Knowledge and practice among health professionals concerning emergency contraception

Abstract

Introduction: Emergency contraception prevents pregnancy after unprotected sexual intercourse. It can be administered after the known failure of existing methods such as broken sheaths and expelled intrauterine contraceptive devices or following intercourse without using any contraceptive method. Emergency contraceptive pill has been available in the UK since 1974. However, knowledge and practice of this method of preventing pregnancy seems less widespread than expected and it does not appear to have any impact on the rate of induced abortion, which has increased over the last 15 years. This suggests that the unplanned and unwanted pregnancies carry a higher risk of morbidity and mortality among mothers and children often due to unsafe abortion. The risk of pregnancy with one unprotected act of intercourse can be as high as 25%, depending on the cycle and the day of exposure in relation to ovulation.

Methods: This study was a national cross-sectional study carried out on 154 employees at health centers. Questionnaires on knowledge were given to all practitioners, family planning midwives and family health members in the health centers in Isfahan University of Medical Science in 1999-2000. All personnel were involved in this research. Medical, menstrual and pregnancy histories, the date of end of using contraceptive method, the date of unprotected intercourse, possible side effects of emergency contraceptive pills, time of menstruation after using emergency contraceptive pills and the date of follow up were observed by the researchers. Findings were analyzed using the SPSS statistical package.

Results: Findings showed that 38.1% of health professionals were at excellent level of knowledge, 29.9% were average, 20% good, 9.7% weak and 8.4% very weak. The survey of emergency contraceptive pills showed that basic awareness on this method was high, although specific knowledge on appropriate use such as the time limit for use, the level of effectiveness and the possible side effects was absent. About 38% of health professionals had poor score practice.

Conclusion: Lack of information causes inappropriate practice resulting in unwanted pregnancy that can induce higher morbidity and mortality in mothers and children.

Key Words: Knowledge, Practice, Post-coital Contraception, Emergency Contraceptive Pill