Acceptability of Contraceptive Services in the Emergency Department: A Cross-sectional Survey

Abstract

Introduction Unintended pregnancy disproportionately affects marginalized populations and has significant negative health and financial impacts on women, their families, and society. The emergency department (ED) is a promising alternative setting to increase access to sexual and reproductive health (SRH) services including contraception, especially among marginalized populations. The primary objective of this study was to determine the extent to which adult women of childbearing age who present to the ED would be receptive to receiving contraception and/or information about contraception in the ED. As a secondary objective, we sought to identify the barriers faced in attempting to obtain SRH care in the past. Methods We conducted a quantitative, cross-sectional, assisted, in-person survey of women aged 18–50 in the ED setting at two large, urban, academic EDs between June 2018–September 2019. The survey was approved by the institutional review board. Survey items included demographics, interest in contraception initiation and/or receiving information about contraception in the ED, desire to conceive, prior SRH care utilization, and barriers to SRH. Results A total of 505 patients participated in the survey. Participants were predominantly single and Black, with a mean age of 31 years, and reporting not wanting to become pregnant in the next year. Of those participants, 55.2% (n = 279) stated they would be interested in receiving information about birth control AND receiving birth control in the ED if it were available. Of those who reported the ability to get pregnant, and not desiring pregnancy in the next year (n = 279, 55.2%), 32.6% were not currently using anything to prevent pregnancy (n = 91). Only 10.5% of participants stated they had experienced barriers to SRH care in the past (n = 53). Participants who experienced barriers to SRH reported higher interest in receiving information and birth control in the ED (74%, n = 39) compared to those who had not experienced barriers (53%, n = 240); (P = 0.004, 95% confidence interval, 1.30–4.66). Conclusion The majority of women of childbearing age indicated the desire to access contraception services in the ED setting. This finding suggests favorable patient acceptability for an implementation study of contraception services in emergency care.

Emergency contraceptive provision in the emergency department and risk analysis for delayed utilization in South Korea

“…[16] In a survey of ED visitors seeking contraceptive management, the responders reported that their experience of ED-based contraception services was favorable. [15] The demand for ECPs at EDs has been increasing. [17] However, research on ED visits for ECP, including visits for sexual diseases or injuries, remains limited, [18,19] and ED-based research on the time interval between coitus and the ED visit is limited to a few surveys.…”

“…The ED has been designated as the primary center to provide ECPs. [5,14,15] Furthermore, the number of ED visits after sexual assault has increased greatly between 2006 and 2019. [16] In a survey of ED visitors seeking contraceptive management, the responders reported that their experience of ED-based contraception services was favorable.…”