use Pakistan as a case study and analyze Pakistan's Demographic Health Survey (DHS) surveys and Pakistan's Contraceptives Logistics Management Systems. Based on commodities dispensed data for ECPs in 2021, about 0.4 percent of all married women in Pakistan use ECPs. While there is currently a small proportion of women, it is growing and the use of ECPs is not zero as indicated by the DHS. Therefore, where available, countries should review their health management information systems data alongside survey data for ECP use.

Qualitative study on stigma as a barrier to emergency contraceptive pill use among university students in the Lango subregion, Uganda

ObjectiveThe aim of the current study was twofold: to understand the nature and extent of stigma and to learn the reasons behind the decision not to use emergency contraceptive pills...

Unveiling reproductive choices: Knowledge and practices of emergency contraceptive pills among the female factory workers in Sri Lanka

BackgroundIn Sri Lanka, the Emergency Contraceptive Pill (ECP) is categorized as a Schedule 2A medication, allowing it to be purchased over-the-counter without a prescription, but exclusively from licensed pharmacists. It is estimated that around 3 million ECPs are consumed by Sri Lankan women each year. This study aims to assess the knowledge and practices of Female Factory Workers (FFWs) on ECP and to unearth the association with unintended pregnancy and unsafe abortion. MethodsAfter receiving written informed consent, a structured interview schedule was administered among 585 FFWs attached to eight factories in a selected Export Processing Zone (EPZ). Data analysis was performed using SPSS software. ResultsOnly 26 % of FFWs were aware of the effective time period to take an ECP to prevent a pregnancy. Most (67 %) had the impression that a valid prescription is required to purchase ECP from the pharmacies. Around one-tenth of the FFWs (11.3 %, n = 66) had used ECP during their lifetime. Among the 65 respondents who reported having experienced unintended pregnancies, only 26.2 % (n = 17) had utilized ECPs. In contrast, among the 22 respondents who disclosed a history of abortion, only two women had ever employed ECPs. ConclusionThe study highlights the low knowledge and use of ECP among FFWs in Sri Lanka, contributing to unintended pregnancy and unsafe abortion. Results call for targeted interventions to improve knowledge and access to ECP, helping to reduce unintended pregnancy and improve reproductive health outcomes.

Do Indian women know about and use the emergency contraceptive pill? An analysis of nationally representative data from 2005–06 and 2019–21

Abstract The emergency contraceptive pill (ECP) is a post-coital contraceptive method that prevents unintended pregnancy and is useful in specific circumstances. This study examined the awareness and use of the ECP in India, as there is scarce evidence in this area to guide policy development. This study used data from the 2005–06 (n = 124 385) and 2019–21 (n = 724 115) rounds of the National Family Health Survey of India. Bivariate analysis and multivariate logistic regression were applied to explore how demographic characteristics including age, education (none, primary, secondary, higher), wealth quintile, place of residence (urban, rural), marital status, parity, desire for children, whether current pregnancy was wanted, whether the women had had an abortion in the past 5 years, and whether current use of contraceptive methods affected the likelihood of knowledge and use of ECP. In the past 15 years, knowledge of ECP has increased by 37 percentage points but still remains relatively low at 48%. Less than 1% of the sample (0.55%) used ECP. Women aged 30–34 years, from wealthier and more educated backgrounds, living in urban areas, and currently using condoms had a higher likelihood of using ECP in comparison with women from age group 15–19 years, those from the poorest backgrounds, those with no education, those living in rural areas and those not using any contraceptive method, respectively. In comparison to married women, never-married women exhibited a higher awareness of ECP but lower use. More efforts must be made to improve awareness of the ECP, especially among adolescents, those with less education, poorer women and those in rural areas. The government is taking steps to improve access to ECP, and India’s female community health workers, the ASHAs, could be further supported to enhance awareness of ECP.

Knowledge, attitudes, and practices toward emergency contraceptive pills among community pharmacists and pharmacy customers: A cross-sectional study in urban Vietnam

ObjectivesThis study aimed to investigate Vietnamese community pharmacists and pharmacy customers' knowledge, attitudes, and practices about emergency contraceptive pills (ECPs). Study designWe recruited 400 pharmacists and 396 customers via a nonprobability convenience sampling technique. We used univariate and multivariate linear regression models to determine factors associated with the knowledge and attitudes toward ECPs among pharmacists and customers. We selected variables in the multivariate models through the Bayesian Model Averaging method using R software (version 4.2.3). ResultsIn medicine outlets, levonorgestrel and mifepristone (ECPs) were highly available. The average knowledge scores on ECPs among pharmacists and customers were 9.98 ± 2.00 and 6.24 ± 2.33, respectively. Many pharmacists did not have adequate knowledge of ECPs’ mechanism of action, dosage, and contraindications. Customers lacked knowledge about their legislation, effectiveness, and side effects. The attitudes toward ECPs among participants were relatively positive. Reliable information sources about ECPs (such as the package leaflet, courses, and books) played an essential role in increasing ECP knowledge and attitudes (p < 0.001). The availability of ECPs (p < 0.001), being educated (p < 0.01 and 0.01), and daily sales (p < 0.001) were significantly associated with pharmacists’ knowledge/attitudes. Age, education level, marital status, and occupation were significantly associated with customers’ knowledge. Participants’ knowledge of was significantly associated with their attitude toward ECPs (p = 0.02 and p < 0.001, respectively). ConclusionsThe knowledge of ECPs among pharmacists was relatively good, while that of customers was poor. There is a need to have policies and interventions to enhance the knowledge and attitudes toward ECPs for both pharmacists and customers. ImplicationsCommunity pharmacies are ideal settings to dispense contraceptive methods, especially over-the-counter ECPs. Community pharmacists can help ensure the availability of ECPs in medicine outlets, increase women’s access to ECPs, and counsel customers on up-to-date and comprehensive knowledge about these medications, thereby guaranteeing rational ECP use.

Emergency contraception – pharmacists’ knowledge and attitude on emergency contraceptives’ dispensing practices

Abstract Objectives Emergency contraceptives have the potential to reduce health complications in women with unintended/unwanted pregnancies. Access to availability and use of emergency contraceptive pills (ECPs) is influenced by pharmacist knowledge and attitudes, and there are limited data in Nigeria on pharmacists’ ECPs dispensing practices. This study assessed pharmacists’ knowledge, attitude and practice towards the use of emergency contraceptives. Methods A cross-sectional study conducted among 100 community pharmacists in Ibadan metropolis, Nigeria with the use of a self-administered structured questionnaire. The questionnaire contained Likert-type 17-item knowledge, 9-item attitude and 15-item practice scales. The scales utilised 5–7 graded responses. The scaled score was graded as good and poor knowledge, positive and negative attitude and high, moderate or low-level practice of emergency contraception. The ability to predict the level of practice of emergency contraception, based on the pharmacist’s knowledge and attitude towards the use of ECP, was determined with hierarchical multiple regression as P &amp;lt; 0.05. Key findings Good knowledge of emergency contraceptives was displayed by 51.5% of the pharmacists, and 51.9% had a positive attitude towards the use of ECPs. The level of ECP dispensing practices was high among 43.4% of pharmacists and low among 30.1% of pharmacists. More than 30% of the pharmacists offer a high level of educational services practice for ECPs. Pharmacists’ knowledge (β = 0.348, P = 0.002) and attitude (β = −0.302, P = 0.007) were predictive of the dispensing practice of ECPs. Conclusion The community pharmacists have good knowledge of emergency contraceptive use and showed a positive attitude towards the dispensing of emergency contraceptive pills.

Patterns of use of emergency and oral contraceptives from an online service in the United Kingdom during the COVID-19 pandemic: A quantitative study of routinely collected data

ObjectivesOur study aimed to describe users of a free online contraception service, compare online emergency contraceptive pill (ECP) users with online oral contraceptive (OC) users, and describe patterns of use of online ECP and OC over time, including transition from ECP to more effective forms of contraception. Study designAnalysis of routinely collected, anonymized data from a large, publicly funded, online contraceptive service in the United Kingdom from April 1, 2019 to October 31, 2021. ResultsThe online service provided 77,447 prescriptions during the study period. About 84% for OC and 16% for ECP, of which 89% were ulipristal acetate. ECP users were younger, lived in more deprived areas, and were less likely to be of white ethnicity than OC users. About 53% ordered OC only, but 37% ordered both ECP and OC. Among those prescribed both OC and ECP (n = 1306), 40% had one method as dominant, 25% appeared to move from one method to the other (11% ECP to OC, 14% OC to ECP), and 35% continued to use both methods. ConclusionsOnline services are accessible to diverse young populations. While the majority of users order OC only, our study suggests that where there is free, online access to both OC and ECP, and those ordering ECP are always offered free OC, transition to more effective ongoing forms of contraception is uncommon. Further research is needed to understand whether online access to ECP increases its attractiveness and reduces likelihood of transition to OC. ImplicationsThis study demonstrates that free, online contraceptive services are accessible to ethnically and socioeconomically diverse users. It identifies a subgroup of contraceptive users who combine use of OC and ECPs over time, and suggests that improved access to ECP may alter contraceptive choices.

Perception of Condoms and Emergency Contraceptive Pill Use among Students in the University of Bamenda

Background: Globally, university students fall in the youth group prone to unattended sexual risks which may lead to unwanted pregnancy and STI/HIV. In Cameroon, more than a third of maternal deaths occur among adolescent girls and young mothers. Unwanted pregnancies results from the infrequent use of modern contraceptive methods and is one of the main causes of death in this population. Condoms are barrier contraceptive that have a beauty of dual protection-against pregnancy and transmission of STI/HIV, meanwhile emergency contraceptives has just one function which is protection against unwanted pregnancy. Aim: To assess the perception of condoms and emergency contraceptive pill use among students in the university of Bamenda, Cameroon. Materials and Methods: A university-based cross-sectional study was conducted among students in the University of Bamenda, North West Region of Cameroon, a cosmopolitan area approximately about 19 km from Bamenda main town (Commercial Avenue). The study was carried out over a period of three months. Data were collected using a structured interviewer questionnaire administered through Google form. Data collected were extracted into excel sheet and analysed with SPSSv23. Results: The study included 719 students (318 males and 401 females). The rate of male and female condom use was 28.5% and 8.1% respectively. The mean age of our study populations was 24.5 ± 4.97 years with 52.7% of population between 20 to 24 years of age. Knowledge about condoms was high at 98.3%, however, 91.9% of participants have never used the female condoms before. Highest factor recorded for non-utilisation of the male and females condoms were reduction in sexual pleasure (47.4%) and lack of knowledge on usage (44.1%) respectively. 95% of students have knowledge on Emergency Contraceptive Pills (ECPs) but just an average (52.4%) have used it before. Fear of side effects (47.4%) was the main reason for not using ECPs. Conclusion: There is a very high knowledge about condom and emergency contraceptive pill among students. However, the rate of usage recorded was very low with highest source of information being the media/internet and lowest among relatives/family.

Factors Responsible for the Decline Contraceptive Prevalence rate in Nepal

This study is based on the factors responsible for the decline in the use of contraceptives in Nepal since 2006. The main objective of this study is to identify potentially responsible factors contributing to the reduction of CPR in Nepal. This study is based on a secondary resource. For the purpose of this study, data and information has been collected from various sources such as demographic and health survey reports, published national and international articles and reports in related contexts. The Family Planning Program is a priority program of the Government of Nepal, established with the objective of ensuring that individuals and couples fulfill their reproductive needs and rights using quality family planning methods based on voluntarily informed choices. The use of temporary contraceptives in Nepal has not increased over the past few years and has remained stable rate since 2011 and 2016. This does not mean an overall decline in the prevalence of contraceptives because of the prevalence rate of any method of contraception has increased (53%) in 2016 from 50 percent in 2011 and 48 percent in 2006. Since 2006, the uses percentage of modern contraceptive methods has not increased, this study is focused on the causes of low or stable contraception rate. Still, the current supply of contraceptives has not able to meet the high demand of contraceptive users. The demand for contraceptives was 67 percent in 2016.The reasons for the decline in contraceptives in Nepal could be (a) Spousal Separation (especially in the reproductive age group), (b) increasing use of traditional methods, (c) legalization of abortion and (d) use of emergency contraception. Results show that 47 percent of married women discontinued the use of family planning methods because of their husband being away from home. Similarly, 9.8 percent of married women were traditional method users. After the legalization of abortion, the number of abortions has been gradually increasing over the year and the use of emergency contraceptive pills is also increasing day by day.

Knowledge and attitude toward emergency contraceptive pills among first-year undergraduate students in Southern Thailand

BackgroundFirst-year undergraduates are at risk of unexpected pregnancy due to changes in their lives. Adequate knowledge and attitudes towards emergency contraceptive pills (ECPs) are essential to help prevent pregnancy. The objective of this study was therefore to investigate knowledge and attitudes towards ECPs among first-year undergraduate students in a university in Thailand.MethodsThis cross-sectional survey study was performed using developed questionnaires that were validated by four experts. The questionnaires were distributed to all first-year students at the university via an online platform. The characteristic data were descriptively analysed, and the knowledge data were analysed using the chi-square test, Mann‒Whitney U test and one-way ANOVA.ResultsData from a total of 335 students who responded to the questionnaires and met the eligibility criteria for the study were analysed. The mean knowledge score of all respondents was 7.76 ± 0.15 out of 15. The most correctly answered questions were those relating to the efficacy and safety of ECPs in pregnant women (78.5% and 72.2% correctly answered, respectively). In contrast, the least correctly answered questions were about the ECP regimens and using ECPs instead of combined oral contraception (COC) (30.4% and 34.9%, respectively). In addition, the results indicated that experience in using ECPs and in ECP education were significant factors in high knowledge scores. Moreover, most respondents trusted and would like to receive information on ECPs from health professionals in hospitals, academic institutions, or pharmacies.ConclusionThe average knowledge of ECPs of first-year students in a university in Thailand was at a moderate level. More information about the regimens of the drugs and the use of ECPs instead of COC should be provided to students, particularly at universities or pharmacies, and should be performed by health care staff.

Emergency Contraceptive Pill Use and its Impact on Condom Utilization Among University Students: A Cross-Sectional Study.

PurposeEmergency contraceptive pills (ECPs) prevent unplanned pregnancy but not sexually transmitted infections (STIs), and the practice of ECP may affect condom use. This study, therefore, aimed to assess ECP use and its impact on condom utilization among female students of private universities in Nekemte town, western Ethiopia.MethodsAn institution-based cross-sectional study was conducted on 400 female students in three different private universities from February 1 to 28, 2019. Study samples were selected through simple random sampling technique. Data collected from a structured self-administered questionnaire were analyzed using SPSS version 23.0. Bivariate and multivariate logistic regression were performed to determine factors associated with condom utilization, and statistical significance was set at 95% confidence interval (CI) using a p-value of <0.05 as a cutoff point.ResultsThe response rate was 95.3% (381/400). Overall, 51.4% (196/381; 95% CI = 45.1%, 57.7%) had awareness of ECP. Besides, 186 (48.8%) students reported history of sexual intercourse, of which 115 (61.8%) have ever practiced ECP and 96 (51.6%) have ever used condom. However, only 11 (5.9%) have ever utilized ECP and condom concurrently. Use of ECPs (adjusted odds ratio (AOR) = 0.32; 95% CI = 0.164, 0.632; p = 0.001), belief that condom prevents STI (AOR = 3.17; 95% CI = 1.045, 8.646; p = 0.041) and thought that ECP does not prevent STI (AOR = 2.217; 95% CI = 1.172, 4.59; p = 0.032) had statistically significant association with condom utilization.ConclusionThe practice of ECP was average, while dual method contraception use was low in the study area. History of ECP use and beliefs that ECP is not effective to prevent STI or condom protects against STI were factors associated with condom use.

Trends in Emergency Contraceptive Use Among Adolescents and Young Adults, 2006–2017

PurposeIn 2013, age restrictions for adolescents on over-the-counter access were removed for “Plan B One-Step”, a single oral medication option for emergency contraception use. Restrictions on generic options of the emergency contraceptive pill (ECP) were removed in 2014. MethodsNational Survey of Family Growth data were used to assess the prevalence of ever use of ECPs among sexually experienced female adolescents and young adults (AYA) aged 15–24 years (2015–2017 sample), and trends in indicators of ECP use and acquisition (2006–2017 samples). Prevalence estimates were obtained by age subgroups for 15–17, 18–19, and 20–24 years. Statistical significance was determined using an alpha of .05 and 95% confidence intervals calculated around the point estimates. ResultsThe weighted estimate of sexually experienced female AYA in the United States ranged from 13.3 million in 2006–2008 to 12.7 million in 2015–2017. The prevalence of ever ECP use was 18.2% (95% CI 15.7–21.1) and 31.8% (95% CI 26.9–37.1) in 2006–2008 and 2015–2017, respectively. Ever use in 2015–2017 varied by age group, number of lifetime opposite-sex partners and abortions, and experience of nonconsensual sex. In 2008–2010, 46.1% (95% CI 36.0–56.5) of respondents last obtained ECPs at community health or family planning clinics, and 31.8% (95% CI 22.9–42.2) last obtained ECPs at a pharmacy compared to 18.1% (95% CI 12.0–26.4) and 70.1% (95% CI 60.6–78.1) respectively in 2015–2017. Prevalence of provider counseling about emergency contraception in female AYA regardless of prior sexual experience in the past 12 months remained at or below 5% from 2006 to 2017. ConclusionIncreasing access to ECPs over-the-counter may have contributed to notable increases in reported ever use of ECPs and in the receipts from a pharmacy among AYA between 2006 and 2017. AYA may benefit if pharmacists and healthcare providers increase reproductive health counseling.

Over-the-counter provision of emergency contraceptive pills: a systematic review

ObjectiveTo synthesise evidence around over-the-counter (OTC) emergency contraceptive pills (ECPs) to expand the evidence base on self-care interventions.DesignSystematic review (PROSPERO# CRD42021231625).Eligibility criteriaWe included publications comparing OTC or pharmacy-access ECP with...

Determinants of emergency contraceptive pill use in Bangladesh: An analysis of national survey data

Objective: To examine the determinants of emergency contraceptive pill use in Bangladesh.Methods: Data for this cross-sectional study came from 2017-2018 Bangladesh Demographic and Health Survey. Characteristics of 906 reproductive age women who were potential candidates for using emergency contraceptive pill were analysed in this study. Data were analysed using univariate and multivariate analyses. Stepwise binary logistic regression was employed as multivariate analysis.Results: Only 10.9% candidates were found to ever use emergency contraceptive pill. The odds of using emergency contraceptive pill for women visited by family planning field worker was significantly higher than that for those who were not visited by family planning field worker [odds ratio (OR) 1.94; 95% confidence interval (CI) 1.19–3.17; P=0.008], while the odds of using emergency contraceptive pill for women with high socioeconomic status was higher than that for those with low socioeconomic status (OR 3.10; 95% CI 1.61–5.97; P=0.001). Additionally, having some media access was linked to an increase in the odds of using emergency contraceptive pill (OR 3.01; 95% CI 1.33–6.83; P=0.008). Women empowerment related factors did not show any significant effect on emergency contraceptive pill use.Conclusions: The findings indicate that family planning programme has a great opportunity of playing an important role in increasing emergency contraceptive pill use in Bangladesh by increasing the knowledge and awareness of women about emergency contraceptive pill.

The emergency contraceptive pill in Brazil: High usage rates but schooling differences persist

ObjectivesThis paper aims to analyze usage rates for the emergency contraceptive pill (ECP) among women living in the city of São Paulo and their associated factors. Study designA population based cross-sectional survey was conducted in 2015 with a probabilistic sample of 4,000 women aged 15 to 44 living in São Paulo, Brazil. Response rate for households was 75% and 77% for eligible women. Binary logistic regression models were used to describe the association between each outcome and selected variables. ResultsA total of 51.4% of women living in the city of São Paulo had used ECP at least once in their lifetime. Women under 35 were more likely to use ECP, as were those with more than 9 years of schooling, having at least one live birth, not cohabiting with a partner, with more than two lifetime sexual partners and as length of sexual life decreased. Among ECP users, 32.6% used it only once, 47.5% used it 2 to 4 times, and 19.9% used it 5 or more times. ConclusionsOur findings suggest that ECPs have been incorporated into the contraceptive method mix for many women as a fundamental strategy for regulating fertility. Particularly young women, unmarried women and those who have had more partners seem to take greater advantage of ECP to prevent pregnancy. ImplicationsDespite the high use rate, lower levels of schooling are associated with lower levels of ECP use. There is a need for both policies to reduce schooling inequities and strategies to improve women's knowledge of reproduction and contraception.

The Role of Health Care Providers in Young Women's Attitudes about and Willingness to Use Emergency Contraceptive Pills.

Emergency contraceptive pills (ECPs) are an underused resource among adolescent and young adult women who have unprotected sex. This analysis examines young women's attitudes about and willingness to use ECPs, with particular attention to their experiences with health care providers. Sexually active young women (ages 15-25, assigned female at birth, N=212) completed a self-administered survey at 10 family planning clinics in the San Francisco Bay Area. Participants reported attitudes about ECP effectiveness, safety, effect on sex drive, and whether it should not be taken often, and their willingness to use ECPs in the next 3months. The predictors of interest were past and current contraceptive experiences with health care providers. Data were analyzed through descriptive statistics and multivariable logistic regression analyses controlling for sociodemographic characteristics, prior contraceptive use, pregnancy history, and pregnancy intentions. Most young women agreed that ECPs are effective at preventing pregnancy (75%) and safe to use (71%); few reported that they reduce sex drive (11%). Yet, the majority (62%) believed ECPs should not be taken often and only 35% reported willingness to use ECPs. In multivariable analyses, more positive health care experiences were associated with more positive attitudes about ECP safety, less concern that ECPs should not be taken often, and greater willingness to use ECPs (p<.05). Health care providers play an important role in the acceptance and provision of ECPs, especially for young women who prefer ECPs over other contraceptive methods. In particular, providers can use the contraceptive visit as an opportunity to destigmatize repeat ECP use.

“It prevents a fertilized egg from attaching…and causes a miscarriage of the baby”: A qualitative assessment of how people understand the mechanism of action of emergency contraceptive pills

ObjectiveThe mechanism of action (MOA) of emergency contraceptive pills (ECPs) is frequently mischaracterized. Our objective was to identify how members of the general public understand the mechanisms of ECPs. Study designWe recruited a convenience sample from social media for a survey about reproductive health attitudes and analyzed spontaneous descriptions of how ECPs work. We inductively coded responses to create themes and subthemes, and collapsed subthemes into three MOA categories based on previous research. ResultsAmong 1443 respondents, 533 mentioned an MOA in their description of ECPs. While nearly half of these responses (49.5%) stated that ECPs prevent pregnancy before fertilization occurs (in accordance with most biomedical ECP research), over 60% described a mechanism related to preventing implantation of a fertilized egg. Nine percent of responses described a postimplantation mechanism that would be considered abortion by mainstream medical standards. Some respondents conveyed significant confusion about the biological processes involved with pregnancy and pregnancy prevention. ConclusionConfusion about how ECPs work was common among our sample. The largest group of responses described a mechanism—preventing implantation of a fertilized egg—listed on the Food and Drug Administration (FDA)-approved ECP labels that does not reflect most relevant biomedical research. Mischaracterizations of ECPs’ mechanisms have been used to limit access to EC. These misunderstandings were common in our sample and may reflect poor quality sex education and public information, and confusion introduced by the FDA-approved labels. Additional research should identify whether public perception of ECPs’ mechanisms influences policy, health care provision, and use of ECPs.

Changes in use of emergency contraceptive pills in the United States from 2008 to 2015

ObjectivesTo describe changes in use and receipt of emergency contraceptive (EC) pills among women in the United States during a period of key EC policy changes, from 2008 to 2015. Study designUsing data from the 2006 to 2010 and 2013 to 2017 National Surveys of Family Growth, we present changes in the percent of women who ever used EC between 2008 and 2015 by select sociodemographic and sexual and reproductive health characteristics, and we examine multivariable relationships of these characteristics with EC ever use in 2015. We also examine changes in repeat EC use, receipt of EC counseling, reasons for EC use and source of EC between the time periods. ResultsAmong sexually experienced women ages 15 to 44, EC ever use increased from 11% in 2008 to 23% in 2015 overall and among nearly all groups of women. In 2015, age 20 to 29, non-Hispanic other or Hispanic race, at least a high school education, working part-time, income at least 100% of the federal poverty level, ever having been married, and having received EC counseling in the prior year all represent characteristics associated with higher odds of having ever used EC. In 2015, a smaller share of women last obtained EC with a prescription or at a health facility than in 2008. ConclusionsIncreases in EC use occurred as access to EC was broadened through regulatory changes that moved some forms of EC from behind-the-counter to fully over-the-counter between 2008 and 2015. ImplicationsOver-the-counter provision of many forms of EC pills may have increased access and introduced more flexibility in how EC is obtained, but these changes may have come with tradeoffs, both in the form of cost barriers and decreased opportunities for clinicians to discuss EC with their patients. Despite improved access to contraception more broadly through the Affordable Care Act, EC remains a necessary component of the overall contraceptive method mix, and clinicians can play a key role in discussing EC as one option among many during contraceptive counseling sessions.

Knowledge and Use of Emergency Contraceptive Pills among Bachelor's Level Female Students of Kathmandu Valley

Emergency Contraceptive Pill (ECP) is used for preventing pregnancy after having unprotected sexual intercourse, contraceptive failure or forced sex. The use of ECP within 120 hours of sexual intercourse could prevent unwanted pregnancy and its adverse effects particularly unintended childbirth and unsafe abortion. The study, therefore, aimed to assess knowledge and use of emergency contraceptives among Bachelors level female students from Kathmandu Valley. A descriptive cross-sectional study was undertaken from August to November 2017 among 347 female students who were studying at the Bachelors's level. A random sampling technique was used to select study participants and a structured self-administered questionnaire was used to assess the knowledge and use of ECP after securing informed consent. Epi data and SPSS version 22 were used for data processing and analysis. The mean age of the female students was 21.5 years. Overall, 91.4% of the respondents had ever heard about emergency contraceptives. The main sources of information were radio or television, the internet and newspapers. About 4.6% of the undergraduate female students used ECP. Age, marital status, use of contraceptives and knowledge of ECP used within 72 hours were significantly associated with use of ECP. Although the findings of this study showed a high prevalence of knowledge among respondents, the improvement of female students’ knowledge on specific details of ECP and its advantages/disadvantages and timely utilization needs to be considered for any future awareness programmes.&#x0D;

Critical ethnographic respect: womens’ narratives, material conditions, and emergency contraception in India

Emergency Contraceptive Pills (ECPs) are increasingly available over the counter as a form of hormonal birth control in India. As use of ECPs is increasing over time, this paper draws on ethnographic research in Dehradun, in Uttarakhand (Northern State) to highlight the everyday material conditions under which women create narrative around choice and agency regarding these ECPs. Women viewed ECPs as better options than abortion, appreciated the sense of empowerment these provided them because they could be consumed in houses where women had limited ‘space and privacy;’ and finally that ECPs and their advertisements could act as ‘agents of social change.’ Feminist scholarship on reproduction demonstrates that choice is a form of agency that is enacted within certain constraints. Using this framework, the research here highlights how women create narratives about ideas of contraceptive choice and notions of ‘empowerment’ when talking about ECPs and their advertisements. In revisiting the dilemma about women’s agency and choice, this paper builds on Rosalind Gill’s concept of ‘critical respect’ to propose ‘critical ethnographic respect’ as an ethnographic tool to help read women’s responses and respectfully contextualise the materiality from within which these narratives emerge.