Emergency Hormonal Contraception (EHC) is a safe and effective method of avoiding unwanted pregnancy after unprotected sex. From the 1st January 2001, pharmacists in the UK have been able to supply EHC without prescription. Such direct sale should make access to EHC easier for many women, and increased access should improve uptake of EHC. However, for women to benefit from the deregulation of EHC, they must be aware of this new development, and must have adequate and correct knowledge of EHC in order for them to use it effectively.

Method

To examine the level of knowledge of EHC, a questionnaire was completed by 52 consecutive GP attendees, over a period of 6 days. The women were aged 16 to 50 years, with a mean age of 32 years. All participants gave consent to take part, and had never used EHC. Participants were approached in the waiting area of a general practice. The response rate was 75%.

Results

All the women were aware of the existence of EHC or the 'morning after pill', but lacked more specific knowledge about EHC. Only 46% of women were aware that EHC should be taken within 72 hours, and 40% aware that EHC is available from a pharmacist without prescription.

Most women (92%) were aware that EHC should be used in the event of unprotected sex. Relatively few (38.5%) were aware that EHC should be used if their oral contraceptive pill (OC) was taken too late in the first week of their pill packet. Even fewer (25%) reported EHC should be used if a women had vomited during the first week of a packet.

Women also had misconceptions regarding the safety of EHC; 57% reported that repeated use of EHC was more risky to a women's health than regularly using the oral contraceptive pill. The media were an important source of knowledge about EHC (63%), with healthcare professionals rated less important (12%). Knowledge was greater among younger women, the group at greatest risk of unwanted pregnancies. Individuals with higher qualifications were found to have a significantly higher level of knowledge than women with fewer qualifications.

Discussion

Greater use of EHC could potentially reduce the number of unwanted pregnancies and terminations within the UK. These findings suggest that the level of knowledge about EHC needs to be increased, particularly in women of a lower qualification level. More information needs to be provided regarding the increased access of EHC. The findings related to OC use are worrying, as 90% of the sample were using the oral contraceptive pill at the time of the survey, or had used it in the past. Younger women were found to have a higher level of knowledge than older women, but their level of knowledge was still inadequate. Health professionals could play a much larger role in informing patients about EHC.