Knowledge and attitudes of Latin American gynecologists regarding unplanned pregnancy and use of combined oral contraceptives

Figures & data

Table 1 Questions and answers regarding unintended pregnancies

	Age (%)		Sex (%)		Working in (%)
	≤49 years	≥50 years	Female	Male	Public sector	Private/public sector
Unintended pregnancy rates are (n=191):
Similar in LA to developed countries	5.6	8.0	4.5	8.2	8.2	5.4
Similar in LA to developing countries	31.5	26.0	31.8	27.9	24.5	33.9
The highest worldwide in LA	25.9	24.0	29.5	21.3	20.4	28.6
The highest worldwide in Africa	37.1	42.0	34.1	42.5	47.0	32.2
Unintended pregnancy is more common among (n =190):
Adolescents	79.5	66.7	69.2	66.1	76.8	69.7
Young adults	12.3	19.3	20.0	13.5	9.0	22.4
All women	8.2	14.0	10.8	10.4	14.3	7.9
Unintended pregnancy has a social impact (n=190):
Yes	97.2	98.4	100.0	96.1	100.0	96.2
No	2.8	1.6	0.0	3.9	0.0	3.8
In your opinion, regarding the women who opt for an abortion (n =191):
Most do not use a contraceptive	54.3	58.6	58.3	54.3	61.8	52.0
Most use a contraceptive incorrectly	44.3	36.2	41.7	40.0	32.7	46.7
Most use a fertility awareness method or were victims of sexual abuse	1.4	5.2	0.0	5.7	5.5	1.3

Abbreviation: LA, Latin American.

Table 2 Questions and answers regarding some aspects of use of COCs

	Age (%)		Sex (%)		Working in (%)		P-value
	≤49 years	≥50 years	Female	Male	Public sector	Private/public sector
Failure rate of COC given typical use (n =175):
1%–2%	32.5	34.4	38.0	30.0	32.7	34.5
4%	16.2	24.1	11.1	27.1	17.3	21.0
8%	31.1	29.3	28.6	31.4	32.7	28.4
10%	20.3	12.1	22.2	11.4	17.3	16.0
According to the OBGYNs, the proportion of women using COCs who recognize forgetfulness (n =153):							0.046
5%–10%	9.8	27.0	23.4	12.5	16.0	18.7
30%	49.3	42.9	42.2	51.4	46.0	47.7
50%	23.9	20.6	20.3	23.6	26.0	19.8
70%	16.9	9.5	14.1	12.5	12.0	14.0
According to the OBGYNs the proportion of women who recognize they forget at least one COC pill per month (n =173):
<30%	49.3	50.8	54.1	47.8	53.8	48.7
50%	39.1	32.2	37.7	33.3	34.6	35.9
70%	8.7	10.2	6.6	11.6	11.5	7.7
≥90%	2.8	6.8	1.6	7.2	0.0	7.7
According to OBGYNs, if women forget to take a pill (n =175):
They know what to do when they forget 2–3 pills	29.7	15.8	22.0	23.8	17.7	26.0
They understand the instructions	14.0	19.3	17.0	15.9	13.3	18.2
They follow the instructions	17.2	14.0	20.3	11.1	20.0	13.0
They do not know what to do	39.1	50.9	40.7	49.2	48.9	42.9

Abbreviations: COC, combined oral contraceptive; OBGYNs, obstetricians and gynecologists.

Table 3 Questions and answers about benefits of COCs

	Age (%)		Sex (%)		Working in (%)
	≤49 years	≥50 years	Female	Male	Public sector	Private/public sector
According to the OBGYNs, women are aware of non-contraceptive benefits of COC (n =187):
Less than 20%	61.1	72.2	62.2	71.4	79.3	58.1
Between 40%–50%	22.2	16.7	24.3	14.3	10.3	25.6
Almost 75%	13.9	8.3	8.1	14.3	6.9	14.0
All women	2.8	2.8	5.4	0.0	3.4	2.3
When OBGYNs prescribe a COC, which non-contraceptive benefits influenced the decision? (n =187):
Improve dysmenorrhea and PMS	53.0	77.2	64.7	66.6	64.3	66.7
Reduce acne and hirsutism	46.9	22.9	35.3	33.3	35.7	33.0
Reduce ovarian/endometrial cancer risk	0.0	0.0	0.0	0.0	0.0	0.0
Which non-contraceptive benefits are your patients looking for when they procure a COC? (n =190):
Improve dysmenorrhea and PMS	27.8	21.6	28.2	20.6	30.0	20.9
Reduce acne and hirsutism	25.0	21.6	20.5	26.5	26.7	20.9
Prevent weight increase	22.2	37.8	30.8	29.4	30.0	30.2
Reduce bleeding flow and number of cycles	25.0	18.9	20.5	23.5	13.3	27.9

Abbreviations: COC, combined oral contraceptive; OBGYN, obstetrician and gynecologist; PMS, premenstrual syndrome.

Table 4 Questions and answers about risks associated with COC use

	Age (%)		Sex (%)		Working in (%)
	≤49 years	≥50 years	Female	Male	Public sector	Private/public sector
Main risk for VTE and COC use (n=184):
Familiar history of VTE	0.0	3.1	0.0	1.9	0.0	1.6
>35 years old	0.0	1.6	0.0	1.9	0.0	1.6
Personal history of VTE	0.0	0.0	25.0	17.0	26.5	17.5
Smoking	0.0	0.0	0.0	3.8	0.0	3.2
Obesity	2.6	7.8	4.5	1.9	0.0	4.8
All	97.4	87.5	70.5	73.6	73.5	71.4
Which statement about COC use and VTE is incorrect? (n =184):
The risk is high within the first months of use	2.3	0.0	0.0	1.9	2.9	0.0
The risk increases after a pause of 4 weeks in use	18.2	14.6	23.1	11.3	20.6	13.8
The risk is independent of the length of use	63.6	64.2	66.7	52.8	47.1	66.5
The risk is high with high estrogen levels	9.1	12.5	5.1	15.1	14.7	8.6
The role of progestin is still controversial	6.8	18.8	5.1	18.9	14.7	12.1
The incidence of VTE among COC users is (n=173):
4/10,000 women/year	1.8	16.7	6.1	11.5	9.3	9.0
9–11/10,000 women/year	90.9	83.3	89.8	85.2	81.4	91.0
15–20/10,000 women/year	5.5	0.0	2.0	3.3	7.0	0.0
21–29/10,000 women/year	1.8	0.0	2.0	0.0	2.3	0.0
According to the OBGYNs, the use of COCs could increase the incidence of cancer of (n =184):
Endometrium	2.8	5.9	5.3	2.9	0.0	7.3
Cervix	83.3	61.8	78.9	64.7	71.0	73.2
Colorectal	0.0	2.9	2.6	2.9	0.0	4.9
All of them	0.0	5.9	0.0	5.9	3.2	2.4
I have doubts	13.9	23.5	13.2	23.5	25.8	12.2

Abbreviations: COC, combined oral contraceptive; OBGYN, obstetrician and gynecologist; VTE, venous thromboembolism.