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Emergency contraception
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Many women perceive the hormonal method to have more risks than regularly taking the combined pill (Ziebland et al., 1996) and often accept the greater risks of an abortion by avoiding taking it. Young men and women are more likely to take the sort of risks that would require emergency contraception than older clients (Pearson et al., 1995) but are less likely to request it. This may be for a number of reasons, from lack of knowledge of its availability and awareness of its use to concern over confidentiality and fear of a hostile reception. This indicates the need to inform clients about emergency contraception – they may never need the information themselves but may inform a friend! Men should not be forgotten when educating clients about emergency contraception; increasingly they are taking an interest and responsibility for contraception which should be encouraged. Often receptionists are forgotten in our zeal to educate, yet it is important that they are aware of the need of these clients to obtain immediate appointments. It is also important that they are aware of other clinics where emergency contraception is available, especially outside normal working hours, as they are most likely to receive telephone requests for this information. Giving emergency contraception can not only save a great deal of anguish over an unwanted pregnancy and abortion but is also much more cost-effective and has less risk to the health of the woman.
Contraception Across the Reproductive Life-Course
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Emergency contraception, used after unprotected sex to prevent pregnancy, plays an important role. There are two main types of emergency contraceptive pills (aka ‘morning-after’ pills), both of which work by preventing ovulation (Faculty of Sexual & Reproductive Healthcare, 2017c). The copper IUD can also be used to prevent pregnancy if it is inserted within five days of unprotected sex. Emergency contraception is subject to many myths, such as the mistaken belief that it is actually an abortion pill or that it is harmful to health or future fertility. Emergency contraceptive pills are available at pharmacies without a prescription in many countries, and even at supermarkets and vending machines in some high schools, but moral concern that increasing accessibility will lead to reckless sexual behaviour continues to curb its availability across the globe.
The Role of Biomedical Technology
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
Emergency contraception, often called the “morning-after pill,” is designed to prevent pregnancy after a woman has unprotected sex or if she thinks that the birth control method has failed to work. Some emergency contraceptive pills (ECPs) can work when taken within five days of unprotected sex. ECPs work mainly by preventing or delaying ovulation, i.e., the release of an egg from the ovary. ECPs to a lesser extent may also prevent fertilization of the egg by the sperm if ovulation has already taken place. Some ECPs require a prescription while others do not.
Uptake and provision of self-care interventions for sexual and reproductive health: findings from a global values and preferences survey
Published in Sexual and Reproductive Health Matters, 2022
Carmen H. Logie, Isha Berry, Laura Ferguson, Kalonde Malama, Holly Donkers, Manjulaa Narasimhan
We found participants preferred access from doctors and pharmacies over online access across the range of SRH self-care interventions included in our study. As two of the benefits to self-care interventions are privacy and ease of access,3 pharmacies hold potential due to their ubiquity and often wide range of opening hours compared with health clinics, particularly in rural areas.36 Pharmacy access may expand access to approaches such as medical abortion36 and pharmacies are already a place of access for medical abortion in many contexts such as Nepal,24 USA,37 and Cambodia.38 Most participants reported preferring pharmacy access for emergency contraception, aligned with the World Health Organization and the International Federation of Gynecology and Obstetrics (FIGO) recommendations for access to emergency contraception without a prescription. In 19 countries persons can access emergency contraception over the counter directly, and in 76 countries persons can access without a prescription from a pharmacist; there remain some places, such as Japan, where access requires a prescription.39 There is growing evidence on the feasibility of offering pharmacy and home-based STI screening,40 including a recent study where women were recruited to collect self-administered vaginal swabs in a pharmacy clinic for STI screening.41 These studies were both conducted in the US, hence pharmacy delivery of these and other SRH self-care interventions can be further explored across diverse low- and middle-income contexts.
Enhancing use of emergency contraceptive pills: A systematic review of women’s attitudes, beliefs, knowledge, and experiences in Australia
Published in Health Care for Women International, 2019
Julie Mooney-Somers, Amber Lau, Deborah Bateson, Juliet Richters, Mary Stewart, Kirsten Black, Melissa Nothnagle
Four studies reported on women’s contraceptive use during the sexual encounter that led to ECP-use. Two studies found the most common reasons for ECP-use were contraceptive failure (31–47%; these included condom failure, sick while using oral contraceptive pill (OCP), missed/OCP, and partner failure to withdraw), and no contraceptive use (34–51%; including during sexual assault and in the context of alcohol use) (Fox et al., 2004; Pyett, 1996). Two qualitative studies reported similar findings (Calabretto, 2004; Keogh, 2005). Medical reasons prevented some women from using a preferred contraceptive method, others had engaged in unplanned sexual intercourse and were unable to implement their preferred method, and finally some women used ECPs as part of their contraceptive strategy (Keogh, 2005). Two studies reported on women’s contraceptive use at the time they were seeking emergency contraception. One survey found that while condoms were the most commonly used method (60%), they were the usual form for only 34%; ECPs were the usual form for 45% of women exclusively, and for 18% in combination with other contraceptives (Pyett, 1996). The remaining women used condoms in combination with withdrawal (7%), withdrawal alone (3%), diaphragm (<3%), or IUD (<2%) (Pyett, 1996). A review of medical records found women seeking emergency contraception were significantly more likely to rely on condoms and less likely to be using hormonal contraceptives than matched controls (Fox et al., 2004).
An overview of properties of Amphora (Acidform) contraceptive vaginal gel
Published in Expert Opinion on Drug Safety, 2018
One approach to reducing the rates of unintended pregnancies has been to increase the use of the top tier methods, such as intrauterine devices and implants, which have typical use failure rates in the first year of use of less than 1% [7]. This approach has been credited with some measurable success. Between 2008 and 2011, unintended pregnancy rates dropped in the US from 51% to 45% of all pregnancies [1], at a time when utilization of these top tier methods expanded from 6% to 14% of contraceptors [8]. However, an even greater reduction in unintended pregnancies would be possible if couples who use no method (but do not want pregnancy) were to use any method at all [8]. Currently 10% of US couples fall into that category; they account for over 55% of the country’s unintended pregnancies [3]. Reducing their pregnancy rates from 85% (pregnancy rates with unprotected intercourse) to rates (20–29%) associated with typical use of even the least effective methods (spermicides) would have a tremendous impact. Today in the United States, virtually all forms of female contraception are available only by prescription; even vaginal barrier methods may soon require clinician visits to obtain access to them. Only one type of emergency contraception (Plan B One-Step) and vaginal spermicides are available to women over-the-counter without a prescription. The availability of a safer female-controlled, self-administered, over-the-counter method that could be used by a wide range of women could make a positive contribution to solving the serious health and social problems associated with unplanned and unprepared for pregnancies.