Emergency Contraception Provision: A Survey of Emergency Department Practitioners

Abstract

Abstract. Objectives: To determine emergency department (ED) practitioner willingness to offer emergency contraception (EC) following sexual assault and consensual sex, and to compare responses of practitioners from states whose laws permit the refusal, discussion, counseling, and referral of patients for abortions (often called ''opt-out'' or ''abortion-related conscience clauses'') with those of practitioners from states without these laws. Methods: Using a structured questionnaire, a convenience sample of ED practitioners attending a national emergency medicine meeting was surveyed. Results: The 600 respondents were: 71% male, 29% female; 34% academic, 26% community, and 33% resident physicians; and 7% nurse practitioners and physician assistants. Many respondents (88%) were inclined to offer EC to those sexually assaulted by unknown assailants. More practitioners said they were willing to offer EC if the assailant was known to be HIV-infected rather than if the assailant had low HIV risk factors (90% vs. 79%, p < 0.01). More respondents would prescribe EC after sexual assault than consensual sex (88% vs. 73%, p < 0.01). The rates of willingness to offer EC were the same for practitioners in states with ''abortion-related conscience clauses'' and those from other states. Conclusions: Most ED practitioners said they were willing to offer EC. Although the risk of pregnancy exists after consensual sex, practitioners were less willing to prescribe EC after those exposures than for sexual assault. ''Abortion-related conscience clauses'' did not seem to influence willingness to offer EC.

Availability of Emergency Contraception in Massachusetts Emergency Departments

“…14 A 2002 national survey of all Catholic hospitals in the United States showed that overall, only 5% would provide EC upon request and only 28% would provide EC in cases of rape. 15 In a study by Keshavarz et al, practitioners self-reported that they were less willing to prescribe EC after consensual sex than after sexual assault, 16 which is consistent with the trends in the findings of this study, although in our study they were found not to be statistically significant.…”

Emergency Contraception for Sexual Assault Victims in North Carolina Emergency Departments

“…Previous research has shown that hospitals do not consistently provide emergency contraception to victims of sexual assault. [1][2][3][4][5] One study of emergency physicians found 8.4% would not prescribe emergency contraception to sexual assault victims. 1 A 2002 national study of Catholic and non-Catholic hospitals by Harrison found that emergency contraception was not available at 55% of Catholic hospitals and 42% of non-Catholic hospitals.…”

Emergency Contraception in Emergency Departments in Oregon, 2003

“…15 The second study, a survey of Pennsylvania emer-gency departments in 2000, found that 32% of non-Catholic and 6% of Catholic hospitals routinely offered counseling and provision of EC to rape patients. 18 The Pennsylvania survey also found that rural emergency departments were less likely to offer EC than were urban emergency departments. 16 In addition, a 2002 national survey of Catholic hospitals found that 28% of Catholic emergency departments offered EC to rape patients (although a majority of these hospitals set up obstacles, such as pregnancy testing and police reports) and 5% offered EC to women who had consensual sexual intercourse.…”