Intention to use emergency contraceptive pills and the role of knowledge in a Dutch national sample

Abstract

Objectives Emergency contraceptive pills (ECPs) are underused for preventing unintended pregnancy. Not all women are willing to use them even when at risk of conceiving. This paper examines whether increased knowledge about ECPs may increase the intention to use these products.

Methods Factors associated with intention to use emergency contraception (EC) were assessed among 1310 women who participated in the nationally representative Sexual Health in the Netherlands 2009 Survey. Logistic regression models included demographics, prior use of ECPs, and ECP knowledge.

Results Seventeen percent of the women did not intend to use EC after unprotected sexual intercourse and a further 27% were unsure whether they would use it. Intention is most strongly related to prior use and not having children. Only two of six knowledge items were related to intention in the multivariate analyses. Being aware that ECPs can be obtained without prescription upgrades intention, whereas knowing that a woman can still get pregnant after having taken the ECP has a negative impact on intention.

Conclusions Improving knowledge may contribute to intention to use EC, but its role will be modest. To understand the reasons behind ECP use it is essential to study the contribution of other factors, like attitudes and social norms.

Chinese Abstract

摘 要 目的 紧急避孕药（ECPs）可用于非意愿妊娠的预防。即使存在妊娠的风险，并非所有女性都愿意使用紧急避孕药。本文调查研究了增加女性对紧急避孕药的了解是否会增加其使用的意愿情况。

方法 选取参与2009年荷兰全国性健康调查的1310名妇女，评估其采取紧急避孕（EC）意愿的相关因素。Logistic回归模型包含人口统计学情况，既往ECP使用情况及对ECP的知识水平。

结果 17%女性在无保护性行为后不愿意采取EC，而27%女性不确定是否会采取紧急避孕措施。使用意愿与既往使用且未妊娠的经历密切相关。经过多重变量分析，6个认知因素中只有2个因素与使用意愿相关。得知ECP为非处方药物会增加妇女使用ECP的意愿，而得知服用后仍存在妊娠风险会降使用意愿。

结论 提高EC的知识水平虽可增加其使用率，但作用有限。对使用态度和社会规范的进一步研究有助于加深对ECP使用原因的理解。

Keywords:

• Emergency contraceptive pills
• Intention
• Knowledge
• Population-based
• the Netherlands

ACKNOWLEDGEMENTS

We would like to thank Floor Bakker, Mieke van Kooten Niekerk and Elizabeth Westley for their comments.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.

This study was funded by the Dutch Health Ministry.