Usage patterns and attitudes towards emergency contraception: the International Emergency Contraception Research Initiative

Abstract

Objectives: The aim of the survey was to gain understanding of women’s usage patterns and attitudes towards emergency contraception (i.e., the ‘morning after pill’) and to gain insight into the role and attitudes of pharmacists as providers of emergency contraception.

Methods: As part of the International Emergency Contraception Research Initiative, approximately 6500 women (15–49 years) and nearly 500 pharmacists from 14 countries in Western, Central and Eastern Europe, and Central Asia completed questionnaires via web-based interrogation or computer-assisted/paper-assisted personal interviews.

Results: Common to almost all countries and cultures was that, while awareness of emergency contraception was high (≥84% of respondents, except in Kazakhstan), usage was generally low (4–18%). In Austria, the Czech Republic, Spain, and the UK, better underlying protection with hormonal contraceptives or male condoms would have meant less need for emergency contraception. In Bulgaria, Lithuania, Romania, and Russia, greater dependence on less reliable contraceptive methods such as calendar + withdrawal was associated with higher use of the emergency contraceptive pill (11–18%) but also with higher abortion rates (19–21%). Overt rejection of emergency contraception in the event of an accident was low, except in countries (e.g., Austria, Poland) where the misperception that it acts as an abortifacient was common. Except for Bulgaria, pharmacists elsewhere tended to have limited knowledge and moralistic attitudes towards emergency contraception.

Conclusions: Improved educational efforts, probably country-specific, are required to increase the use of highly effective methods of regular contraception and overcome barriers to acceptance of emergency contraception as a suitable postcoital solution to avoid unwanted pregnancy or abortion.

Chinese abstract

目的：该调查的目的是了解女性对紧急避孕（如房事后用的女用口服避孕药）的使用模式和的态度, 以及药剂师作为紧急避孕服务的提供者对紧急避孕的理解和态度。

方法：作为国际紧急避孕研究计划的一部分, 约有6500名15-49岁的妇女和近500名来自西欧、中欧和东欧以及中亚的14个国家的药剂师, 通过网络调查或计算机辅助/纸质辅助个人访谈完成问卷。

结果：几乎所有的国家和文化背景都存在以下现象：人们紧急避孕意识是高的（≥84%的受访者, 除哈萨克斯坦以外）, 但紧急避孕使用率普遍较低（4-18%）。在奥地利, 捷克共和国, 西班牙和英国, 应用激素类避孕药和男用避孕套提供了更多基础的保护, 这意味着很少需要紧急避孕。在保加利亚, 立陶宛, 罗马尼亚, 俄罗斯这些国家, 更多的依靠不可靠的避孕方法如日历法和体外排精法, 与之相关的不仅是较高的紧急避孕药使用率（11-18%）还有较高的流产率（19-21%）。在一些国家（如奥地利、波兰）, 认为紧急避孕药是堕胎药的误解很普遍, 除这些国家外, 避孕时如果发生意外, 对紧急避孕的明显拒绝的发生率较低。除了保加利亚, 其他地方的药剂师对紧急避孕持有说教的态度, 而且紧急避孕知识有限。

结论：可能在一些特定的国家, 加大宣传教育的努力方向是要求增加高效的常规避孕方法的使用和克服障碍采用紧急避孕作为性交后避免非意愿妊娠及流产的有效解决手段。

Keywords:

• Abortion
• Asia
• attitudes
• contraceptive behaviour
• emergency contraception
• Europe
• survey

Acknowledgements

The authors wish to thank sincerely Professor Johannes Bitzer in his role as advisor and for his valuable contribution in evaluating and structuring the data for this article. The authors also acknowledge Kerry Dechant of Content Ed Net (Madrid, Spain) for assistance in the preparation of this manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding information

The study and manuscript development were funded by Gedeon Richter Plc (Budapest, Hungary).