Emergency Contraception: A National Survey of Adolescent Health Experts

Abstract

In a survey of 167 physicians with expertise in adolescent health, 84% said they prescribe contraception to adolescents, but only 80% of these prescribe emergency contraception, generally a few times a year at most. Some 12% of respondents said they believe that providing emergency contraception to adolescents would encourage contraceptive risk-taking, 25% said they think it would discourage correct use of other methods and 29% said they think repeated use of the method could post health risks. Physicians who were more likely than their colleagues to prescribe emergency contraception included obstetrician-gynecologists (92%), those who graduated from medical school after 1970 (77%) and those who describe their practice as being in an "academic" setting (76%). Physicians may restrict use of the method by limiting treatment to adolescents who seek it within 48 hours after unprotected intercourse (29%), by requiring a pregnancy test (64%) or an office visit (68%), or by using the timing of menses as a criterion for providing the method (46%). While 41% of physicians who provide emergency contraception counsel adolescents about the method during family planning visits, only 28% do so during visits for routine health care; 16% counsel women who are not yet sexually active about the method.

Emergency Contraception Provision: A Survey of Emergency Department Practitioners

“…The majority of these physicians, however, did not counsel their adolescent patients about EC during family planning visits. 36 In a case series of 1,076 consecutive sexual assault survivors presenting to a Denver ED, only 60% received EC. 37 A previous case series noted a similar figure.…”

The Visit Before the Morning After: Barriers to Preprescribing Emergency Contraception

“…Yet EC is underprescribed and underused in the United States. 1 Though the lack of awareness of EC is a barrier to wider use, 2 evidence indicates that physicians with good knowledge of the method routinely underprescribe EC, 3 whereas patients who know about EC often fail to use it when needed. 4 Furthermore, opinion surveys generally fi nd favorable views of the method among both physicians and patients.…”

“…Few physicians educate patients about EC or assess need for EC during routine health or contraceptive-counseling visits. 3,10,11 Most prescribe EC on an emergency basis, when a patient requests it after an act of unprotected intercourse. In addition to preventing EC from reaching many patients who may not know enough about EC to ask for it, the emergency model constrains access in other ways.…”

Emergency Contraception: Knowledge and Practices of Tertiary Students in Osun State, South Western Nigeria

“…Only 36% of respondents in a study were aware that anything "could be done "within a few days to prevent pregnancy, 55% "had heard" of emergency contraception and only 1% had used it [7]. A study of inner-city adolescents found that only 25% "had heard"of emergency contraception [8]. World wide, one of the biggest obstacles to the widespread use of emergency contraception is that many women do not know it [9].…”