Emergency contraception methods: efficacy, safety and acceptability

Prevention of unwanted pregnancies, abortions and their complications is one of the major problems of healthcare. The most effective method of unwanted pregnancies prevention is family planning with highly effective contraceptive methods. Currently number of unwanted pregnancies cases is still numerous. Problem of unwanted pregnancy cannot be solved completely with any method of contraception. Every fourth pregnancy in the world is considered as unplanned, more than half of them end in abortion, which can pose a threat to health of the patient. Overall, more than 90% of abortions are performed due to unwanted pregnancies. Emergency contraception continues to play an important role in family planning today. It is known that the effectiveness of emergency contraception decreases with the time after unprotected sex. Today a variety of emergency contraception methods exists, which allows individual approach to specific patient. The article presents the results of randomized clinical trials and meta-analyses evaluating all currently used methods of emergency contraception from the evidence-based point of view. The article also describes drugs specifics, features, and effects on the reproductive system.

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Introducing emergency contraception in Bangladesh: A feasibility study

10.31899/rh2001.1019 ◽

2001 ◽

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Feasibility Study ◽

Emergency Contraception ◽

Unwanted Pregnancy ◽

Psychological Injuries ◽

Pregnancy And Delivery ◽

Unwanted Pregnancies ◽

Health Project ◽

National Family Planning

Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC could also reduce the psychological worries and health risks associated with unwanted pregnancies, MR, and abortions. The Directorate of Family Planning in collaboration with the Population Council’s Frontiers in Reproductive Health Project, Pathfinder International, and John Snow Inc., is conducting this feasibility study to develop, test, and document operational details for introducing EC as a back-up support for existing FP methods. This report is an interim update of the study’s accomplishments so far.

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Health care providers knowledge, attitudes and perceived barriers towards emergency contraception in a sub-Himalayan state of India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183325 ◽

2018 ◽

Vol 7 (8) ◽

pp. 3244

Author(s):

Rajiv Kumar Gupta ◽

Bhavna Langer ◽

Parveen Singh ◽

Rashmi Kumari ◽

Najma Akhtar ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Emergency Contraception ◽

Tertiary Care ◽

Unwanted Pregnancy ◽

Unprotected Sex ◽

Perceived Barriers ◽

Family Welfare ◽

Care Providers ◽

Cross Sectional

Background: Emergency Contraception (EC) is a method of contraception used within 72 hours of unprotected sex to prevent unwanted pregnancy. More than ten years since its use, a study was conducted among health care providers to assess their knowledge, attitudes and perceived barriers towards EC.Methods: The current cross-sectional study was conducted among the health care providers (HCPs) in all the health institutions of Jammu city, one of which included a tertiary care teaching hospital. The HCPs for the purpose of the current study included Medical Officers (MOs), Lady Health Visitors/ Staff Nurses (LHV/ SNs) and pharmacists. A 24 item pre-tested questionnaire was administered to the respondents to gather the relevant information.Results: MOs and LHV/SNs were found to have better knowledge than the pharmacists. Higher proportion of LHV/SNs and pharmacists were willing to learn more about EC (p<0.05). About two-third of MOs and LHV/SNs agreed about shortage of time during clinic schedule to counsel the users about EC (p<0.05).Conclusions: Gaps in the knowledge of the respondents need to be taken care of with continuing in-service trainings along with behaviour change communication. Role of pharmacists as health care provider especially in the context of family welfare services needs to be reassessed.

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Training service providers on emergency contraception: Lessons learned from an OR study

10.31899/rh2002.1004 ◽

2002 ◽

Keyword(s):

Family Planning ◽

Emergency Contraception ◽

Service Providers ◽

Unwanted Pregnancy ◽

Lessons Learned ◽

Critical Element ◽

Emergency Contraceptive Pills ◽

Contraceptive Pills ◽

Emergency Contraceptive ◽

National Family Planning

The Bangladesh Directorate of Family Planning in collaboration with the Population Council, Pathfinder International, and John Snow, Inc. is conducting an operations research project to test the feasibility of introducing emergency contraceptive pills (ECP) in the national family planning (FP) program and to answer operational questions on implementing the use of ECP efficiently. In Bangladesh, 1.2 million births are unplanned and the number of menstrual regulation/abortions is increasing. ECP could be a good reproductive health intervention for women since it gives them a chance to avoid unwanted pregnancy. ECP does not induce abortion. In fact, it helps in reducing the number of abortions. In Bangladesh, emergency contraception is relatively new and there is general lack of knowledge even among doctors. Thus, training providers will be a critical element for the introduction of ECP. The present feasibility study, detailed in this research update, has been undertaken to answer operational questions that need to be addressed while introducing ECP in the national FP program. The study has been carried out in two districts, Tangail and Mymensingh.

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Emergency contraception: A quick lesson

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i1.2 ◽

2019 ◽

Vol 10 (1) ◽

pp. 8-9

Author(s):

Reena Kulshrestha ◽

Sharit Shekhar Barman ◽

Soumita Bhattacharya ◽

Arnab Chakrabarty ◽

Koushik Bhattacharya

Keyword(s):

Emergency Contraception ◽

Unwanted Pregnancy ◽

Unprotected Sex ◽

Personal Life ◽

Normal Life

Unprotected sex is only the major cause of unexpected, unwanted pregnancy which is a serious problem for the female which can interfere in their personal life. To achieve their normal life, abortion is one of the general as well as common out-turn to them as a result increasing rate of abortion use to be an incident in Indian female of fertile age. Thus, this incidence is giving a prone to enter in an unsafe life to those females. To avoid this unsafe and uninterrupted personal life the knowledge about Emergency Contraception is necessary.

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Contraceptive Use Dropout-adjusted Unmet Need for Family Planning

F1000Research ◽

10.12688/f1000research.54823.1 ◽

2021 ◽

Vol 10 ◽

pp. 780

Author(s):

Budi Utomo ◽

Hariyanti Hariyanti ◽

Sabarinah Prasetyo ◽

Robert Magnani ◽

Sukma Rahayu

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unwanted Pregnancy ◽

Unmet Need ◽

Discontinuation Rate ◽

Study Results ◽

Unwanted Pregnancies ◽

Contraceptive Discontinuation ◽

History Of ◽

Calendar Data

Background: In the last two decades, unmet need for family planning in Indonesia remains stagnant, and contraceptive discontinuation has increased. These two indicators describe the risk of unwanted pregnancy in a population. Therefore, this study aims to develop an accurate calculation of the unmet need for family planning in Indonesia. Method: The study uses 2017 IDHS data to compare unmet need at survey-time and five years preceding the survey, measured by contraceptive calendar data that measured history of contraceptive use within five years preceding the survey. Unmet need at five years preceding the survey is measured by calculating the proportion of months not using contraceptive to the duration of months exposed to pregnancy in a period of 69 months. The study population is married women in Indonesia, with a sample size of 35,681. Results: Unmet need with contraceptive calendar calculation is higher than unmet need at survey-time. A difference of 3% concerns an additional of nearly 1.6 million unwanted pregnancies. This study proves that the high number of contraceptive discontinuations is directly proportional to higher unmet need with contraceptive calendar calculation. Conclusion: In Indonesia, with a relatively high contraceptive discontinuation rate, the calculation of unmet need using the calendar method is more precise than at survey-time method. The study results suggest the use of unmet need calendar for countries with high contraceptive discontinuation rate and provision of primary health care that is responsive to a potential unwanted pregnancy.

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Kontrasepsi Darurat dan Permasalahannya

Medical Scope Journal ◽

10.35790/msj.3.1.2021.34908 ◽

2021 ◽

Vol 3 (1) ◽

pp. 94

Author(s):

Erna Suparman

Keyword(s):

Emergency Contraception ◽

Intrauterine Device ◽

Unwanted Pregnancy ◽

Unprotected Sex ◽

Contraceptive Methods ◽

Emergency Contraceptive Pills ◽

Emergency Contraceptive Pill ◽

Contraceptive Pills ◽

Emergency Contraceptive ◽

Copper Intrauterine Device

Abstract: Emergency contraception is a contraceptive method that can prevent pregnancy if used immediately following unprotected sex. The use of emergency contraception could reduce the rate of unwanted pregnancy by up to 50%. There are two emergency contraceptive methods, including the emergency contraceptive pill and copper intrauterine device (IUD). Emergency contraceptive pills should be taken immediately following unprotected sex and are most effective when taken within 24 hours. IUD as an emergency contraceptive can be applied five days after unprotected sex, and it does not cause abortion. There is no absolute contraindication for emergency contraception except for known pregnancy, and simply because it is ineffective. The efficacy of emergency contraception can be defined by the proportion of women who become pregnant after using this method and the total pregnancy observed after using the method divided by the estimated number of pregnancies that would occur without using the method.Keywords: emergency contraception; sexual intercourse; pregnancy Abstrak: Kontrasepsi darurat dapat mencegah kehamilan bila digunakan segera setelah senggama. Penggunaan kontrasepsi darurat dapat menurunkan angka kehamilan yang tidak diinginkan hingga 50%. Terdapat dua metode kontrasepsi darurat, yaitu pil kontrasepsi darurat dan alat kontrasepsi dalam rahim (AKDR) yang menggunakan tembaga. Pil kontrasepsi darurat harus diberikan sesegera mungkin setelah senggama tidak terlindungi, dan paling efektif bila diberikan dalam waktu 24 jam. AKDR sebagai kontrasepsi darurat dapat dipasang hingga lima hari pasca senggama tidak terlindungi. Kontrasepsi darurat terutama bekerja dengan mencegah fertilisasi, dan tidak menggugurkan kehamilan. Tidak ada kontraindikasi absolut untuk penggunaan kontrasepsi darurat kecuali kehamilan yang diketahui, dan ini hanya karena tidak efektif. Efektivitas kontrasepsi darurat dapat didefinisikan dari proporsi wanita menjadi hamil setelah menggunakan metode ini, dan jumlah kehamilan yang diamati setelah penggunaan dibagi dengan perkiraan jumlah kehamilan yang akan terjadi tanpa penggunaan.Kata kunci: kontrasepsi darurat; senggama; kehamilan

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A New Perspective on Covid-19 Treatment: When a Paradigm Changes in Infectiology Become Necessary against an Emerging Virus as the SARS-Cov2

10.20944/preprints202009.0561.v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Louis Sylvain Peng-Wende Ouedraogo ◽

Sodjehoun Apeti ◽

Dieudonne Ouedraogo

Keyword(s):

Immune System ◽

English Language ◽

Randomized Clinical Trials ◽

Point Of View ◽

System Response ◽

Global Public Health ◽

Language Studies ◽

French And English ◽

New Perspective ◽

Meta Analyses

Background & Aims: The covid19 is a world changing challenge. Furthermore, this disease challenges our capacities to change our point of view in the domain of infectiology, immunology and global public health. Many trials try some drug such as antiviral (lopinavir, remdesivir) interferon, and the chloroquine. Unfortunately, all approach is not really convincing at this time. We are proposing another approach on this issue. In infectiology there are two protagonists : the host and its immune system versus pathogens and its virulence. Our approach focuses on an intervention on the host’s immune system and how stimulate and modulate its reactions. Methods: We searched on PubMed and Google Scholar databases for French and English-language studies, without a limit of date of publications, for randomized clinical trials, meta-analyses, reviews, systematic reviews, observational studies, case report. We performed a review on the field of immunology enhancements by nutrients use. Results: We identified groups of vitamins (D and C), oligo-elements (magnesium, zinc, selenium) and nutrition advice which enhance immune system response. Indeed, these supplements have some proved properties in modulating and stimulating the immune system. For example, a recent study demonstrates that vitamin D deficiency is linked with the severity of covid19. Majority of the population has a deficiency in these elements. According to this, we propose a therapeutic protocol using these elements to reach an efficient therapy against covid19 by enhancing host’s immune system. Conclusion: Due to this serious pandemic, any solutions must not be disregarded. The nutrition way is an entire part of the solution.

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Utilisation of Emergency Contraception Among Final Year University Female Students

10.21203/rs.3.rs-1067157/v1 ◽

2021 ◽

Author(s):

Gilbert Ti-enkawol Nachinab ◽

Mubarick Nungbaso Asumah ◽

Vida Nyagre Yakong ◽

Edwina Pwamang ◽

Cynthia Apawo Awe ◽

...

Keyword(s):

Marital Status ◽

Emergency Contraception ◽

Unwanted Pregnancy ◽

Female Students ◽

Unprotected Sex ◽

Categorical Variables ◽

P Value ◽

Cross Sectional ◽

Chi Square Analysis ◽

Emergency Contraceptives

Abstract Introduction: Unwanted pregnancy and unsafe abortion have become serious public health concerns around the world, particularly among female students in both developed and developing countries. The general objective of this study was to investigate the utilization of emergency contraception among final-year female students of a public university in Ghana. Methods A stratified random sample was used to enroll 199 female university students for descriptive cross-sectional research. SPSS version 25 was used to analyze the data. To compare categorical variables, Chi-square analysis was employed, and a p-value of 0.05 was considered statistically significant. Results Majority (88.4%) of the respondents demonstrated sufficient knowledge, and 84.4% had a favorable attitude towards emergency contraceptives (ECs). On the indications for EC; after unprotected sex (65.3%), after a missed period (22.6%), when one is raped (83.4%), unwanted pregnancy (75.9%), and rupture of condoms (88.9%) were identified. The majority (59.3%) of students have used EC, with most of the students (43.7%) using Postinor-2. The overall attitude towards EC and Residence (X2=7.5; p=0.023), Religion (X2=6.2; p=0.042), and marital status (X2=17.1, p=0.001) were statistically significant. There was a significant association between the use of EC and Residence (X2=10.9; p=0.004) and marital status (X2=8.6; p=0.035). Conclusion The findings of this study indicated that students had a high degree of awareness, understanding, and attitude about EC, with a significant number of the respondents likely to utilize it in the future. This may aid in the treatment of female students' sexual and reproductive health issues and prevent dropping out of school as a result of unwanted pregnancy. Also, there is the need to engage opinion leaders to address their concerns to allow for the effective utilization of emergency contraceptives.

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Knowledge and practice of emergency contraception among female students of public university of Ouagadougou, Burkina Faso, West Africa

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185409 ◽

2018 ◽

Vol 8 (1) ◽

pp. 135

Author(s):

Yobi A Lexis Sawadogo ◽

Issa Ouedraogo ◽

Sibraogo Kiemtore ◽

Fatou Ouedraogo ◽

Boubakar Toure ◽

...

Keyword(s):

Emergency Contraception ◽

Contraceptive Use ◽

Unwanted Pregnancy ◽

Cross Sectional Study ◽

Public University ◽

Female Students ◽

Unprotected Sex ◽

Unsafe Sex ◽

Cross Sectional ◽

Emergency Contraceptive

Background: Female students are exposed to unsafe sex, sources of unwanted pregnancy and abortions. It is recognized that emergency contraception can effectively prevent pregnancy. The purpose of this study was to evaluate the knowledge and practices of Ouagadougou public university students in relation to emergency contraception in order to propose solutions to reduce the proportion of unwanted pregnancies among female students.Methods: This was a cross-sectional study conducted between May 1st and October 31st, 2016 in the public universities of Ouagadougou. A questionnaire was administered to a sample of 732 students randomly selected.Results: The average age of female students was 22.7 years old. The age group 19 to 24 was the most represented (68.03%). Of the students surveyed, 87% knew or had heard of emergency contraception. The students only used the emergency contraceptive pill. The emergency contraceptive use rate was 44.42%. Approximately, 83% of users were aware of the delay in using emergency contraception. The reasons for using emergency contraception were condom breakage (25.10%) and unprotected sex (74.9%). Female students purchased the contraceptive directly in pharmacies (93.61%).Conclusions: Emergency contraception gives women a last chance to avoid an unwanted pregnancy after unprotected sex. Awareness and free availability of emergency contraception (EC) could improve the reproductive health of female students.

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Correlates of mistimed and unwanted pregnancy among women in the Democratic Republic of Congo

Journal of Biosocial Science ◽

10.1017/s0021932019000518 ◽

2019 ◽

Vol 52 (3) ◽

pp. 382-399

Author(s):

Tara Ballav Adhikari ◽

Pawan Acharya ◽

Anupa Rijal ◽

Mala Ali Mapatano ◽

Arja R Aro

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Reproductive Health ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Unwanted Pregnancy ◽

Well Being ◽

Birth Spacing ◽

Republic Of Congo ◽

Unwanted Pregnancies

AbstractUnwanted and mistimed pregnancies impose threats on the health and well-being of the mother and child and limit the acquisition of optimal sexual and reproductive health services, especially in resource-constrained settings like the Democratic Republic of Congo (DRC). This study aimed to determine the prevalence and correlates of mistimed and unwanted pregnancies among women in the DRC. Data were drawn from the 2013–14 DRC Demographic Health Survey (EDS-RDC II). Bivariate and multivariate logistic regression analysis was performed to identify correlates of mistimed and unwanted pregnancies. Sequential logistic regression modelling including distal (place of residence), intermediate (socio-demographic and socioeconomic factors) and proximal (reproductive health and family planning) factors was performed using multivariate analysis. More than a quarter (28%) of pregnancies were reported as unintended (23% mistimed and 5% unwanted). Women who wanted no more children (aOR 1.21; CI: 1.01, 1.44) had less than 24 months of birth spacing (aOR 2.14; CI: 1.80, 2.54) and those who intended to use a family planning method (aOR 1.24; CI: 1.01, 1.52) reported more often that their last pregnancy was mistimed. Women with five or more children (aOR 2.13; CI: 1.30, 3.49), those wanting no more children (aOR 13.07; CI: 9.59, 17.81) and those with more than 48 months of birth spacing (aOR 2.31; CI: 1.26, 4.23) were more likely to report their last pregnancy as unwanted. The high rate of unintended pregnancies in the DRC shows the urgency to act on the fertility behaviour of women. The associated intermediate factors for mistimed and unwanted pregnancy indicate the need to accelerate family planning programmes, particularly for women of high parity and those who want no more children. Likewise, health promotion measures at the grassroots level to ensure women’s empowerment and increase women’s autonomy in health care are necessary to address the social factors associated with mistimed pregnancy.

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