Knowledge about emergency contraception in women attending a termination of pregnancy clinic

Knowledge about emergency contraception in women attending a termination

of pregnancy clinic

L.R. Graves, S. Padayachee, Z.M. Van der Spuy

Department of Obstetrics and Gynaecology, Faculty of Health Sciences,

University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa

Objectives: Emergency contraception, if correctly used, may prevent

pregnancy after unprotected coitus and lower the incidence of unintended

conception. This study was undertaken to assess the knowledge of emergency

contraception among women who presented to our unit requesting termination of

pregnancy (TOP).

Methods: Interviews were conducted with 204 women requesting TOP in

our service. Information about their knowledge and use of emergency

contraception was obtained. In addition, demographic data was recorded and they

were questioned about their understanding of basic reproductive physiology.

Results: Almost 70% of the women who requested TOP had an educational

level above grade 10 (senior high school). Forty four percent of the patients

presented in the second trimester and 56% in the first trimester. Most of the

patients were multiparous (72%). At the time of conception of the index

pregnancy, 122 of the patients had not thought they were at risk of pregnancy.

About one third of the group had been using some form of contraception. Only 38%

of the whole group had every heard of emergency contraception and 8 had utilised

it prior to the index pregnancy. Most of the women presenting for TOP (87%) had

no knowledge at all of when they were most likely to conceive during their

menstrual cycle. In addition, despite educational campaigns, 72% of the women

said that they did not know how and when to use emergency contraception. The

majority of the women said that more information about emergency contraception

and easier access were essential. Many of them expressed resentment at not being

aware of this possible method of preventing unwanted conception.

Conclusions: Despite the fact that most of these women had a high

school education, knowledge about emergency contraception was limited.

Particularly concerning was the very poor understanding of basic reproductive

physiology. As this is central to avoiding unwanted pregnancy, educational

strategies which inform about physiology as well as contraceptive availability

are urgently needed in our reproductive health services.

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