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Contracepção de Emergência: Abstracts Selecionados |
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The effects of self-administering emergency contraceptionGlasier A; Baird D - N Engl J Med, 1998 Jul, 339:1, 1-4Background: Emergency postcoital contraception prevents pregnancy, but it must be prescribed by a doctor and taken within 72 hours of intercourse. It has been proposed that emergency contraception be made available without a prescription. We undertook a study to learn how women might behave if given a supply of emergency contraceptive pills to keep at home.Methods: We assigned 553 women to be given a replaceable supply of hormonal emergency contraceptive pills to take home (the treatment group) and 530 women to use emergency contraception obtained by visiting a doctor (the control group). The frequency of use of emergency contraception, the use of other contraceptives, and the incidence of unwanted pregnancy were determined in both groups of women one year later. Results: The results for 549 women in the treatment group and 522 women in the control group were available for analysis. Three hundred seventy-nine of the women in the treatment group (69 percent) and 326 of the women in the control group (62 percent) contributed detailed information at follow-up. One hundred eighty of the women in the treatment group (47 percent) used emergency contraception at least once. Among those who returned the study questionnaire, 98 percent used emergency contraception correctly. There were no serious adverse effects. Eighty-seven women in the control group (27 percent) used emergency contraception at least once (P<0.001 for the comparison with the treatment group). The women in the treatment group were not more likely to use emergency contraception repeatedly. Their use of other methods of contraception was no different from that of the women in the control group. There were 18 unintended pregnancies in the treatment group and 25 in the control group (relative risk, 0.7; 95 percent confidence interval, 0.4 to 1.2). Conclusions: Making emergency contraception more easily obtainable does no harm and may reduce the rate of unwanted pregnancies. Emergency postcoital contraceptionChiou VM; Shrier LY; Emans SJ - J Pediatr Adolesc Gynecol, 1998 May, 11:2, 61-72Of the estimated 3.5 million unintended pregnancies that occur each year in the United States, some 1.7 million are thought to be the result of contraceptive failure. The extremely high numbers of unintended pregnancies not only in the United States but also worldwide indicates that emergency contraception remains an important but underused method of pregnancy prevention. Emergency postcoital contraception via mechanical or pharmacological means inhibits fertilization and/or implantation from unprotected sexual intercourse. Although emergency contraception has been used primarily in victims of sexual assault, it offers a low-cost, highly effective method to reduce the incidence of unintended pregnancy. Emergency contraception decreases the costs and emotional and physical risks to women who have had unprotected intercourse. Emergency contraception also increases the latitude women have to make reproductive decisions by offering an alternative to abortion and childbearing. The heart of the problem with emergency contraception is not the failure rate or side effects of specific methods but the fact that so few women and adolescents who have had unprotected intercourse know the option exists, and their providers may be reluctant to prescribe the method. Emergency contraception--why women don't use itYoung L; McCowan LM; Roberts HE; Farquhar CM - N Z Med J, 1995 Apr, 108:998, 145-8Aim: The aim of the study was to examine knowledge of and perceived availability of the emergency contraceptive pill as well as reasons for its non use.Methods: One hundred women each attending Epsom day unit or the Auckland medical aid clinic in Auckland seeking termination of pregnancy, and 100 women seeking contraceptive advice from the Alice Bush centre in Auckland, were asked to take part in the study. Results: At Alice Bush centre 57% of women had previously used the emergency contraceptive pill compared with 43% women at Epsom day unit and 32% women at Auckland medical aid clinic. Only 7% of women attending Epsom day unit or Auckland medical aid clinic had used the emergency contraceptive pill in the month they conceived. When asked why they had not used the emergency contraceptive pill 38% of respondents said they had not heard of it and 41% did not know where to obtain it. Pacific Island women were least likely to have heard of it. Approximately 50% knew the correct time interval for using the emergency contraceptive pill. Sixty two percent attending the abortion clinics would have used the emergency contraceptive pill if they had a supply at home and 57% stated they would have used it if it was available over the counter through pharmacies. Conclusions: The discrepancy between the numbers of women who knew of the emergency contraceptive pill (72%) and the numbers who used it to try to prevent pregnancy (7%) indicates that there are barriers to obtaining and using the emergency contraceptive pill. This study demonstrated a lack of knowledge of the emergency contraceptive pill in women attending the abortion clinics. The majority of women seeking termination of pregnancy would have used the emergency contraceptive pill if they had it available at home or over the counter through a pharmacy. Doctors prescribing the pill and barrier methods of contraception should consider providing a supply of emergency contraceptive pill at the same time and consideration should be given to over the counter prescribing of the emergency contraceptive pill in New Zealand. |
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