Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review

Abstract

BackgroundExposure to domestic violence and abuse (DVA) results in a reduction of women’s use of regular contraceptives. This evidence suggests that women exposed to DVA are more likely to have unprotected sexual intercourse and therefore may use more emergency contraception (EC) than those women who are not exposed to DVA. We aimed to test this hypothesis through evaluating the evidence for an association between exposure to DVA and use of EC.MethodsWe systematically searched eight electronic databases from inception until December 2017, checked references and citations, and contacted corresponding authors. Primary studies that evaluated the association between exposure to DVA and use of EC were included. Two reviewers were involved in screening, data extraction, quality assessment and analysis. We evaluated the quality of included studies with the adapted Newcastle-Ottawa Scale. We used tables and descriptive text to summarise and synthesise the data. Odds ratios (ORs) and 95% confidence intervals (CIs) for each estimate of the association between DVA and use of EC were plotted on a forest plot.ResultsOur search retrieved 1216 records of which six studies with 15,297 women were included. Five studies were observational; one study included intervention on the outcome (advance supply of EC). All studies were at high risk of bias. Four studies provided evidence of an association between DVA and EC use – ORs from 1.51 (95% CI 1.13, 2.02) to 6.50 (95% CI 4.15, 10.17). Two studies found no evidence of a such association – ORs 0.46 (95% CI 0.11, 1.96) and 0.76 (95% CI 0.29, 1.98). The latter differed by how the authors recruited participants, measured EC use and adjusted for confounders.ConclusionsThis systematic review provides some evidence of increased use of EC among women exposed to DVA. Request for EC can indicate possible exposure to DVA. Therefore, each consultation for EC could be an appropriate context for clinical enquiry about DVA and signposting/referral to specialist DVA services.Protocol registrationPROSPERO CRD42017058221.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0652-7) contains supplementary material, which is available to authorized users.

Exposure to domestic violence and abuse and consultations for emergency contraception: nested case-control study in a UK primary care dataset

“…This study supports the recent systematic review of cross-sectional studies that found some evidence for an association between exposure to DVA and increased use of EC 5. The two main reasons for seeking EC are women’s fear that the contraceptive method they used would not work, and women’s fear of unintended pregnancy after unprotected intercourse 38.…”

“…Two systematic reviews have found an association between exposure to DVA and reduction in use of regular contraception 3 , 4. The authors’ recent systematic review found some evidence for a positive association between exposure to DVA and use of emergency contraception (EC) 5. However, none of these reviews included UK studies.…”

Low use of Modern Family Planning Methods in women suffering from Physical and Psychological abuse by their partiners: Findings from Cross-Sectional Study

“…The study results is consistent with a study done in Egypt assessed the effects of married women's autonomy on utilization of modern FP methods revealed that, married women who are under the control of male partners are also limited to access modern FP (39). These ndings are contrasted with a study done in England and South Asia, which reported that, there is no relationship between married women experienced IPV and modern FP use (40,41). The similar ndings of no association between IPV and modern FP use were also reported from a study done in Uganda (Kidman & Bertrand, 2015; Wandera, et al, 2018).…”

The European Union and Violence Against Women: Fundamental Rights and Con Games

“…When agencies miss an opportunity to intervene effectively, women are at risk of returning to the exploitation and abuse from which they are attempting to escape (Hodges and Burch, 2019;Matthews et al, 2014;WAFE, 2017). Women seeking support to escape abuse do not typically approach specialist services directly (AVA & Agenda, 2019;Lewis et al, 2018). It is therefore crucial that everyone with whom they come into contact, including non-specialist staff in general practice surgeries and other agencies, know how to respond appropriately, which agencies in their locality (women's centers, hostels, refuges, etc.)…”