UK Health Secretary blocks bid to give girls ECPs in advance

The National Institute for Health and Clinical Excellence (NICE) recommended in draft guidance proposed in 2010 that doctors, nurses, and pharmacies should “ensure all young women are able to obtain free emergency hormonal contraception, including advance provision.”  The recommendation has been on the Health Secretary’s desk since the Spring but he has not yet given it approval over concerns that NICE has not provided any evidence that the move would bring down unwanted pregnancies.

Study on EC use in Poland

In an effort to identify the main reasons for EC requests, observed failure rates, and the type and incidence of adverse effects among EC users in Poland, a prospective single-center observational study was conducted among 4655 women living in Warsaw. Data was collected via a questionnaire completed by healthcare providers prescribing EC and focused on the following outcomes: reason for EC request, time lapse between unprotected intercourse and EC use, age of women requesting EC, and reported cases of pregnancy. The study found that of the women requesting EC, 62.9% were ≤ 25 years old and 0.75% became pregnant; adverse effects were rare and mild; and the main reason for requesting EC was problems associated with condoms. Additionally, the mean interval between unprotected intercourse and EC use was 21.2 hours, although it was 26.7 hours when EC failed. The researchers concluded that women living in Warsaw seeking EC used it very soon after unprotected intercourse, and this was probably one of the most important reasons for the low pregnancy rates observed in the study population.

Thanks to the Nordic Federation of Societies of Obstetrics and Gynecology for sharing this article, which can be found in their journal Acta Obstetricia et Gynecologica Scandinavic.

November 25: International Day for the Elimination of Violence against Women

According to the WHO report Global and regional estimates of violence against women, 25% of women in the European Region experience physical and/or sexual violence by intimate partners at some point of their life, and 5% experience sexual violence from people who are not their partners.

On the International Day for the Elimination of Violence against Women, ECEC shares some valuable tools to help ensure timely access to emergency contraception to rape survivors.

Debate over LNG EC status continues in Germany

The German Bundesrat, the legislative body that represents the sixteen Länder (federal states) at the federal level, recently voted in favor of a resolution to remove the prescription-only status of LNG emergency contraception (EC). The resolution now goes to the Bundestag, the constitutional and legislative body, for a vote next January. If approved, women would no longer have to visit a doctor for a prescription before being able to obtain LNG EC.

Read the original article in German.

Spanish women and EC: New KAP study

In September 2013, the Spanish Society of Contraception (SEC) published the study ESTUDIO POBLACIONAL SOBRE USO Y OPINIÓN DE LA PÍLDORA POSTCOITAL 2013, which assesses women’s knowledge, opinions, and use of emergency contraception pills (ECPs) in Spain among 14 to 50 year olds. The study was conducted by SIGMA DOS and sponsored by Chiesi and is a follow up to a similar study conducted in 2011 which you can see here.

The study found that 16.6% of women of reproductive age have ever purchased ECPs, and 14.7% have ever used ECPs (this increased from 14.1% in 2011). The use of ECPs is associated with being in an emergency situation, primarily due to contraceptive failure (78.9%), usually the condom. Read the full 2013 survey report here (in Spanish only).

Inequalities in access to contraceptive choice in Europe

In June 2013, the International Planned Parenthood Federation European Network (IPPF EN) launched The Barometer of Women’s Access to Modern Contraceptive Choice in 10 EU Countries. This report provides a policy and status overview of women’s access to modern contraceptive choices in Bulgaria, the Czech Republic, France, Germany, Italy, Lithuania, the Netherlands, Poland, Spain, and Sweden.

The report reveals inequalities in access to contraceptive choice and calls for coherent policies on sexual and reproductive health and rights. “This report shows the diversity in which national governments address the issue of contraceptive choice across Europe and highlights inadequacies in national policy frameworks, pressing the need for increased dialogue between stakeholders and policy makers around sexual and reproductive health and rights.”

Knowledge of EC Among Male Students in Latvia

In an effort to curb the number of unwanted pregnancies in Latvia, a small-scale study was undertaken to determine male students’ knowledge about and attitudes towards EC, the first of its kind undertaken in this country. Researchers posited that within Riga Stradins University, male students of the Social Science Faculty were less informed about EC than male students of the Medical Faculty. Additionally, the researchers believed that first-year students would be less knowledgeable about EC than third-year students. To test this, the researchers administered an anonymous survey with a closed and structured questionnaire consisting of 23 questions, and the results were varied. 95.2% of the students knew when to use EC, but only slightly more than half of respondents, 59.4%, knew such specific things as time limit for use. The study also showed that 91.4% of students believed that EC was harmful to women’s health. As stated in the hypothesis, the third-year Medical Faculty students knew more about EC than the first-year Medical Faculty students, but the first-year Social Science Faculty students were more aware and knowledgeable about EC than the third-year Social Science Faculty students. Promisingly, though, 86.7% of students knew where to buy EC and 83.8% knew that it was available over-the-counter. This study also found that although most of the students had very little information about EC, many stated that they would like to learn more. The researchers interpreted this as meaning that male students care about the problem of unwanted pregnancy and are ready to help solve it.

Perceptions of EC in France Among Women and Gynecologists

In 2012, HRA Pharma and the BVA Institute conducted a survey among a representative sample of 2,500 women aged 16-45 on their perceptions of EC. The survey found that among women who reported having unprotected or inadequately protected intercourse, only 20% used EC, due mainly to an underestimation of the risk of pregnancy. This survey also confirmed that women expect to receive more information on EC from health professionals but wish to obtain EC directly from pharmacists. Concurrently, the French Society of Gynecology and the National Federation of Colleges of Medical Gynecology conducted a survey, called GYNECUR, among 500 gynecologists to gauge their perceptions of EC. The vast majority of the gynecologists reported that they are adequately informed about EC, they are conscious of the important preventive role they play in this matter, and in case of need, they refer their patients to pharmacists who provide EC. According to 70% of the gynecologists, women, in general, do not know how to identify situations that put them at risk for unwanted pregnancy, and they are not adequately informed about EC. However, contrary to the view of the gynecologists, 2/3 of the women surveyed reported that they believe that they would be perceived by others as imprudent when requesting EC, and 1/5 of them reported that they would feel ashamed to use EC. Overall, these surveys proved that gynecologists’ and women’s perceptions of EC are similar on two points: (1) the progress EC represents for women and (2) making EC available and increasing access and use is a responsible action. These two surveys show that there is an important need to inform women about emergency contraception and the situations that put them at increased risk for unwanted pregnancies.

For more information on the methodology behind the GYNECUR survey, please review this presentation in English or French.

Impact of OTC EC Access in Switzerland

Amid concerns that OTC (over the counter) EC access might result in less efficient use of contraceptive methods, overuse, and riskier sexual behavior, Swiss researchers studied whether the behaviors of EC users have changed since EC was made OTC in 2002. The researchers studied the profiles of EC users in a pharmacy in the city of Zurich one and six years after EC was made OTC and analyzed age, contraceptive methods used, reasons for EC use, and last contact with a gynecologist. The study found that OTC EC access had no impact on regular contraceptive behavior, as the percentage of pill and condom users was very high (85%) and the percentage of EC users without any contraception remained consistent over the years (17-18%).  However, six years after EC was made OTC, condom rupture was reported more frequently, and significantly more women reported having used EC previously in their history. The authors concluded that OTC EC access has not resulted in less use of efficient contraceptive methods, even among adolescents, who reported using EC mainly as a back-up method and seldom in the context of unprotected intercourse.

EC Country Profiles Now Available on ECEC Website

Do you want to know more about access to emergency contraception in a specific country? In cooperation with national experts, ECEC is developing country profiles. Click here to learn more about EC accessibility, prescription status, cost, guidelines, common practices, and use in European countries.