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Notes from the ED: Contraception

Surprisingly few women surveyed at an urban ED reported using contraception.

The emergency department (ED) might seem an unusual place to discuss contraception, but it may be the only source of healthcare for some women. To determine the prevalence of knowledge about and attitudes toward contraceptive use, researchers surveyed English-speaking women (age range, 18 to 55) seen at an urban ED who were awake, responsive, and neither critically or mentally ill nor intoxicated.

Of 539 respondents, 316 (59%) were defined as being at risk for pregnancy (intact uterus, not pregnant, no tubal ligation, and using either condoms or no contraceptive method). Most at-risk women were aged 35 or less (76%), white (63%), privately insured (63%), single (52%), and Catholic (49%). Although 70% of these women reported having had intercourse during the past month, only 26% reported using oral contraceptive pills (OCPs), and 18% reported always using condoms. Ten percent had ever used emergency contraception (EC), and none were using other birth control methods. Regardless of pregnancy risk, women were knowledgeable about OCPs and condoms. More than 80% of each group answered all six questions about OCPs and condoms correctly. Only 32% of at-risk and 23% of women not at risk for pregnancy answered the single EC question correctly. Between 5% and 10% of women in each group considered OCPs either morally wrong or against their religion.

Comment: Although some of the at-risk group might have been planning a pregnancy, their low rate of contraceptive use is disturbing, especially because most of these women were insured and presumably had access to primary care. Given that about half of all U.S. pregnancies are unplanned, non-emergent visits to the ED may be a good opportunity to discuss contraception.

— Diane E. Judge, APN/CNP

Published in Journal Watch Women's Health November 2, 2006

Citation(s):

Merchant RC et al. Contraceptive usage, knowledge and correlates of usage among female emergency department patients. Contraception 2006 Sep; 74:201-7.

• Medline abstract (Free)