Knowledge, attitude and practice survey toward emergency contraception
among women undergoing surgical abortion in Rome, Italy
S. Donati (1), E. Vigiliano (1), M.E. Grandolfo (1), C. Bastianelli (2), M.
Farris (2), S. Bergami (2)
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute,
Istituto Superiore di Sanita` Rome, Italy (1); Department of Gynaecological
Science, Perinatology and Child Care, University of Rome ‘La Sapienza’ Rome
Italy (2)
Introduction: according to growing worldwide acceptance and promotion
of emergency contraception (EC) as a measure to reduce unwanted pregnancy, we
undertook a study to assess knowledge, attitude and practice toward EC among a
sample of women undergoing voluntary surgical abortion in a university hospital
in Rome.
Aims and methods: to test the hypothesis that lack of knowledge and
negative attitudes about the method may limit its impact, we interviewed 197
women who underwent a surgical abortion by the Day Surgery Centre, Department of
Gynaecological Science Perinatology and Child Care, University of Rome ‘La
Sapienza’ from April to July 2003. Women were randomly selected and
interviewed before hospital discharge, by trained interviewers. Out of the 201
women selected, 4 refused the interview (respondance rate 98%). Statistical
univariate and multivariate analysis has been performed using SPSS software.
Results: women’s median age at time of interview was 31 years. Sixty
percent of the interviewed was nulliparous and single. Twenty six percent of the
sample had a low educational level (5secondary school) and 74% a higher degree
(5secondary school). Although 98% of the sample had heard about EC, mostly
through relatives, friends and media, knowledge of the EC components, of the
correct time for taking it after unprotected sex, as well as knowledge of it’s
efficacy and side effects rated very poor. Thirty eight percent of the
interviewed was not aware about medical prescription need, 72% reported EC
should be assumed within 24 hours from intercourse and less than 20% had a
correct idea of EC efficacy. Fourty percent of the sample reported that EC
causes an abortion and more than 30% that is responsible for neonatal
malformations. Better knowledge was associated to previous EC use and to women’s
higher educational level. Nevertheless, attitude among EC was positive. Eighty
percent of the sample would recommend the method to a friend.
Conclusions: this small pilot study revealed how modern methods of EC
resulted desirable among women who underwent surgical abortion and how level of
awareness was poor among them. Nevertheless, in Italy part of medical providers
limit support of EC because of anti-abortion sentiment. We believe EC needs
promotion by making information regarding the methods mechanism of action and
safety, key features of future educational campaigns. Further studies on
knowledge, attitude and practice among providers (family doctors, gynaecologists
and pharmacists) and among school students and women in reproductive age are
also recommended.
