Compliance with Mandated Emergency Contraception in New Mexico Emergency Departments

Abstract

EDs in New Mexico are not universally complying with the law. Better dissemination of the law and education about EC could improve care of sexual assault survivors in New Mexico.

Emergency Contraception: a survey of Hospital Emergency Departments Staffs

“…A similar study conducted in Oregon in 2003 (10), which also employed a questionnaire, found that physician attitudes differed depending on whether the woman had been sexually assaulted or had consented to unprotected intercourse: 46% of emergency physicians did not provide EC to women requesting it, if they had consented to unprotected intercourse; the women were referred to another medical facility where they could obtain EC. The same questionnaire was later administered to a sample of medical staff in New Mexico (11): in 21% of cases, the request was motivated by consensual unprotected intercourse and in 52% by an episode of sexual assault; in 13% of cases, the women were referred to an external health care provider, and in 15% they received neither a prescription nor a referral to another medical facility, despite the medical staff' s knowing the time limit for effective EC. A 2005 national telephone survey in which anonymous requests for EC were made to 600 emergency departments in the U.S. (12) revealed that EC was never offered at 42% of non-Roman Catholic hospitals or at 55% of Roman Catholic hospitals; in 45% of the latter, EC was offered only to sexual assault victims and after the woman had undergone specific procedures -pregnancy testing and police reports -but still at the discretion of the physician on duty.…”

Availability of emergency contraception: A survey of hospital emergency department gynaecologists and emergency physicians in Piedmont, Italy

“…Indeed the prescription of EC pills does not usually need medical or laboratory examinations, and it may be more appropriately addressed by general practitioners and physicians of out-of-hours duty. Both these aspects could explain the findings of former inquiries that highlighted that doctors were less likely to prescribe EC pills to women asking for them after a voluntary unprotected intercourse than to victims of rape who need urgent medical assistance 11,12,15 . Unfortunately our study did not focus on this aspect and it did not allow us to further investigate the reasons for the feelings and opinions given by professionals.…”

“…Second, it was conducted in a health system where women who go to an ED and ask for a prescription of LNG-EC pills can be seen either by emergency physicians or by gynaecologists, so that we could make a comparison between these two groups of professionals. Third, it examined the level of knowledge of the pharmacokinetic and pharmacodynamic characteristics of LNG-EC pills by ED medical staff, an aspect that other studies on record did not take into consideration 11,12,14,15 .…”

Pediatric Emergency Health Care Providers’ Knowledge, Attitudes, and Experiences Regarding Emergency Contraception

“…The support of EC expressed by physicians and NPs is in contrast to current literature. Many studies have shown EC is infrequently prescribed in the ED and is more frequently prescribed following alleged sexual assault rather than after unprotected consensual intercourse 19–23 . In this context, it may be useful to consider a recent study by Sable et al, 23 which applied the theory of reasoned action to explain physician intent to prescribe EC.…”

“…HCP attitudes and beliefs have also been shown to affect EC provision. EC is more frequently prescribed in the ED following alleged sexual assault than after unprotected consensual intercourse 19–23 . Additionally, physicians have concerns that EC would discourage other contraception use and increase risk‐taking behavior 15,16,18,23 .…”