Emergency contraception cultural aspects
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Cultural Aspects
Emergency contraception and Risky Sex
The current (October 2005) AAP Policy Statement on Emergency Contraception states: "The concern that widespread emergency contraception use would encourage unprotected coitus in teens is not supported in the literature."
The current (December 2005) ACOG Practice Bulletin on Emergency Contraception states: "A prominent concern among both women and health care providers is that making emergency contraception more readily available could encourage irresponsible sexual behavior, which would increase the risks of both unintended pregnancy and sexually transmitted diseases. However, numerous studies have shown that this concern is unfounded."
Emergency Contraception and Abortion
The latest (April 2007) review by emergency contraception experts Trussell and Raymond states: "Reported evidence demonstrates that making ECPs more widely available does not increase risk-taking[1][2][3][4][5][6][7][8][9][10] and that women who are the most diligent about ongoing contraceptive use are those most likely to seek emergency treatment."[11]
However, the availability of ECPs has not been shown to lower abortion rates. In France, Sweden, and Britain—where Yuzpe-regimen EC had been available by prescription for more than a decade and progestin-only EC has been available without a prescription for 8, 6, and 2 years respectively—the abortion rate was stable or higher during that time period. Another study concluded that distribution of free, advance supplies of EC to large numbers of women in Scotland did not reduce abortion rates.[12] A randomized controlled trial of 2000 women in China compared women with advance access to EC to women without access, and noted that the pregnancy rate was the same between the two groups. The study observed that "...providing EC in advance increases use, but there is no direct evidence that it reduces unintended pregnancy" and concluded that EC may not lower abortion rates.[13]
In September 2006, emergency contraception expert Anna Glasier wrote a BMJ editorial entitled "Emergency Contraception. Is it worth all the fuss?" that said in closing: "So is emergency contraception worth the fuss? If you are a woman who has had unprotected sex then of course it is, because emergency contraception will prevent pregnancy in some women some of the time—and if you don’t want to get pregnant anything is better than nothing. If you are the CMAJ’s editor or FDA commissioner then yes, because scientific freedom is worth the fight. If you are looking for an intervention that will reduce abortion rates, emergency contraception may not be the solution, and perhaps you should concentrate most on encouraging people to use contraception before or during sex, not after it."[14]
Emergency Contraception and Sexual Assault
Before EC was used in the general population or defined as "emergency contraception," it was used, beginning in the 1960s and 70s, specifically as a treatment for victims of sexual assault.[15][16] Although EC is in wide use as an option for victims of sexual assault, some researchers believe it is underutilized as a public health measure.[17] Abortions because of rape account for less than one percent of all annual abortions.[18]
References
- ↑ Glasier A, Baird D (1998). "The effects of self-administering emergency contraception". N Engl J Med. 339 (1): 1–4. PMID 9647872.
- ↑ Raine T, Harper C, Leon K, Darney P (2000). "Emergency contraception: advance provision in a young, high-risk clinic population". Obstet Gynecol. 96 (1): 1–7. PMID 10862832.
- ↑ Jackson RA, Schwarz EB, Freedman L, Darney P (2003). "Advance supply of emergency contraception: effect on use and usual contraception―a randomized trial". Obstet Gynecol. 102 (1): 8–16. PMID 12850599.
- ↑ Gold MA, Wolford JE, Smith KA, Parker AM (2004). "The effects of advance provision of emergency contraception on adolescent women's sexual and contraceptive behaviors". J Pediatr Adolesc Gynecol. 17 (2): 87–96. PMID 15050984.
- ↑ Lo SS, Fan SYS, Ho PC, Glasier AF (2004). "Effect of advanced provision of emergency contraception on women's contraceptive behavior: a randomized controlled trial". Hum Reprod. 19 (10): 2404–10. PMID 15333602.
- ↑ Hu X, Cheng L, Hua X, Glasier A (2005). "Advanced provision of emergency contraception to postnatal women in China makes no difference in abortion rates: a randomized controlled trial". Contraception. 72 (2): 111–6. PMID 16022849.
- ↑ Belzer M, Sanchez K, Olson J, Jacobs AM, Tucker D (2005). "Advance supply of emergency contraception: a randomized trial in adolescent mothers". J Pediatr Adolesc Gynecol. 18 (5): 347–54. PMID 16202939.
- ↑ Trussell J, Raymond E, Stewart FH (2006). "Advance supply of emergency contraception: a randomized trial in adolescent mothers (Letter to the editor)". J Pediatr Adolesc Gynecol. 19 (3): 251. PMID 16731424.
- ↑ Walsh TL, Frezieres RG (2006). "Patterns of emergency contraception use by age and ethnicity from a randomized trial comparing advance provision and information only". Contraception. 74 (2): 110–7. PMID 16860048.
- ↑ Raymond EG, Stewart F, Weaver M, Monteith C, Van Der Pol B (2006). "Impact of increased access to emergency contraceptive pills: a randomized controlled trial". Obstet Gynecol. 108 (5): 1098–106. PMID 17077230.
- ↑ Kosunen E, Sihvo S, Hemminki E (1997). "Knowledge and use of hormonal emergency contraception in Finland". Contraception. 55 (3): 153–7. PMID 9115003.
- ↑ Glasier A, Fairhurst K, Wyke S, Zieblad S, Seaman P, Walker J, Lakha F (2004). "Advanced provision of emergency contraception does not reduce abortion rates". Contraception. 69 (5): 36. PMID 15105057.
- ↑ Hu X; et al. (2005). "Advanced provision of emergency contraception to postnatal women in China makes no difference in abortion rates: a randomized controlled trial". Contraception. 72 (2): 111-6. PMID 16022849.
- ↑ Glasier, A (2006). "Emergency contracpetion: Is it worth all the fuss?". BMJ. 333 (7568): 560–1. PMID 16973989.
- ↑ Glover D eta al (1976). "Diethylstilbestrol in the treatment of rape victims". West J Med. Retrieved 2006-11-09.
- ↑ Diamond EF (1978). "Physician notes hazards of DES use to prevent pregnancy". Hosp Prog. 59 (3): 6-10. PMID 631811.
- ↑ Stewart, Felicia H. (2000). "Prevention of pregnancy resulting from rape: A neglected preventive health measure". American Journal of Preventive Medicine. 19 (4): 228-229. doi:10.1016/S0749-3797(00)00243-9. PMID 11064225. Retrieved 2006-08-23. Unknown parameter
|month=ignored (help); Unknown parameter|coauthors=ignored (help) - ↑ Finer, Lawrence B. (2005). "Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives" (PDF). Perspectives on Sexual and Reproductive Health. 37 (3): 110–118. PMID 16150658. Retrieved 2006-08-23. Unknown parameter
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