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Background: Proper use of emergency contraception can reduce unintended pregnancy and the risk of abortion. Despite this fact, there is a high rate of unwanted pregnancies among adolescents in Ethiopia. Therefore, determining the level of knowledge and use of Emergency contraceptives (EC) among female youth is important., Objective: To assess Knowledge and use of EC methods and their associated factors among female college students in Gondar City, Northwest Ethiopia, 2023., Methods: Institution-based cross-sectional study was employed among 814 female college students in Gondar City from April 15 to 28, 2023. A multi-stage sampling technique was applied to select the study participants. A self-administered questionnaire was used to collect the data. Epi-data version 4.6 and STATA Version 16, respectively, were used for data entry and analysis. A logistic regression model was fitted to identify factors associated with the outcome variables. Statistical significance was defined at a p-value < 0.05 and a corresponding 95% confidence interval., Result: In this study, 46.2% [95% CI (42.78, 49.63%)] of the participants had adequate knowledge about EC and 26.1% [95% CI (22.82-29.74%)] of sexually active participants used EC. Muslim religion [AOR = 1.82: 95% CI (1.07, 3.09)], being single [AOR = 0.34: 95% CI (0.19, 0.63)], no discussion about reproductive health issues with their husband/partner [AOR = 0.43: 95% CI (0.27, 0.69)], year of study; second year [AOR = 1.63: 95% CI (1.03, 2.58)], third year [AOR = 1.80: 95% CI (1.11, 2.94)], and fourth-year students [AOR = 2.91: 95% CI (1.43, 5.96)] were significantly associated with knowledge about EC. While no discussion about reproductive health with their husband/partner [AOR = 0.09: 95% CI (0.04, 0.20)], monthly allowance [AOR = 3.03: 95% CI (1.54, 5.95)], perceive use emergency contraceptives as not a sin [AOR = 2.59: 95% CI (1.20, 5.60], knowledge about EC [AOR = 2.32: 95% CI (1.253, 4.29)] were associated with the use of EC., Conclusions: Participants' knowledge and of use EC in the study area was low. Religion, years of study, marital status, monthly allowance, perception and knowledge, and having discussion were associated with the use of EC. School-based health education, and behavioral change communication interventions should be established and/or strengthened to address students in need of EC services., (© 2024. The Author(s).)

Objectives: The study aimed to assess the prevalence and factors associated with knowledge and use of the emergency contraceptive pill (ECP) among ever-married women in Bangladesh., Methods: The study was based on a secondary dataset of the 2014 Bangladesh Demographic and Health Survey. Complete (weighted) data of 17,592 women aged 15-49 years were analysed., Results: The prevalence of having knowledge and use of the ECP among ever-married women in Bangladesh was 13.6% and 1.8%, respectively. Administrative region and type of residence (urban or rural), household wealth index, educational level (of both the woman and her spouse), spouse's occupation, number of living children, weight, current use of contraception and a history of pregnancy termination were positively associated with knowledge and use of the ECP., Conclusion: A large proportion of Bangladeshi women of reproductive age had a lack of knowledge and use of the ECP. Nationwide reproductive health education programmes may improve the situation.

Context: Despite the prominence of informal drug shops as sources of contraceptives in Kinshasa, Democratic Republic of the Congo, evidence on the quality of services they provide is scant. Given efforts to leverage the private sector to increase contraceptive access, evaluating the contraceptive knowledge, attitudes and practices of these providers is warranted., Methods: In April-May 2018, a mystery client study on the provision of emergency contraception (EC) was conducted in 854 informal drug shops in Kinshasa. Twelve mystery clients, presenting as younger or older than 18 and married or unmarried, visited the outlets to request something to "avoid getting pregnant" after unprotected sex, and to purchase the recommended medicine. Frequencies of key outcomes were calculated, and chi-square testing assessed associations between client age and marital status and the methods and counseling received., Results: Overall, providers recommended EC in 77% of visits, and in 54% of visits, clients left with the method. In 62% of the visits in which providers recommended EC, they specified a time frame for taking the pill; the correct window of efficacy was indicated in 75% of these visits. In 18% of visits, other (noncontraceptive) drugs were provided, and in 7% of visits, providers did not help the client. Regardless of the visit outcome, providers were nearly always deemed respectful (96%)., Conclusions: Leveraging informal outlets to increase contraceptive provision will require identifying quality outlets, strengthening supply chains and advocating for policy changes that recognize them as effective contraceptive providers without decreasing their perceived advantages for women.

Background: In developing countries, most maternal deaths are related to the lack of accessibility and availability of reproductive health services. In those nations, emergency contraceptive pills are the most commonly used family planning methods to prevent unintended pregnancy. However, women do not use this family planning method for different reasons. Consequently, women expose to unsafe abortion which results in maternal morbidity and mortality., Objective: To assess the knowledge of and utilization of emergency contraceptive and its associated factors among women seeking induced abortion in public hospitals, Eastern Tigray, Ethiopia, 2017., Methods: Hospital-based cross-sectional study was conducted on 380 women, who came for safe termination of pregnancy from April to July 2017. Systematic random sampling technique was used. Pretested structured questionnaire was used to collect data through interview. Data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Data were presented using descriptive statistics. Bivariate and multivariate logistic regression was carried out to see if there was significant association between variables at P < 0.05 and 95% confidence interval (CI)., Result: Out of the total 369 respondents, 149 (40.4%) had the knowledge about emergency contraceptive pills. The magnitude of utilization of emergency contraceptive among respondents was found to be 45 (12.2%). Protestant in religion (AOR = 60.85, CI (5.34-693.29)), previous utilization of any contraceptive method (AOR = 0.13, CI (0.05-0.36)), and women who were not knowledgeable about emergency contraceptive (AOR = 0.030, CI (0.006-0.14)) were significantly associated with the utilization of emergency contraceptive., Conclusion: Most of the women were not knowledgeable about emergency contraceptive and utilization of emergency contraceptive was also very low. In conclusion, religion, knowledge, and previous utilization of emergency contraceptive were associated with the utilization of emergency contraceptive., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2019 Desta Abraha et al.)

Over a decade after emergency contraceptive pills (ECPs) became available without a prescription, the rate of unintended pregnancies remains high in many settings. Understanding women's experiences and perceptions of ECPs may provide insights into this underutilization. We systematically searched databases to identify qualitative and quantitative primary studies about women's beliefs, knowledge, and experiences of ECPs in Australia. Findings demonstrate persistent misunderstandings around access, how ECPs work, and a moral discourse around acceptable versus unacceptable use. Addressing knowledge and the stigma around ECPs use is fundamental to increasing the use of this medically safe and effective strategy.

Background: Globally, the rate of unplanned pregnancies among students at institutions of higher education, continue to increase annually despite the universal awareness and availability of contraceptives to the general population. This study examined family planning among undergraduate university students focusing on their knowledge, use and attitudes towards contraception in the University of Education Winneba., Methods: The study was a descriptive cross-sectional survey using a structured self-administered questionnaire. One hundred undergraduate students from the University of Education Winneba were selected using a multistage simple random sampling technique. A Likert scale was used to assess the attitude of the respondents towards family planning methods., Results: Findings show that the respondents had a positive attitude towards family planning with an average mean score of about 4.0 using a contraceptive attitude Likert scale. Knowledge of contraception, awareness and benefits however do not commensurate contraceptive use among undergraduate students since availability, accessibility and preference influence usage. Emergency Contraception (Lydia) was reported as easy to get contraceptive, hence the most frequently used contraceptive (31%) among young female students aged 21-24 years who appeared as the most vulnerable in accessing and using contraceptives due to perceived social stigma., Conclusion: The observation that levels of Family Planning awareness levels do not commensurate knowledge and usage levels calls for more innovative strategies for contraceptive promotion, and Education on the various university campus. The study recommends that public Universities in Ghana should consider a possible curriculum restructuring to incorporate family planning updates. In this regard, a nationwide mixed method study targeting other tertiary institutions including colleges of education in Ghana is required to explore the topic further to inform policy and programme decisions.

Background: Informing the individuals on family planning including emergency contraception is a significant step for preventing unintended pregnancies. Although there is a number of studies on family planning and emergency contraception globally and in Turkey, no such data are available in the Turkish Republic of Northern Cyprus. The objective of this study was to evaluate the knowledge and perceptions on family planning and emergency contraception of the first year students of an international medical school in Nicosia, Northern Cyprus and to increase awareness for developing new policies on the issue., Methods: The data of this cross-sectional study were collected in February 2016 by a questionnaire of 36 questions. Of the 229 students, 189 (82.5%) completed the questionnaire. The data were evaluated by SPSS 18.0 statistical program. The differences of variables were evaluated by Chi square test, p < 0.05 being accepted as significant., Results: The distribution of participants from 23 countries according to nationality revealed three leading countries: Nigeria, Turkey and Syria. Of the students, 53.6% knew the definition of family planning. The sources of information were mainly school, the internet and media, with a total of 60.9% of the participants who stated having prior information on the subject. Awareness of contraceptive methods was indicated by more than 90% and emergency contraception by 66.1% of the participants. However, the students were unable to differentiate between modern and traditional family planning methods; 85.6% did not have knowledge of the most effective period for emergency contraception and 63.1%, of the definition of emergency contraceptive pills., Conclusions: In conclusion, the knowledge and awareness level of the first year medical students on family planning and emergency contraception was insufficient. Family planning and emergency contraception education should be provided for the students at the first year of all faculties as well as medical schools and relevant programs should be included in the curricula of medical education.

Background: Emergency contraceptive pills (ECPs) are one of the means by which women can use after intercourse to prevent pregnancy. ECPs can be used to reduce the prevalence of unwanted pregnancies and unsafe abortions. This study investigated awareness and use of ECPs among reproductive age (15-49 years) women in Tamale, Ghana. Factors associated with the use of ECPs were also investigated., Methods: This cross sectional study was conducted among 200 women of reproductive age (15-49 years) in Tamale, Ghana. Data on socio-demographic variables, awareness and usage of ECPs were assessed by means of a previously validated questionnaire. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the use of ECPs., Results: Awareness level of ECPs were found to be 69.0% (n = 138); 42.8% (n = 59) got the awareness from a health worker, 31.8% (n = 44) from the radio/TV and 25.4% (n = 35) from family members/friends. Eighty-five percent (n = 117) knew the correct time-frame for an effective use of ECP to prevent pregnancy. Forty percent (39.9%, n = 55) of the participants who had awareness have ever used ECPs. Factors that were found to be associated with the use of ECPs were; participants who said ECPs were affordable (AOR = 6.1, 95% CI = 2.51-10.40, p = 0.001), available (AOR 2.1, 95% CI = 0.61-6.01, p = 0.001), cultural (AOR = 3.5, 95% CI = 1.01-10.15, p = 0.011) and religious unacceptable (AOR = 4.0, 95% CI = 1.02-10.0, p = 0.005)., Conclusion: A relatively high level of awareness and usage of ECPs was found. Factors that were associated with the use of ECPs were availability and affordability. Cultural and religious unacceptability did not hinder the use of ECPs. Health authorities should continue to make ECPs available to women of reproductive age.

Objective: To identify knowledge of and attitudes towards emergency contraception (EC) in women from five European countries., Methods: In an internet-based survey, sexually active women aged 16 to 46 years from France, Germany, Italy, Spain, and the UK were asked about their use of and opinions on EC., Results: Overall, 7170 women completed the survey. Thirty percent reported having had unprotected sexual intercourse during the previous 12 months (population at risk). Twenty-four percent of the population at-risk reported using EC. The most common reasons given for not using EC were: not perceiving themselves to be at risk of pregnancy; and not thinking about EC as an option. A third of respondents indicated they did not know how EC works, with several misconceptions about EC noted e.g., leading to infertility, similar to abortion. Seventy-nine percent of women agreed that EC is a responsible choice to prevent unwanted pregnancy, but nearly a third of women who used EC felt uncomfortable or judged when obtaining it., Conclusions: EC is underutilised by three-quarters of the women surveyed. Women do not recognise they may be at risk of pregnancy when contraception fails. There are still several misbeliefs about EC indicating a need for better education of the public.

Background: Unwanted teenage pregnancies have a notable detrimental impact on the learners' trajectory and have been associated with jeopardising the students' educational progress and future career prospects. These pregnancies are mostly unplanned and unintended and many are terminated, either legally or illegally., Aim: The aim of this study was to explore the contributory role played by the knowledge, attitude and practices of female college students with respect to the utilisation of emergency contraceptives., Setting: Three tertiary institutions in Dessie, Ethiopia., Methods: Quantitative self-administered questionnaires were used to collect descriptive data from 352 female college students., Results: The study revealed that there was a high percentage (78.3%) of unwanted pregnancies amongst those engaging in sex. Significantly, nearly half (43.3%) of these unwanted pregnancies resulted in abortion. Only 10% of the students sampled admitted to ever having used emergency contraception. Even though more than half (69.9%) of the students knew about emergency contraception, only 27% of them felt confident that they understood when it was most effective., Conclusion: These and other observed findings confirm the need for improvement of female college students' knowledge and timely utilisation of emergency contraception.

Objective: The aim of this study is to assess Turkish pharmacists' counseling practices and attitudes regarding emergency contraception pills (ECPs)., Setting: This cross-sectional observational study was conducted via a web-based survey in Turkey., Methods: Pharmacists registered at a professional web site (n = 822) were invited to fill in the study questionnaire; 624 questionnaires were completed and further analyzed. Pharmacists who agreed to participate in the study completed the questionnaire which was structured to elicit their demography, professional experience, counseling practices and attitudes regarding ECP. Attitudes were measured by 18 items under four domains: "reproductive health; information and availability; risk behavior and regulatory restrictions". The answer choices consisted of five items as: "totally agree, agree, neither agree nor disagree, disagree and totally disagree"., Main Outcome Measures: The rate of counseling on various aspects of the ECPs and the rate of negative/positive attitudes., Results: The aspects most frequently counseled on by the pharmacists were dosage, timeframes, efficacy and pregnancy testing. Less frequently counseled aspects were mechanism of action, methods of contraception and side-effects. In general, the pharmacists displayed positive attitudes towards all domains of the survey; while they were negative to the items suggesting that ECP should be sold only to women and only on prescription. Another interesting finding is that 58 % of the pharmacists agreed with the item suggesting limiting the ECP sales to those over 18 years of age., Conclusions: Our results showed that the pharmacists served the clients in need of emergency contraception more frequently than the other health-care providers and in general had favorable attitudes towards ECP. Some aspects of their counseling practices need to be improved. This can be accomplished through continuous education programs that would equip them with the competence to provide counseling on emergency contraception which will in turn help prevent unintended pregnancies and reduce abortion rates.

Background: In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH)., Methods: Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011 Data was collected using structured questionnaire and analyzed using SPSS version 17.0., Results: In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives., Conclusion and Recommendation: The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.

Objective: To assess the theoretical and practical knowledge about emergency contraception (EC) among family-planning (FP) providers in Ghana and to examine the association between FP providers' theoretical and practical knowledge., Methods: Data on 600 FP providers were collected through a census of facilities offering FP services in Kumasi, Ghana, in 2008. Nested linear multivariate regression analysis was used to identify sociodemographic, facility-related, and work-related variables associated with FP providers' theoretical and practical knowledge about EC., Results: On average, FP providers gave 4.1 correct answers to the 11 questions assessing theoretical knowledge and 5.6 correct answers to the 8 questions assessing their practical ability to provide EC. The FP providers seemed to learn provision-related aspects through practice without having a particularly good theoretical knowledge on EC as a contraceptive method. The health sector in which FP providers worked, their education and having received EC-specific training, the number of services offered, and the number of women seen during a week were all significant correlates of both theoretical and practical knowledge about EC. The 2 knowledge domains were significantly and positively associated., Conclusion: There is need to improve knowledge about EC among FP providers in Ghana through in-service training., (Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Purpose: This study aimed to investigate the extent of knowledge and use of emergency contraception among women of reproductive age and to identify barriers existing in Turkey in this context. There is limited research regarding the knowledge and use and barriers to emergency contraception use, since the prepackaged form of hormonal emergency contraception has been available over the counter in Turkey., Methods: This is a descriptive, cross-sectional study of 257 women. Data were collected through face to face interviews with a questionnaire on sociodemographic features, knowledge, use and barriers to emergency contraception., Results: The rate of unintended pregnancies and abortions was noteworthy in the study, where 36.3% of the subjects revealed previous unintended pregnancies and 62.3% of them had undergone surgical termination or spontaneous loss. Remarkably, 42.1% of the respondents had never heard of emergency contraception. Common barriers to the use of emergency contraception were lack of awareness, misconceptions that the pills are abortion-inducing and unavailable without prescription, and anxiety about harming the fetus. The results indicated differences in practice, although emergency contraception is included in contraception counseling. Sixty percent of the subjects counseled by healthcare professionals stated that they were not informed about emergency contraception; a majority expressed a willingness to receive such information., Conclusion: Our study has revealed knowledge deficiency on the part of reproductive-aged women about the effective use, safety, mechanism of action, availability without prescription and legal status of emergency contraception. Client barriers were also found, particularly a lack of awareness. Healthcare professionals are in a key position to provide information and to overcome the barriers.

Background: It can prove challenging to create social marketing materials aimed at a specific subsection of the population, especially when the topic is relatively new and possibly misunderstood. Therefore, the objective of this study was to assess adolescent knowledge of and attitudes towards emergency contraception (EC), with the goal of creating a locally relevant social marketing campaign and intervention., Methods: This qualitative study consisted of 18 in-depth interviews and four focus groups (n=29) with adolescents and young adults ages 15 to 21 years, conducted in New York City between August and December 2006., Results: While respondents seemed generally aware of EC's existence, most were unclear about circumstances warranting its use and its mechanism of action. The FDA change to behind-the-counter availability appeared to increase knowledge and access to EC, although substantial barriers to EC access and use remain, including price., Conclusions: Further work remains in educating those in need of EC, especially adolescents under the age of 18 years. Results from this study initiated a social marketing campaign and intervention aimed at increasing adolescent knowledge of and access to EC.

Objective: The objective of this study was to assess the proportion of emergency medicine physicians who had prescribed emergency contraception pills to adolescents, to identify potential barriers to emergency contraception pill prescription for adolescents, and to assess physician knowledge of emergency contraception pills., Participants and Methods: A cross-sectional, anonymous, Internet-based survey of members of the American Academy of Pediatrics Section of Emergency Medicine was conducted. Providers were included in analysis if they were attending physicians caring for children (<22 years of age) in the emergency department setting >30% of the time. Survey questions included demographics, emergency contraception pill prescription rates for adolescents, attitudes toward emergency contraception pills for adolescents, and emergency contraception pill knowledge questions., Results: A total of 1005 Section of Emergency Medicine members were contacted; 424 (42%) responded, and 133 did not meet inclusion criteria. Of the 291 eligible respondents, 282 had complete surveys. Eighty-five percent of the respondents stated that they had prescribed emergency contraception pills to adolescents, 71% within the previous year. Of those, 81% prescribed emergency contraception pills <5 times. The 5 most frequently cited barriers were concern for lack of follow-up (72%), time constraints (40%), lack of clinical resources (33%), discouraging regular contraceptive use (29%), and concern about birth defects (27%). Thirty-nine percent of respondents identified >/=5 barriers to emergency contraception pill prescriptions for adolescents. Forty-three percent incorrectly answered >50% of the questions. Physicians were more likely to report prescribing emergency contraception pills if they had answered >3 of the knowledge-based questions correctly and were less likely to report prescribing if they identified >5 barriers., Conclusions: Although a large proportion of emergency department physicians reported prescribing emergency contraception pills to adolescents, the pills were prescribed infrequently. Factors associated with nonprescription were decreased knowledge of emergency contraception pills and identifying >5 barriers. Identification of these potential barriers and education regarding emergency contraception pills may ultimately improve adolescent access to emergency contraception pills in the emergency department.

Introduction: Emergency contraception (EC) reduces women's risk for pregnancy after unprotected intercourse, and women's awareness of the method is increasingly important for expanding access. However, knowledge of EC alone does not predict use, and few population data exist to describe EC use among those aware of the method., Methods: Using data from the 2003 California Health Interview Survey, we measured EC awareness among 11,392 women ages 15-44, and EC use among 7,178 respondents who were aware of EC and at risk for pregnancy. Using chi(2) analyses and multivariable logistic regression, we examined population characteristics that epidemiologically predict EC awareness and use, including age, race/ethnicity, income, health insurance status, usual source of health care, immigration status, languages spoken at home, and urban versus rural residence., Results: Nearly 76% of respondents had heard of EC, but awareness was lower among teens, women of color, poor women, women with publicly funded health insurance, those without a usual source of care, immigrants, non-English-language speakers, and rural residents. Among women aware of EC, about 4% reported having used the method in the previous year; young age, low income, attending a community/government clinic for care or not having a source of care, and living in an urban area significantly increased the odds for using EC., Conclusions: Among California women in 2003, awareness and use of EC remained low. However, similar rates of use were reported among racial, ethnic, and linguistic subgroups. Those most likely to report use of the method included population groups at high risk for unintended pregnancy.

Context: Pregnancies among contraceptive users account for nearly half of all unintended pregnancies and are almost entirely due to inconsistent or incorrect contraceptive use. Understanding what factors contribute to inconsistent contraceptive behavior can help efforts to reduce unintended pregnancy., Methods: In 2004, a nationally representative sample of women aged 18-44 using reversible contraceptive methods were surveyed to examine factors associated with contraceptive choice and with inconsistent use of the pill and condoms. Bivariate and multivariate analyses were used to examine the data., Results: Contraceptive choice was associated with a range of socioeconomic and partnership characteristics, and with pregnancy-, method- and provider-related experiences and attitudes; inconsistent pill or condom use was associated mainly with partnership, experiential and attitudinal factors. For example, not having a college education was negatively associated with pill use (odds ratio, 0.6) and positively associated with use of long-acting methods (1.8-1.9). Women for whom avoiding pregnancy was only a little or not important had reduced odds of using the pill (0.4) and elevated odds of using other methods, such as withdrawal or periodic abstinence (4.4), and of using condoms inconsistently (2.6). Use of a method chosen mostly out of dislike of other methods was positively associated with condom use (4.0) and negatively associated with use of the pill or long-acting methods (0.4 for each). Women who were not completely satisfied with their method were more likely than others to use their method inconsistently (1.6 for pill users and 1.9 for condom users)., Conclusions: Greater efforts are needed to provide women and their partners with a range of method options, to facilitate selection of methods that best suit their needs and circumstances, and to identify and assist users who are dissatisfied or are having difficulties using contraceptives effectively.

Background and Objective: The authors examined college students' perceptions regarding emergency contraception (EC) provision in light of the then pending U.S. Food and Drug Administration (FDA) decision about the over-the-counter (OTC) status of EC., Methods: We randomly sampled 7000 male and female students who were enrolled full-time at the University of Michigan during the winter 2006 semester. A total of 1585 (22.6%) students responded to our web-based survey and were included in these descriptive analyses., Results: Nearly all (94%) respondents knew of EC. When asked whether EC should be made available OTC, 60% of respondents agreed, 23% disagreed, and 17% were unsure. If EC were to be made available OTC, 34% of respondents indicated that they (or their partner) would purchase EC in advance of need, and 44% stated that they would purchase it only after unprotected sexual intercourse or contraceptive failure. Advance discussion and provision of EC is underused. Only 10% of all female respondents indicated that their current healthcare provider had spoken to them about EC in a routine health visit, and just 5% of female respondents were offered a supply of EC in advance of need., Conclusions: Continued efforts are needed to ensure timely access to EC in this population.

Women attending a dedicated medical gynaecology and family planning referral clinic for women with HIV were surveyed using a standard questionnaire about their knowledge and attitudes to post-exposure prophylaxis after sexual exposure (PEPSE) and emergency hormonal contraception (EHC). Eighty percent of them had not heard of PEPSE, but once informed about it, 86% said they would inform a partner about it. Less than 10% had any idea of the duration of effectiveness. Seventy-three percent of the women knew about EC and 45% of them had used it previously. Ninety-eight percent of them would use it in the future if necessary. Eighty percent of them knew its period of effectiveness. There is a clear need for information about PEPSE, which needs to be delivered around the time of HIV diagnosis and reinforced later. Some women will need help in discussing it with HIV-negative partners.

Purpose: The possible mechanisms of action of emergency contraception (EC) include preventing ovulation, fertilization, or implantation of an embryo. Differences in the use of terminology between medical personnel and the general public could be misleading to patients who would use EC. This cross-sectional survey evaluated women's beliefs regarding pregnancy and EC's possible mechanisms of actions., Methods: An anonymous questionnaire was developed and pilot tested for an appropriate reading level and ease of analysis. It collected information on demographics and beliefs about pregnancy and EC. During an 8-week period, the questionnaire was given to a convenience sample of female patients aged 18 to 50 years visiting 2 academic family medicine clinics in the southeastern United States. Descriptive statistics and logistic regression models were used for analysis., Results: A total of 178 women completed questionnaires. Nearly one-half (47%) of respondents believed that pregnancy begins with fertilization; however, less than one-third (30%) believed that life begins with fertilization. Thirty-eight percent of respondents stated that they would use EC only if they believed it worked before fertilization or implantation. Generally similar proportions thought that EC works before fertilization (24%) and before implantation (36%), or were unsure about when it works (34%). Younger age was associated with higher odds of believing that EC works before fertilization; none of the other demographic factors studied conferred either higher or lower odds., Conclusions: Many women are uninformed about the possible mechanisms of action of EC, and we found no reliable predictors for those who were better informed. This study raises questions regarding women's understanding of EC and demonstrates the need to better educate them about its possible mechanisms of action.

Background: Adolescents need to be aware that there is a method of preventing pregnancy even after an unprotected intercourse. Limited information is available on the awareness of young adolescents and the effects of selling emergency contraception (EC) over-the-counter, and the findings are controversial. The aims of this study were to investigate awareness and use of EC among Finnish girls aged 12-18 years in 1999-2003, and to assess the effect of the 2002 non-prescription status on the use., Methods: A self-administered questionnaire was sent to a population-based sample of 12-18-year-olds girls in 1999, 2001, and 2003. Response rate was 83% in 1999 (N = 4,369), 79% in 2001 (N = 4,024) and 77% in 2003 (N = 3,728), altogether N = 12,121. Logistic regression model was used to examine the association of unawareness and use of EC with socio-economic background and health behaviour., Results: In 2001, nearly all 14-18-year-olds and a majority of 12-year-olds were aware of EC. Among 12-14-year-olds, a slight increase in awareness between 1999 and 2003 was observed but this was not related to non-prescription status. Health-compromising behavior (alcohol use, smoking), dating and having good school achievement were related to higher awareness of EC.Nine percent of 14-18-year-olds had used EC once and 1% three times or more. No statistically significant change in EC use was found after non-prescription status. EC use increased with increasing alcohol consumption, particularly at age 14. Smoking, dating, and poor school achievement were related to increased use as well as not living in nuclear family. A lower use was observed if living in rural area or father's education was high. Mother's education was not related to use., Conclusion: Adolescent girls were well aware of the existence of emergency contraception even before the non-prescription status. Over-the-counter selling did not increase the use.

Unlabelled: Adolescents and young women are at the greatest risk of unintended pregnancy because they are unlikely to see a family planning provider before or immediately after the sexual activity. Therefore, preventing unintended pregnancy among them is the important concern. Sexually active young women are clients with special needs for contraception. They are eligible to use a variety of the available contraceptives. Introduction of emergency contraception (EC) in the recent past can help them avoid such unintended pregnancies., Objective: To investigate the awareness of emergency contraception in female college students., Study Design: Cross-sectional, questionnaire-based study., Materials and Methods: This study was conducted among college-going undergraduate and graduate female students of Punjab University, Chandigarh. Systematic random sampling was used to select the respondents., Results: Of the 1,017 college students included in the study, 507 (49.9%) knew about different contraceptive methods. Maximum awareness was regarding oral contraceptive pills (239, 47.1%). Only 74 (7.3%) had knowledge about emergency contraceptive pills (ECP). Of them, 10 (14.7%) students knew the correct time for use of ECP and the side effects of ECP were known to 48 (88.9%) respondents., Conclusions: Awareness about ECP was very low among female college students of Chandigarh, especially regarding correct timing of its use and its side effects. Appropriate awareness programs on EC are needed for them.

Context: Despite advances related to the provision of emergency contraception in Canada, particularly the granting of independent prescriptive authority to pharmacists in 2000, little is known about the ways in which women perceive potential barriers to using it., Methods: In 2004, an ethnically diverse sample of 52 women living in Greater Vancouver participated in interviews that were analyzed for an assessment of women's knowledge, attitudes and experiences related to emergency contraception, with particular attention to the ways in which ethnicity affected their stories., Results: Participants generally misperceived emergency contraception as an abortifacient, and often mistakenly thought that it has long-term effects on health and fertility. Knowledge gaps regarding reproductive physiology impeded clear understanding of when it is most effective. Participants also reported receiving subtle and sometimes overtly stigmatizing messages from providers when they sought emergency contraception. Asian and South Asian women were particularly concerned about negative interactions with providers; for example, they feared that female providers from their sociocultural community might recognize, chastise or gossip about them. Institutional policies (e.g., a Catholic hospital's refusal to provide the method), coupled with low awareness of pharmacists' prescriptive authority, also created barriers to use., Conclusions: Women's ability to benefit from emergency contraception is hampered by lack of knowledge and conservative cultural or social mores. Serious contextual and structural shifts are required before woman-centered approaches to provision of the method become the norm.

Objective: To examine trends in knowledge of emergency contraception (EC) and determine whether disparities in knowledge have persisted over time., Study Design: This study is based on 6 years of the California Women's Health Survey, a population-based telephone survey. We examine predictors of EC knowledge among 11,998 women age 18-44., Results: Between 1999 and 2004, the percentage of women aware of EC increased from 40-57%. Despite this increase, disparities in EC knowledge based on women's age, race/ethnicity, and socioeconomic status persist. Foreign-born Hispanic women, women whose income falls below the poverty level, and women who did not complete high school reported the lowest levels of EC knowledge in 2004., Conclusions: Education efforts may increase overall knowledge of the method. However, efforts must tailor these messages to women who may be outside the reach of traditional media and remain unaware of EC.

Objective: To evaluate a community-based intervention consisting of an information campaign and advance provision of emergency contraceptive pills (ECP) to abortion applicants., Methods: Submission of repeated waiting room questionnaires to abortion applicants in two cities in mid-Sweden; one intervention city (IC) and one comparison city (CC) in 2002 (IC = 92, CC = 95) and 2003 (IC = 244, CC = 204)., Results: The overall response rate was 90%. The percentage of women who had undergone an abortion within the previous year had decreased in the intervention group but not in the comparison group. Almost two-thirds (63%) of the targeted women had noticed the information campaign and one out of three (33%) who had visited a family planning clinic recalled being given information about ECP. There was a small decline in the use of combined oral contraceptives and intrauterine devices over time. After the intervention, women in the intervention city had better knowledge of ECP and had used it more than women in the comparison city did., Conclusions: More than half of the targeted women had noticed the information campaign and it may have had a limited impact. Further investigations are needed to determine whether advance supply of ECP to abortion applicants can reduce repeat abortions.

Objectives: To assess the level of knowledge and practice of emergency contraception among female undergraduates in University of Lagos and to determine the factors that influence knowledge and practice of emergency contraception among female undergraduates., Design: Cross-sectional descriptive study., Setting: The University of Lagos, Lagos, South-West, Nigeria between August 2003 and March 2004., Subjects: Four hundred and eighty randomly selected female undergraduate students., Results: The findings revealed that 67.8% of the respondents reported knowing about emergency contraception. More than half (56.1%) were sexually active and of this group, 96.8% had ever practiced contraception with only 33.9% having ever practiced emergency contraception. However, only 37.8% and 36.3% of respondents who had reported knowing about emergency contraception knew the correct time frame for effective use, and correctly identified emergency contraceptives respectively. Among those who were aware of, and had used emergency contraception, 34.1% obtained their information from health care providers, while the larger majority obtained from friends. Knowledge and practice of emergency contraception was found to be directly related to age, level of study, medical education, marital status, sexual activity, previous history of use of contraceptives and previous history of induced abortion., Conclusion: Education efforts that focus on the training of health care providers and young adults on emergency contraception with regards to available methods and correct timing of use would greatly improve women's access to and effective use of this method in Nigeria.

Context: In South Africa, emergency contraceptive pills are available directly from pharmacies without a prescription, yet few studies have assessed pharmacists' knowledge of and attitudes toward the medication., Methods: In-person interviews were conducted with 34 pharmacists practicing in Soweto and the Johannesburg Central Business District, from February through April 2003. The pharmacists provided data on their knowledge of emergency contraceptive pills and their attitudes toward providing the medication to women in specific situations., Results: Nearly all pharmacists sold at least one of the two types of dedicated emergency contraceptive pills available in South Africa. Although most had accurate knowledge about the method's dosing schedule, side effects and mechanism(s) of action, more than half erroneously believed that repeated use posed health risks. A large majority of pharmacists believed the pills should be available to rape victims, to single or married women and to women who had never given birth, but almost half did not think the pills should be given to women younger than 18, and a fourth said they would not give them to women with a late menstrual period. About one-third to half of pharmacists supported advance provision of the medication under certain circumstances. Most were willing to display promotional materials on emergency contraceptives in their pharmacies., Conclusions: Interventions aimed at educating pharmacists about the benefits of emergency contraceptive pills, especially for adolescents, are needed. Government and medical authorities should take advantage of pharmacists' willingness to display educational materials as a way to increase women's knowledge and use of the medication in South Africa.

Our objective was to investigate the knowledge, use and attitude towards emergency contraceptive pills among female undergraduates. This was done using a randomly selected sample of female undergraduate students at three tertiary institutions in Enugu, Nigeria. The majority of the respondents (95%) were aware of contraception. However, 61% of the female undergraduates had heard of emergency contraception but only 31% had actually used it. The most common source of information about emergency contraceptive pills was from friends and teachers. Most respondents (19%) used Postinor rather than other types. While using emergency contraception, 16% got pregnant, of whom 9% carried the pregnancy to term and delivered the baby while (10%) procured an illegal abortion. Increased utilization of emergency contraception is plagued with fear of infertility, anovulation, ill health and sexually transmitted infection. Though 40% of the female undergraduates accepted it when informed and would recommend it to other female students, more information dissemination is required to further create awareness and enhance wider acceptance. Awareness programmes should address the barriers to effective use of ECP preferably using peer educators and the media.

Purpose: To evaluate the association between knowledge about, or experience with, emergency contraception (EC), and condom use among school-attending adolescents in the state of Morelos, Mexico., Methods: We analyzed data from anonymously self-administered questionnaires (n = 10,918), from a cluster-randomized controlled trial among first year students from 40 (75%) public high schools in Morelos, Mexico. The survey included specific questions about EC knowledge and experience as well as questions about perceived ability to negotiate and condition sexual relations on condom use; and condom use at first and last sexual intercourse., Results: Overall, 61% (6384) of students had heard of EC, and 36% (1964) of girls and 39% (1997) of boys had correct knowledge about EC. Correct knowledge was based upon knowing that EC is pills taken up to 3 days after unprotected sex to prevent pregnancy. Of 1695 (15.6%) reporting lifetime sexual activity, 16.4 % (275) reported they had tried to obtain EC and almost of all them (263) reported having used EC. The probability of a student reporting he/she is capable of interrupting sexual intercourse to use a condom was significantly higher for those who had correct EC knowledge, and a history of EC use was strongly correlated with condom use at last sexual intercourse., Conclusions: Experience with emergency contraception has no adverse effects on condom use, but rather is associated with an increased probability of condom use and an increased perceived capacity to negotiate condom use. Despite concern that information about, and access to EC may encourage sexual risk taking, our results suggest the reverse is true. These data support the position that there is no justification to withhold EC information or access from adolescents.

The aim of this study was to investigate women s knowledge about and attitude toward emergency contraception (EC) in women who referred to health centers of Tehran University of Medical Science. The subjects in this study consisted of 250 married women of fertility age who had been selected randomly and interviewed by the researcher. The majority of the subjects had not used EC. Just 5.2% (13 women) had used this method and 8.31% had knowledge and information about EC. There was a significant correlation between knowledge about and use of this method (p = 0.0001). Although the users of this method were more knowledgeable about EC than nonusers, a majority of subjects (76.57%) had a positive attitude toward EC; however, there was not a significant correlation between positive attitude and use of EC (p = 0.184).

Context: The reproductive health hazards of unintended pregnancies and unsafe abortions are well documented. The potential of emergency contraceptives to prevent unwanted pregnancy in developed countries has been described, but in Nigeria, the awareness about the method is poor and no study has looked at efficacy., Methods: Between September and October 2001, a randomly selected sample of female undergraduate students at the University of Benin, Nigeria, were surveyed about their demographic information, sexual history and contraceptive use, and their awareness and knowledge of emergency contraception., Results: Of the 880 respondents, 43% were sexually active, 39% had ever practiced contraception and 34% had ever had an induced abortion. Overall, 58% of respondents reported knowing about emergency contraception; sexually active respondents were significantly more likely than those who were not and those who had ever practiced contraception were more likely than those who had not to be aware of emergency contraceptives. However, only 18% of respondents who reported knowing about emergency contraception knew the correct time frame in which emergency contraceptives must be used to be effective., Conclusion: There is an urgent need to educate Nigerian young people about emergency contraception, emphasizing available methods and correct timing of use.

Objectives: The purpose of this article is to determine the knowledge status of women concerning postcoital contraception when they turn to curettage in order to terminate an undesired pregnancy., Methods: This defining study has been carried out at a maternity hospital in Izmir on pregnant women admitted for curettage. We interviewed 150 pregnant cases using an improbability sampling method., Results: We discovered that 48.7% of women had avoided pregnancy before curettage by withdrawal before ejaculation. When we investigated the method used after uncontrolled coitus, 27.3% of cases reported vaginal douche while 12.7% indicated curettage. After having an unprotected coitus or failure in contraceptive methods 99.3% of the women indicated they would report to health institutes to utilize postcoital methods if they were familiar with them., Conclusions: Postcoital contraception may be a solution for undesired pregnancies.

Emergency contraception is safe and effective for preventing an unplanned pregnancy, although it is not widely used. Widespread and appropriate use of emergency contraception should be encouraged as it is a promising means to arrest the increasing abortion rate. It is therefore important for all doctors to be able to prescribe emergency contraceptive pills and to educate women of reproductive age about emergency contraception. This article provides an update on the prescription of emergency contraceptives so that doctors may become more confident at prescribing emergency contraceptives and educating women about this back-up contraceptive. The current changes in the delivery of emergency contraceptive pills from prescription-only through self administration to over-the-counter sales will be discussed.

Emergency contraception (EC) refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure, or incorrect use. There is growing worldwide acceptance and promotion of EC as a measure to reduce the level of unwanted pregnancies and, hence, unsafe abortions. The potential effect of EC in this regard could be most evident in sub-Saharan Africa. In Ghana, the Ministry of Health has since 1996 included EC in its reproductive health service policy and standards. The Planned Parenthood Association of Ghana is the only agency involved in the promotion of EC in the country. Very little is known about societal perception of EC. We undertook a study to assess knowledge and attitude toward EC among a sample of students at the University of Ghana. We used a two-page, self-administered questionnaire in a cross-sectional study among students chosen by random sampling. The aspects of EC assessed included level of knowledge, extent of use, common traditional methods of emergency contraception, as well as socially and culturally acceptable ways to promote EC in Ghana. We also assessed how the availability of EC could influence the use of condoms among male respondents. Less than half (43.2%) of the 194 respondents (88 males and 106 females) had heard of modern emergency contraceptive methods. Postinor-2, a dedicated emergency contraceptive product, which was already on the Ghanaian market, was known to 1.5% of respondents. Only 11.3% of respondents indicated correctly the recommended time within which emergency contraceptive pills (ECPs) are to be taken after unprotected sex. Taking concentrated sugar solutions, having an enema, and douching were commonly used traditional methods of EC. More than half (55.0%) of the male respondents indicated that they would either "certainly" or "probably" reduce how often they used condoms once they knew that EC was available. Almost all (97.4%) the respondents wanted to learn more about EC. The indications from this study are that the promotion of EC in Ghana is desired and must be encouraged. The fact that EC does not offer protection against sexually transmitted infections should always be emphasized.

Objective: To evaluate women's use, knowledge of and attitudes toward self-administered emergency contraceptive pills (ECP) at the University of Pennsylvania family planning clinic (FPC)., Study Design: The University of Pennsylvania FPC is a Title X, publicly funded clinic serving urban, low-income women. All women attending the clinic were offered ECP packets. Exclusion criteria for ECP were current pregnancy or newly diagnosed hypertension. Women signed consent forms and were given specific instructions on using ECP with the standard Yuzpe method. Women were contacted for a phone interview after they had the ECP packets at home for six to eight months., Results: One hundred ninety-two women received the ECP packets. Forty-eight were contacted and completed the survey. One hundred forty-four women had moved, no longer had phone service or were unreachable after three or more attempts. Eleven of the 48 women (22.9%) used the ECP, but only 2 of 11 (18.2%) took the pills correctly. One of these two women became pregnant. Of the women who had not used the ECP packets, only 25 of 37 (67.6%) could locate them, and only 9 of 37 (24%) could recall how to use them correctly. Four of 37 (10.8%) experienced an unplanned pregnancy., Conclusion: Emergency contraception utilization was far lower than anticipated, suggesting that ready access is not the only issue. Many of the women did not administer ECP correctly or could not state how they would use it in the future despite extensive instruction. Patients will require new and creative approaches to encourage their appropriate use of emergency contraception.

Study Objective: To determine knowledge, opinion, and experience concerning emergency postcoital contraception in primary care physicians who are in training., Design: Cross-sectional survey using a questionnaire survey distributed to primary care specialty housestaff., Setting: Questionnaire surveys were distributed to all active primary care housestaff in training and Obstetrics and Gynecology attendings at the University of Kentucky., Participants: The study surveyed all primary care specialty housestaff. Specialties included family practice (FP), internal medicine (IM), pediatrics (PD), and obstetrics and gynecology (OG). The attending faculty in Obstetrics and Gynecology (OGA) were also surveyed as a comparison group., Main Outcome Measures: Study variables were compared between specialty of training, year of training, and abortion opinion. ANOVA or Student's t tests were used, with statistical significance defined as P <.05. Each questionnaire was scored 0 to 9 based on knowledge and utilization questions. Overall response rate was 48%, 90 out of 189 surveyed. Response rates per specialty are as follows: FP = 51%, IM = 37%, PD = 48%, OG = 65%, and OGA = 69%., Results: The average score on the survey was significantly different based on specialty of training (P value <. 0001). Scores were not significantly different based on year of training. However, the average attending OG's score was significantly higher than for all the housestaff (P value <.0001)., Conclusion: Knowledge and utilization of postcoital contraception is dependent on specialty. Unfortunately, this knowledge does not appear to increase with year of training, suggesting that there is a lack of education during the years of training.

Study Objective: Emergency contraception, otherwise known as postcoital contraception, refers to a group of birth control modalities that, when used after unprotected intercourse within defined time constraints, can markedly reduce the risk of a resultant unintended pregnancy. The English literature, using British and American awareness data, consistently claims that these contraceptive options are underutilized in the United States because of a lack of patient and physician awareness of their existence. The objective of this study was to determine the level of awareness of postcoital contraceptive techniques in a population of American women who were presenting for pregnancy termination. The secondary goal was to calculate (theoretically) how many of these surgical terminations could have been prevented through the use of postcoital contraception., Methods: A questionnaire was administered to patients presenting to an abortion clinic. It was intended to anonymously identify patient demographics and knowledge of the various emergency contraceptive options and, in hindsight, to determine what percentage of these women would have been willing candidates for one of these medical modalities. On completing the questionnaire, all patients received an emergency contraceptive information sheet for future consideration., Results: Eighty-three patients completed the study. They ranged in age from 15 to 44 years (mean, 24 years). Forty-six percent of the patients were 21 years of age or younger. A total of 71% of all patients had no real knowledge of the existence of emergency contraceptive options; 26% had some limited knowledge, and only 3% had somewhat complete and valuable information. Fifty-one percent of the patients would have been appropriate, realistic, and willing candidates for at least the emergency contraceptive pill. Assuming at least a 75% effectiveness rate for the emergency contraceptive pill, 38% of the surgical pregnancy terminations performed on this population of women could have been avoided., Conclusion: Our data confirm that emergency contraceptive options are underutilized because of a lack of patient awareness. Contraception education, especially directed toward adolescents, should include disseminating enhanced information about postcoital contraception options.

Objectives: As a form of contraception which is used after sex, emergency contraception occupies a singular place in the birth control repertoire. The relatively high UK incidence of pregnancy terminations and of teenage pregnancy, combined with the recognition that much early sex remains unplanned and unprotected, has led to calls for better access to emergency contraceptive methods. In this study a combination of self-completion questionnaires and semi-structured interviews was used to explore views of emergency contraception among women who were using the method., Methods: Five hundred and ten women attending two family planning clinics in Oxford and London completed a questionnaire in the waiting room and 53 women who were attending for emergency contraception took part in semi-structured interviews., Results: The view, presented in recently published UK guidelines, that emergency contraception is a reliable method and not dangerous to repeat, was not shared by the respondents. The rationale for and sources of women's concerns about the strength of the dose of hormonal emergency contraception and the nature of side-effects are explored.