Science, Politics, and Over-the-Counter Emergency Contraception

Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, I-456 SHM, PO Box 208008, New Haven, CT 06520, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 30.39). 12/2011; 307(4):365-6. DOI: 10.1001/jama.2011.1957
Source: PubMed
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    ABSTRACT: Background: There are no current studies on the opinions of obstetricians and gynaecologists in Germany about emergency contraception (or post-coital contraception, morning-after pill). The opinions of a large group of physicians were collected using of a questionnaire and compared with the results of an American survey (n = 1154). Methods: A two-part questionnaire was used - part 1: sociodemographic data, part 2: 4 scenarios to illustrate the possible advantages and disadvantages of free access to emergency contraception as well as 4 indications and situations for which emergency contraception can be prescribed. Results: The response rate was 91.7 % (165/180 questionnaires). 63.9 % (103/161) of the German responding physicians were of the opinion that women with access to emergency contraception experienced unwanted pregnancies less frequently than those without access. Merely 26.2 % of the responding physicians supported the prescription-free availability of emergency contraception in apothecaries. The German-American comparison ultimately revealed only a few major differences, e.g., in answers to the question whether or not access to emergency contraception could reduce the number of unwanted pregnancies (89 vs. 64 %). Conclusions: The high rejection rate of free access to emergency contraception of almost 70 % in our surveyed group supports the current position published by the German Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe) and the German Professional Union of Gynaecologists (deutscher Berufsverband der Frauenärzte). Since other medical organisations, e.g., WHO, supported the prescription-free access to levonorgestrel formulations as emergency contraception a few years ago, it would be interesting to ask a larger sample of German gynaecologists and obstetricians about their opinions on emergency contraception.
    Geburtshilfe und Frauenheilkunde 11/2012; 72(11):1004-1008. DOI:10.1055/s-0032-1327992 · 0.96 Impact Factor
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    ABSTRACT: Objective Emergency contraception (EC) accessibility has evolved differently in Catalunya as compared with other autonomous communities in Spain. Free-of-charge access within the Public Health System was authorised in 2004, and over-the-counter (OTC) access was implemented in 2009. The aim of the study is to assess the impact of these measures on demand and users’ profiles at our institution. Methods A retrospective study, in our Emergency Department, was conducted to evaluate EC requests in relationship to accessibility modifications. The age of women and which days of the week they attended were analysed. Results The number of EC requests, the distribution by age and the demand over the week remained stable after access to EC became free of charge. However, requests sharply decreased following OTC access implementation. Distribution by age also changed, with a significant increase in requests from women under 25 years (72% vs 56%, p < 0.001). Demand was greatest on Sunday and Monday, and this distribution persisted over the study period. Conclusion EC requests remained unchanged following free-of-charge access to EC, but decreased after OTC implementation. Women currently seeking EC at no cost at our institution are more likely to be younger and to request it on a Monday.
    The European Journal of Contraception and Reproductive Health Care 05/2014; 19(4). DOI:10.3109/13625187.2014.913787 · 1.84 Impact Factor
  • Contraception 07/2013; 88(4). DOI:10.1016/j.contraception.2013.07.005 · 2.93 Impact Factor