Advance supply of emergency contraception: Effect on use and usual contraception - A randomized trial

Rebecca A. Jackson, Eleanor Schwarz, Lori Freedman, Philip Darney

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate whether advance provision of emergency contraception increases its use and/or adversely affects usual contraceptive practices. Methods: We performed a randomized controlled trial comparing advance provision of emergency contraception with usual care in 370 postpartum women from an inner-city public hospital. Participants were followed for 1 year; 85% were available for at least one follow-up session. All participants received routine contraceptive education. The intervention group received a supply of emergency contraception (eight oral contraceptive pills containing 0.15 mg of levonorgestrel and 30 μg of ethinyl estradiol) and a 5-minute educational session. We compared use of emergency contraception and changes in contraceptive behaviors between groups. RESULTS: Women provided with pills were four times as likely to have used emergency contraception as women in the control group over the course of the year (17% versus 4%; relative risk [RR] 4.0; 95% confidence interval [CI] 1.8, 9.0). Women were no more likely to have changed to a less effective method of birth control (30% versus 33%; RR 0.92; 95% CI 0.63, 1.3), or to be using contraception less consistently (18% versus 25%; RR 0.74; 95% CI 0.45, 1.2). About half of each group reported at least one episode of unprotected intercourse during follow-up, but women who received emergency contraception were six times as likely to have used it (25% versus 4%; RR 5.8; 95% CI 2.1, 16.4). CONCLUSION: Advance provision of emergency contraception significantly increased use without adversely affecting use of routine contraception. It is safe and appropriate to provide emergency contraception to all postpartum women before discharge from the hospital.

Original languageEnglish (US)
Pages (from-to)8-16
Number of pages9
JournalObstetrics and Gynecology
Volume102
Issue number1
DOIs
StatePublished - Jul 1 2003

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Postcoital Contraception
Contraception
Confidence Intervals
Contraceptive Agents
Postpartum Period
Contraception Behavior
Levonorgestrel
Ethinyl Estradiol
Public Hospitals
Urban Hospitals
Oral Contraceptives
Randomized Controlled Trials
Education
Control Groups

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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Advance supply of emergency contraception : Effect on use and usual contraception - A randomized trial. / Jackson, Rebecca A.; Schwarz, Eleanor; Freedman, Lori; Darney, Philip.

In: Obstetrics and Gynecology, Vol. 102, No. 1, 01.07.2003, p. 8-16.

Research output: Contribution to journalArticle

Jackson, Rebecca A. ; Schwarz, Eleanor ; Freedman, Lori ; Darney, Philip. / Advance supply of emergency contraception : Effect on use and usual contraception - A randomized trial. In: Obstetrics and Gynecology. 2003 ; Vol. 102, No. 1. pp. 8-16.
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abstract = "OBJECTIVE: To evaluate whether advance provision of emergency contraception increases its use and/or adversely affects usual contraceptive practices. Methods: We performed a randomized controlled trial comparing advance provision of emergency contraception with usual care in 370 postpartum women from an inner-city public hospital. Participants were followed for 1 year; 85{\%} were available for at least one follow-up session. All participants received routine contraceptive education. The intervention group received a supply of emergency contraception (eight oral contraceptive pills containing 0.15 mg of levonorgestrel and 30 μg of ethinyl estradiol) and a 5-minute educational session. We compared use of emergency contraception and changes in contraceptive behaviors between groups. RESULTS: Women provided with pills were four times as likely to have used emergency contraception as women in the control group over the course of the year (17{\%} versus 4{\%}; relative risk [RR] 4.0; 95{\%} confidence interval [CI] 1.8, 9.0). Women were no more likely to have changed to a less effective method of birth control (30{\%} versus 33{\%}; RR 0.92; 95{\%} CI 0.63, 1.3), or to be using contraception less consistently (18{\%} versus 25{\%}; RR 0.74; 95{\%} CI 0.45, 1.2). About half of each group reported at least one episode of unprotected intercourse during follow-up, but women who received emergency contraception were six times as likely to have used it (25{\%} versus 4{\%}; RR 5.8; 95{\%} CI 2.1, 16.4). CONCLUSION: Advance provision of emergency contraception significantly increased use without adversely affecting use of routine contraception. It is safe and appropriate to provide emergency contraception to all postpartum women before discharge from the hospital.",
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