Knowledge about emergency contraception in women attending a termination
of pregnancy clinic
L.R. Graves, S. Padayachee, Z.M. Van der Spuy
Department of Obstetrics and Gynaecology, Faculty of Health Sciences,
University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa
Objectives: Emergency contraception, if correctly used, may prevent
pregnancy after unprotected coitus and lower the incidence of unintended
conception. This study was undertaken to assess the knowledge of emergency
contraception among women who presented to our unit requesting termination of
Methods: Interviews were conducted with 204 women requesting TOP in
our service. Information about their knowledge and use of emergency
contraception was obtained. In addition, demographic data was recorded and they
were questioned about their understanding of basic reproductive physiology.
Results: Almost 70% of the women who requested TOP had an educational
level above grade 10 (senior high school). Forty four percent of the patients
presented in the second trimester and 56% in the first trimester. Most of the
patients were multiparous (72%). At the time of conception of the index
pregnancy, 122 of the patients had not thought they were at risk of pregnancy.
About one third of the group had been using some form of contraception. Only 38%
of the whole group had every heard of emergency contraception and 8 had utilised
it prior to the index pregnancy. Most of the women presenting for TOP (87%) had
no knowledge at all of when they were most likely to conceive during their
menstrual cycle. In addition, despite educational campaigns, 72% of the women
said that they did not know how and when to use emergency contraception. The
majority of the women said that more information about emergency contraception
and easier access were essential. Many of them expressed resentment at not being
aware of this possible method of preventing unwanted conception.
Conclusions: Despite the fact that most of these women had a high
school education, knowledge about emergency contraception was limited.
Particularly concerning was the very poor understanding of basic reproductive
physiology. As this is central to avoiding unwanted pregnancy, educational
strategies which inform about physiology as well as contraceptive availability
are urgently needed in our reproductive health services.