Use Of Emergency Contraception 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.

Contraceptive risk events among family planning specialists: a cross sectional study

BackgroundProponents of abortion restriction cite advancements in contraceptive technology as a reason against the need for abortion care today, most recently through oral arguments in the Supreme Court of the United States case, Dobbs v. Jackson Women’s Health. However, consistent and correct use of contraception requires reproductive health literacy. Our objectives were to quantify contraceptive risk events and assess contraceptive history and preferences among a population well-equipped to evade contraceptive risks, family planning specialists following initiation of their medical training. “Risk events” are defined as reported episodes of contraceptive failure, emergency contraception use and/or unprotected or underprotected intercourse.MethodsThis was a cross-sectional study among current members of a professional organization of family planning specialists. Inclusion criteria included: status as a current or retired clinician, consensual penile-vaginal intercourse and personal or partner capacity to become pregnant since the start of medical training. Descriptive statistics were performed. This study was IRB exempt.ResultsAmong 229 respondents, 157 (69%) reported experiencing a contraceptive risk event since training. Twenty-nine (13%) respondents reported an occurrence within the last year. By category, 47% (108/229; 3 reported unknown) reported under- or unprotected intercourse, 35% (81/229) reported emergency contraception use, and 52% of participants (117/227; 2 unknown) reported known or suspected contraceptive failure. The mean number of contraceptive methods used was 3.7 (SD 1.7) out of the 13 methods listed. Almost all (97%) participants reported at least one method was not an acceptable option, with a mean of 5.6 (SD 2.7) of the 13 listed methods.ConclusionsThe majority of family planning specialists have experienced contraceptive risk events during times of active pregnancy prevention since their medical training. Contraceptive method change is common and most respondents were limited in the number of methods that were personally acceptable to them. Dialogue idealizing the role of contraception in minimizing or eliminating abortion need is simplistic and inaccurately represents the lived realities of pregnancy-capable individuals and their partners, including among those with exceptional contraceptive literacy and access.

Use of Oral and Emergency Contraceptives After the US Supreme Court’s Dobbs Decision

The US Supreme Court Dobbs v Jackson Women's Health Organization decision allowed states to strengthen restrictions on abortion access, triggering the closure of family planning clinics and leading to confusion about the legality of emergency contraceptives (ECs). To evaluate the association between the Dobbs decision and fills for oral and emergency contraceptives in states that enacted the most restrictive abortion policies after Dobbs. This cohort study used data on contraceptive fills for women of reproductive age (15-49 years) in the US from IQVIA's National Prescription Audit PayerTrak and data from the Guttmacher Institute were used to categorize changes in abortion restrictions in each state. A difference-in-differences analysis compared changes in monthly fill rates for daily oral contraceptive pills (OCPs) and ECs in states that became most restrictive (implemented a full abortion ban after Dobbs) and comparison states (kept a medium level of abortion restrictions after Dobbs) before (March 2021 to November 2021) and after (July 2022 to October 2023) the Dobbs decision. State-level abortion restrictions. Monthly fills of OCPs and ECs per 100 000 women of reproductive age. Between March 2021 and October 2023, 142.8 million prescriptions for OCPs and 904 269 prescriptions for ECs were dispensed at US retail pharmacies. Before Dobbs, trends in monthly fill rates were similar for OCPs and ECs between the most restrictive and comparison states. After the Dobbs decision, states that became the most restrictive experienced an additional 4.1% decline in OCP fills with 285.9 fewer fills per 100 000 (95% CI, -495.8 to -6.8; P = .04). In contrast to OCPs, fills for ECs increased during the first year after Dobbs (July 2022 to June 2023) in both groups of states. However, 1 year after Dobbs (July 2023 to October 2023), the most restrictive states experienced an additional 65% decrease in emergency contraceptive fills with 13.2 fewer fills per 100 000 (95% CI, -27.2 to -4.1; P = .01). In this cohort study of prescriptions filled at US pharmacies, the Dobbs decision was associated with declines in oral contraceptives, particularly ECs, in states enacting the most restrictive abortion policies. Given the important role of OCPs and ECs in preventing pregnancy and the need for abortion, efforts to improve access may be needed, especially in states where legal abortion is no longer an option.

Role of Medical Treatment in Abortion-An Observational Study

Background: Medical treatment of abortion has been identified as safe and effective Method of evacuation of uterus and is more amenable to provision through primary care facilities, ever where providers may not have the skills to perform a surgical evacuation. Medical treatment of abortion care encompasses the management of various clinical conditions including incomplete abortion missed abortion, blighted ovum, as well as post-abortion contraception. Medical management of abortion generally involves misoprostol. Objective: To assess the role of medical treatment in abortion in pregnant women-an observational study. Methods: This is an observational study done at Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh from July 2021 to July 2023. 101 patients fulfilling the inclusion criteria were enrolled. This is an attempt to study incomplete abortion after medical treatment of abortion and to observe the success read of this method of taking it among patients, with prescriptions or without it. Questionnaires were prepared and women were interviewed. Questions pertaining to women knowledge, attitude, perception and use of medicine for treatment of abortion, use of emergency contraception were asked. Study was carried out by using responses in the preform given. Results: This study was done in duration of two years and 101 patients fulfilling the inclusion criteria were enrolled. Women who had ectopic pregnancy, threatened abortion &amp; excessive P/V bleeding were excluded. In our study, most of the women interviewed, were between 25-34 years of age (51.5%). Out of the 101 women, 99 women (98.01%) were married and 2 (1.99%) were unmarried. 76 women (75.2%) belonged to urban residence. 16 women (15.9%) were working women. 81 women (80.2%) were housewives. 4 (3.9%) interviewed were students. 41 women interviewed were illiterate (40.6%) while only 9 women (8.9%) were graduates. In our study, majority of women 76 (75.2%) had taken abortifacient or spontaneous abortion occur at &lt;12 weeks of gestation. However, 05 (4.9%) women did not know about their gestational age. Main complication after taking medicine for abortion was moderate bleeding mentioned by 60 women (59.4%), incomplete abortion by 10 women (9.90%), Repeat prescription after 1 week 05 women (4.95%), pain by 27 women (26.7%) and need MVA or D&amp;C by 07 women (6.93%). Among the 101 women who used misoprostol with known outcome, 90.09% had complete abortions, 10 (9.90%) had incomplete abortions. The rates of incomplete abortion and surgical intervention were not significantly different among the women with administration of misoprostol. Among blighted ovum after treatment, complete abortion 69.3% and 30.7% incomplete abortion. Conclusion: Medical treatment of abortion is safe and effective but complications can occur if not used in accordance. However, the awareness about medical treatment of abortion is increasing. It is therefore of utmost importance to increase the awareness about medical treatment of abortion not only among doctors but also among general population.

“Even when you write with a pencil there is an eraser to clean it”: Examining men's conceptualisations of and involvement in emergency contraceptive use in Accra, Ghana

Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy.This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use.Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term ‘emergency contraception’ was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from ‘emergency’ are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.

Frequency of same-day contraceptive initiation, recent unprotected intercourse, and pregnancy risk: a prospective cohort study of multiple contraceptive methods

BackgroundSame-day start removes barriers to contraceptive initiation and may reduce the risk of unintended pregnancy. Same-day start may be appropriate for all contraceptive methods, but we lack data comparing methods. ObjectivesTo assess the frequency of same-day initiation among six contraceptive methods selected for “same-day start” among new contraceptive users and describe the efficacy of same-day start first cycle pregnancy risk by all contraceptive methods and by each method. Study DesignUsing prospective data from the HER Salt Lake Contraceptive Initiative, we identified and assessed outcomes for participants initiating a new method of contraception beyond the first seven days of their menstrual cycle (same-day start). Enrolled participants at four family planning clinics in Salt Lake County, Utah between September 2015-March 2017 received their method of choice regardless of their cycle day or recent unprotected intercourse. All participants self-reported last menstrual period data and unprotected intercourse events in the previous 2 weeks. We excluded participants that received care immediately after or within two weeks of abortion care. Clinical electronic health records provided information on contraceptive method initiation and use of oral emergency contraception. Participants reported pregnancy outcomes in 1-, 3-, and 6-month follow-up surveys with clinic verification to identify any pregnancy resulting from same-day initiation. The primary outcomes report the frequency of same-day start use and first cycle pregnancy risk among same-day start users of all contraceptive methods. The secondary outcomes include frequency of and pregnancy risk in the first cycle of use among same-day start contraception users by method. We also report frequency of unprotected intercourse within 5 days and 6-14 days of contraception initiation, frequency of concomitant receipt of oral emergency contraception with initiation of ongoing contraception, and pregnancy risk with these exposures. We analyzed pregnancy risk by contraceptive method initiated same-day and assessed for simultaneous use of oral emergency contraception. ResultsOf the 3,568 individuals enrolled, we identified the majority as same-day start users (n=2,575/3,568, 72.2%), with one in eight of those reporting unprotected intercourse in the previous 5 days (n=322/2,575, 12.5%) and one in ten reporting unprotected intercourse 6-14 days prior to contraceptive method initiation (n=254/2,575, 9.9%). We identified 11 pregnancies among same-day start users (0.4%, 95% CI 0.2%-0.7%) compared to 1 (0.1%. 95% CI 0.002%-0.6%) among those who initiated contraception within seven days from the last menstral period. Users of oral hormonal contraception and vaginal hormonal methods reported the highest 1st cycle pregnancy rates (1.0 – 1.2%). Among same-day start users, 174 (6.8%) received oral emergency contraception at enrollment in conjunction with another method. Of the same-day user who received emergency contraception at initiation, 4 (2.3%) pregnancies were reported. Conclusion(s)Same-day start is common and associated with a low pregnancy risk. Using the “any method, any-time” approach better meets contraceptive clients’ needs and maintains a low risk of pregnancy.

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...

A contracepção como um valor: histórias de jovens sobre desafios no uso e manejo dos métodos

Abstract This study presents the findings of the social anthropological research project “Jovens da era digital: Sexualidade, reprodução, redes sociais e prevenção às IST/HIV/AIDS” [Young people in the digital age: Sexuality, reproduction, social media, and prevention of STI/HIV/AIDS], which was conducted with interlocutors between the ages of 16 and 24 years old from six Brazilian cities. This study focuses on contraceptive management among heterosexual adolescents and young adults, with particular emphasis on women, given their prominent role in family planning within hierarchical gender contexts. We describe the typical script for youth contraception, which involves the use of condoms at the onset of sexual activity, followed by the incorporation of hormonal methods or the withdrawal method. We also find that adolescents frequently resort to the use of emergency contraception. Women frequently report experiencing side effects from hormonal contraceptives, which results in high rates of discontinuation and an increased interest in copper IUDs, which are scarce resources within the Brazilian National Health System. It can be concluded that, despite gender constraints and social, ethnic, and racial inequalities, the interviewees value contraception, offering insights for the review and improvement of public policies concerning young people.

KNOWLEDGE AND ATTITUDE ON EMERGENCY CONTRACEPTION AMONG HIGHER SECONDARY STUDENTS

Background: Emergency contraception is a modern contraceptive method that can be used to prevent pregnancy after unprotected sex. Adolescents are one of the vulnerable groups for premarital, unsafe/unprotected sexual intercourse resulting in unintended pregnancy. The aim of this study was to assess the knowledge and attitudes of secondary school students. Methods: An analytical cross-sectional study design was used, and the study population included students in grades 11 and 12, including all faculties, selected by a proportional simple random sampling technique. Data were collected using a self-administered questionnaire. Descriptive and inferential statistics were used to analyze the data and findings. Results: The present study revealed that out of 222 respondents, the majority of respondents 65.3% had good knowledge and 52.3% of respondents had favorable attitudes towards emergency contraception among secondary school students. Some socio-demographic characteristics were significantly associated with good knowledge age (p&lt;0.001), educational level (p&lt;0.001), and faculty of education (p=0.004) and were not significant with other socio-demographic variables. However, there was no significant association between attitude towards emergency contraception and socio-demographic variables. Conclusions: Most of the respondents have good knowledge and a positive attitude towards emergency contraception. However, very few of them knew about the right time to use emergency contraception and other related aspects. Therefore, awareness programs can be conducted at the high school level to increase the level of knowledge and correct use of emergency contraception.

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.

RETROSPECTIVE AND SINGLECENTER STUDY WITH THE AIM OF PHARMAECONOMIC ANALYSIS IN PREGNANCY TERMINATIONS AT SAN GIULIANO HOSPITAL OF ASL NAPOLI 2 NORD.

Introduction: Pregnancy termination (IG) is a widely practiced clinical procedure and can be therapeutic (IGT), pharmacological (IGF), or surgical (IGS). The analysis of total costs associated with different methods is useful to highlight advantages and disadvantages for the patient and to enable decision-makers to intervene in a precise manner on company policies supported by concrete data. The relevant legislation governing pregnancy termination is Law 194/78, with specific reference to voluntary termination, permitted within the first 90 days of gestation. This deadline can only be exceeded in special cases, such as severe risk to the mother or fetal malformation. The Law 194/78 aims to ensure that the process of voluntary termination (IVG) is guaranteed, and in this sense, family planning clinics serve as a reference service for many women and couples. The organization of IVG services must be such that there is enough professional figures to provide women with access to voluntary pregnancy termination. From the latest reports published by the Ministry, there is a noticeable decrease in voluntary pregnancy terminations, a trend also observed among foreign women. This is undoubtedly influenced by the increased use of emergency contraception – Levonorgestrel (morning-after pill) and Ulipristal acetate (5-day after pill). On the other hand, due to the more frequent use of pharmacological termination (using Mifepristone+Prostaglandins), there is an increased access to termination within the first 8 weeks of gestation, which represents the deadline for undergoing this variant of the procedure. Materials and Methods: The study is retrospective and uncentered, with an evaluation of data from questionnaires administered to patients who underwent Pregnancy Terminations in the years 2020, 2021, and 2022 at San Giuliano Hospital in Giugliano in Campania (Na), which falls within the territory of the Local Health Authority Napoli 2 Nord.From the analysis of the questionnaires, it is possible to reconstruct sensitive patient data, including place and date of birth, residence, domicile, age, origin, education level, as well as all clinical data related to the patient and pregnancy in general. Surgical pregnancy termination compared to pharmacological termination appears to be less common in all three periods considered. The pharmacological method involves taking an antiprogesterone hormone (Mifepristone) followed by an analogue of prostaglandins (Misoprostol). From a cost analysis perspective, the starting point was the Diagnosis Related Group (DRG) of pharmacological and surgical pregnancy terminations in the Campania Region for each method considered. Results: The laboratory tests which the patient must undergo in the preliminary phase are the same in all abortion (IG) procedures. In the surgical treatment, the patient is admitted to the day hospital, and under anaesthesia, the gestational sac is removed (an invasive procedure with associated risks). In the pharmacological procedure, the patient makes three hospital visits for the administration of two tablets with different active ingredients and at least one follow-up. Conclusions: Although there is a minimal difference between two Diagnosis-Related Groups (DRGs), only 40 euros, the total expenditure is higher in the case of IGF, which prevails significantly in terms of the number of cases compared to IGC. On the other hand, the involvement of professional figures, technical and logistical infrastructure, is inconsistent in IGF, whereas it is much greater in the case of IGC. With IGF, the patient does not undergo any anaesthesia evaluation or surgical intervention, with recovery times estimated to be a few hours and, above all, exposing the patient to fewer risks than the surgical procedure. Additionally, medical and healthcare staff and the operating room structure with all intervention techniques are engaged to a lesser extent in IGF compared to IGC, generating potentially higher company marginality in IGF, especially considering the actual cost of the drugs used. It is worth noting that the DRG falls under regional jurisdiction and may not be the same across the entire national territory. In fact, the Campania Region's case may be different in other regions, resulting in a higher reimbursement amount for IGC treatment compared to IGF.

Descriptive Study on a Nationwide Exploratory Questionnaire Survey of Emergency Contraceptive Pills and Their Sexual History and Knowledge in Japan.

A shift towards obtaining emergency contraceptives without a prescription have been discussed in Japan. In response to this social background, we aimed at investigating the background of sexual intercourse, emergency contraceptive use, and knowledge of sexual and reproductive health education among women of reproductive age in Japan. In this study, we conducted a national wide cross-sectional questionnaire survey using a total of 4 web-based domains (background, sexual history, emergency contraceptives, and sexual and reproduction-related knowledge) composed of 50 questions. We obtained responses from a total of 4,631 participants of varying age groups (18-25, 26-35, and 36-45 years old) and 47 prefectures (84 to 118 from each prefecture). Among participant responses, 69.7% are sexually active, of which 49.0% had experiences of sexual intercourse with an unknown person. The responses from a total of 737 participants who have sexual intercourse, know of emergency contraceptives, and have experienced a situation that necessitated the use of emergency contraceptives, were analyzed. Of these participants, 46.4% (342/737) took emergency contraceptives, while 43.6% (321/737) participants did not take emergency contraceptives. Participants who have the knowledge for obtaining emergency contraceptives through the correct means were 52.6% (2438/4631). This study showed that approximately half of participants may not have correct knowledge of emergency contraceptives. In addition, approximately half of sexually active participants are facing unintended pregnancies due to a lack of sexual and reproductive awareness. Hence, comprehensive sex education is necessary to achieve social and regulatory changes centered on emergency contraceptives.

Emergency contraceptive use of Metronidazole among University female students in Dodoma region of Tanzania: a descriptive cross-sectional study

BackgroundMetronidazole is known for its therapeutic effect as antibacterial and anti-parasitic. However, its toxicity on the reproductive system remains unclear. Metronidazole use in rodents is associates with toxic effects on the reproductive system, including hormonal alterations, reduced number of fertile cells and reduced sites for implantation, size of the placental disc area, constituent elements of the labyrinth, and spongiotrophoblast layers. Its use at a therapeutic dose among humans has been associated with an increased risk of spontaneous abortion. The effects on the reproductive system in humans may result in misconceptions about contraceptive effects hence sexually active individuals like students who, for any reason, fail to access safe contraceptive services use any possible methods to protect them from conception. This study aims to investigate the unofficial (un-prescribed) use of Metronidazole as an emergency contraceptive and some of its associated factors.MethodsThis quantitative cross-sectional study involved 470 participants where stratified random sampling technique was used to obtain the sample from three educational institutions in the Dodoma Municipal, Dodoma region. Collected data were analyzed using SPSS version 25, descriptive statistical analysis was done to determine frequencies, percentages, and association, p < 0.05 was used to determine statistical significance. Further analysis using Multivariate binary logistic regression was done to determine the nature of the association between the study variables.ResultsThe finding shows that 169(62.4%) use Metronidazole as an emergency contraceptive. Notably, 345(73.4%) stated that they had ever heard someone use Metronidazole for contraception, especially their peers. Furthermore, an increase in the year of study was significantly associated with reduced use of Metronidazole as an emergency contraceptive (B = [-0.45], p = [0.02]). Furthermore, an increase in age, studying in non-medical college/university, the experience of using contraceptive methods, and hearing someone ever used Metronidazole was found to be positively associated with its use as an emergency contraceptive, although not statistically significant.ConclusionMetronidazole was found to be used as an emergency contraceptive in high doses, different factors associated with its use, and reasons influencing its use. Further research may be done to explore the toxicological effect of high doses of Metronidazole as a contraception and compare the efficiency of Metronidazole over other emergency contraceptives.

Pharmacist furnishing of hormonal contraception in California’s Central Valley

BackgroundIn the United States, more than 19 million people of reproductive age need access to publicly funded hormonal contraception or live in areas where it is not readily available. These include rural areas of the country, commonly known as contraception deserts. Pharmacist prescribing has been proposed to increase access, but little is known about its implementation in such areas. ObjectiveThis study quantified the extent of pharmacists’ furnishing (prescribing) of hormonal contraception in California’s Central Valley community pharmacies and identified barriers and facilitators to implementation. MethodsThe researchers conducted a cross-sectional, mixed methods, observational study by (1) contacting all community pharmacies in the 11 counties of the Central Valley to determine furnishing rates and (2) surveying and interviewing pharmacies that indicated they furnished hormonal contraception. ResultsOverall, 13% of pharmacies within the Central Valley reported that they furnished hormonal contraception. Pharmacists reported that barriers to furnishing included costs to patients and the pharmacy, lack of time and staff, lack of training and certifications, limited patient awareness of pharmacists’ ability to furnish, pharmacists’ limited confidence in furnishing, and patient use of emergency contraception as an alternative to hormonal contraception. Pharmacists reported that patients often sought hormonal contraception from pharmacists owing to ease of accessibility to a pharmacist; some other facilitators included advertising, confidentiality, low cost to patients, and referrals from other providers. ConclusionsCommon barriers were identified across pharmacies that furnished hormonal contraception, indicating the need for strategies that reduce these barriers to help expand patient’s access to these services and to increase pharmacists’ ability and confidence to prescribe.

Knowledge and Practice on Emergency Contraceptive Pills Among Non-Health Bachelor Level Female Students in Kathmandu

Introduction: Emergency contraception (ECPs) is hormonal contraception that is used within 72 to 120 hours after unprotected and unsafe sexual intercourse for the prevention of unintended pregnancies. It is important to prevent unwanted pregnancy and there by induced abortion. This study aimed to evaluate the knowledge and practice on ECPs among non-health bachelor level female students in Kathmandu. Methodology: This was a descriptive cross-sectional study of 388 female respondents at non-health bachelor colleges in Kathmandu, Nepal. Simple random sampling technique was used. Pre-tested self-administered questionnaire were used for data collection. Result: The study analyzed the knowledge levels of the study participants, finding that 55.15% had adequate knowledge, while 44.84% had inadequate knowledge. 21.64% practiced ECPs. The study also found a significant association (p value= 0.04) between knowledge level and ECPs practice. Conclusion: The study found that most respondents had adequate knowledge and a significant prevalence of ECP use in Kathmandu district. It is suggested that ECPs not intended to be used as regular form of contraception and should only be used in emergency situation. Frequent use can lead to irregular menstrual cycle and hormonal imbalances.

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.

The current status of emergency contraception use in reproductive-aged Korean women: a population-based internet survey

Objective This study was conducted to assess the current status of emergency contraception (EC) use in reproductive-aged Korean women. Materials and methods This study utilized a population-based, cross-sectional online survey using a self-completed questionnaire in women aged 20-44 years who had visited a clinic in the previous six months for contraception counseling. Reason for use, anxiety, and counseling for further contraception at EC use were analyzed according to age, history of childbirth, and contraceptive failure in EC users. Results Among 1,011 respondents, 461 (45.6%) had experience with EC use. Younger age, need for EC due to inadequate contraception, and high anxiety were highly prevalent among EC users. However, women in the 20s were less likely to get counseling for further contraception at EC use. Additionally, the proportions of women who used EC due to inadequate contraception during sexual intercourse and who experienced high anxiety were lower among women who had a history of childbirth. Women who had a history of contraceptive failure worried less about EC use. Conclusion Our findings offer insight for developing and improving individualized strategies for appropriate contraception, especially in young Korean EC users.

Awareness and use of emergency contraception among women attending Kidwany MCH center, Assiut City

Awareness and use of emergency contraception among women attending Kidwany MCH center, Assiut City

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.