Strategies used to enhance acceptability of emergency contraception


used to enhance acceptability of emergency contraception

M.M. Lech

School of Public Health, National Postgraduate Center of Medical

Education, Warsaw, Poland

Abortion rates

in most European countries are unacceptably high [Russia – 1860 for 1000 live

births (1997), Hungary – 782 (1997), Lithuania – 518 (1999)]. Emergency

contraception [EC] is a type of the “last resort method” of the reduction of

the number of unplanned pregnancies and abortions. The EC use (with

levonorgestrel) during the first 72 hours after unprotected sexual intercourse

may decrease the risk of unwanted pregnancy by over 75%. This is a simple,

highly effective and not expensive method of reduction of unintended

pregnancies, especially in adolescent and teenagers girls.


some countries, in spite of the availability of EC methods, these methods are

the best-kept secrets of society. Some physicians and other persons who are not

familiar with the current state of knowledge often spread unproven information

about the mechanism of action of EC pills. The mechanism of action of hormones

in EC is still not completely known, but from this what is known EC has nothing

to do with an “early abortive pills”. It has been discovered that hormones used

in EC have effect on the migration and function of spermatozoas, they affect

ovulation but the effect on endometrium is rather doubtful. The patients’

beliefs concerning the mechanism of action of EC may have an important

influence on their individual decision. Some of them may not wish to use EC (as

a method which may harm the development of fertilized ova) because of ethical

reservations. There are also other barriers to use EC like lack of awareness in

general public and difficult access both to prescribers and pharmacies. Lack of

awareness is the result of ambivalent attitude policy makers to EC, lack or

failure of sexual education. There is also a lot of not used space for EC

social marketing.


products which are registered for EC are available in all European countries,

in several countries (Belgium, France, UK, Spain, Portugal, Norway, Sweden,

Finland, Switzerland) these products are registered for OTC in other countries

EC products are provided by special emergency contraception clinics. But what

is most important, it is the reliable information for general public and active

EC promotion in settings where young adults are likely to engage in casual and

risky sex. There is a big room for EC promotion and information in internet

(very popular medium for spread of information in young adult group). There is

also space for EC promotion in the community of health workers, there are

suggestions that European Society of Contraception should play active role in

this process and the Seminar entitled “From Biology to Emergency Contraception”

should be organized in the nearest future. The ECS and other international

organizations (IPPF, WHO, UNICEF, UNFPA) supposed to start the campaign for

treatment of EC products as an OTC products all over the Europe.    

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