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PubMed1997

Contraceptive continuation and its determinants in Benin.

To understand better the rates of continuation of different contraceptive methods, a study in 12 family planning centers in Cotonou and Porto Novo, the two largest cities in Benin, was conducted. From January 1 to December 31, 1993, 944 questionnaires completed by new women acceptors of one of three methods of contraception (oral contraceptive, injection, or IUD) were analyzed. For all methods of contraception, the average length of follow-up was 9.5 months. From the start of the analysis, 44.4% (n = 419) of the women were regularly followed, 49.5% (n = 467) were not regularly followed, and 6.1% (n = 58) reported discontinuation of the method. One year after beginning the use of contraception, the cumulative proportion of women at risk of becoming pregnant, for all the methods together, was 42.0% (38.6-45.4%). Age was associated with the probability of abandoning oral contraception (p = 0.01). Three months after the start, the cumulative proportion of drop-out women having chosen oral contraceptive was 37.2% (22.8-51.6%) of the less than 20-year-olds, 19.0% (14.3-23.7%) of the 20- to 30-year-olds, and 23.4% (15.6-31.2%) of the over 30-year-olds. In contrast, drop-out was not associated with age for women using injection (p = 0.96) or the IUD (p = 0.47). Our results indicate a relatively high and rapid rate of discontinuation for modern contraceptive methods, particularly for young women having chosen oral contraceptive. This finding should incite the family planning educators to give more emphasis to the counseling programs, especially during the first three months.

Adolescent↗
PubMed1996

Factors related to choosing oral contraception at age 15.

This report aims to identify factors which are related to use of oral contraceptives at an early age. A self-administered questionnaire was completed at schools in 1988 and 1992 in southern and western Finland (N = 1339). Sexually experienced girls (mean age 15.8 years) who had answered the question concerning their oral contraceptive use were included (N = 389). Logistic regression analysis was used to compare oral contraceptive users (N = 121) with the group of non-users. Total number of coital experiences was associated with oral contraceptive use: the odds ratio for those having at least 10 coital experiences was 6.30 compared with those with only one intercourse. The proportion was 73% among oral contraceptive users and 30% among non-users. Girls using oral contraceptives perceived more often (67%) that parents accept their sexual relationship (30% among non-users). Oral contraceptive users were less afraid of getting pregnant (9% compared with 31% among non-users) and felt more often that sex was very important in their life (31 and 13%, respectively). Other factors that entered the model were age at menarche, having a steady partner and frequency of disco visits. When a young girl asks for oral contraceptives, she is probably at true risk of pregnancy, and regular contraception should be considered both in view of effective prevention of pregnancies and sexually transmitted diseases.

Adolescent↗
PubMed1986

Drug interactions with oral contraceptives.

In the very rare cases where a pregnancy occurs during oral contraceptive use, the blame is usually laid against the patient for having forgotten to take the pill. Evidence has started to accumulate to suggest that neither the patient nor the pill is at fault in some contraceptive failures. It may be because the patient is taking other medicines and these may be preventing the pill from suppressing ovulation. Most drug interactions reducing or negating contraceptive activity are due to concomitant use of drugs having microsomal enzyme-inducing activity (e.g., some antibiotics, especially rifampicin, and anticonvulsants, including phenobarbital, phenytoin, and primidone. Other antibiotics (e.g., tetracycline) may also interact by interruption of the enterohepatic circulation of contraceptive steroids. Less well appreciated, oral contraceptive steroids may themselves modify the metabolism and pharmacological activity of various other drugs (e.g., anticoagulants, benzodiazepines, beta-blockers, caffeine, corticosteroids, and tricyclic antidepressants); in this respect the oral contraceptives are acting as enzyme inhibitors. Contraceptive steroids may also interact with drugs that cause enzyme inhibition and this delays the metabolism of the hormonal agents. Interactions of this type would be expected to potentiate the action of the contraceptive steroids. It is suggested that the effects of such interaction might be presented in terms of increased incidence of side effects, including water retention, diabetogenic effects, hypertension, and an increased risk of thromboembolic disorders. The spectrum of interactions with oral contraceptives is presented in three tables.

Binding, Competitive↗
PubMed1989

Sexual behavior, contraception and unintended pregnancy among young females.

Information about contraceptive usage and sexual experiences was sampled in 1985-86 from 16-20-year-old Danish females admitted for legally induced abortion on Funen (N = 140). In attempts to elucidate the causal relations behind undesired pregnancy among teenagers, data were in the present context compared with answers to the same questions from a representative Danish sample of sexually experienced, non-pregnant females of the same age (N = 201). Of the reference sample, 83.6% were using contraceptives at the time of the interview--mostly oral contraceptives (O.C.). Of the abortion sample, 90.7% said they had used contraception earlier in their reproductive life. Approximately one third conceived in spite of contraception (most frequently the condoms). O.C. was the contraceptive method used most recently (by 43.6%). Thus, a pause in an effective contraceptive often precedes an unintended pregnancy, pointing to the need for follow-up counselling when O.C. is prescribed to teenagers. Only the minority could state the total number of times they had experienced sexual intercourse. Significantly more females in the abortion sample were in an alliance with a male partner with whom they had regular sexual intercourse. However, they also reported a higher average number of different sexual partners, indicating an association between changing sexual relationships and undesired pregnancy. In the abortion sample significantly more pregnancies prior to the index pregnancy were reported during a corresponding period of risk of conception lasting only a few years. Taking the widespread use of contraception into account, it is possible that an increased fecundity might be a co-factor behind unsuccessful contraception.

Adolescent↗
PubMedDate not supplied

Contraceptive use in Canada: 1984-1995.

CONTEXT: In every country, contraceptive behavior has important implications for fertility and the prevalence of sexually transmitted diseases (STDs). There has been relatively little attention to contraceptive practices in Canada, however, particularly how patterns of method use may have changed. METHODS: Data on contraceptive use were collected from 5,315 women in the 1984 Canadian Fertility Survey, and from 3,220 women and 3,449 men in the 1995 General Social Survey. RESULTS: Among Canadian women aged 15-49, current contraceptive use declined from 69% to 60% between 1984 and 1995. Pill use dropped from 19% to 17%, and IUD use declined from 6% to 3%. However, during the same period, condom use increased from 6% to 10%; tubal ligation declined from 24% to 17%, while vasectomy increased. In addition, the proportion of women sterilized for reasons other than contraception rose between 1984 and 1995. Men were less likely to rely on sterilization than were women (31 % vs. 40%). Men reported higher levels of condom use (22%), but lower levels of pill use among their partners (9%), than did women (10% and 17%, respectively). CONCLUSIONS: Contraceptive behavior in Canada is unique: The decline in contraceptive use over the last decade has left Canada's overall contraceptive prevalence among the lowest in the industrialized world, and the rate of sterilization among the highest These changes in contraceptive behavior complicate efforts to plan for social and health needs, particularly policy decisions focusing on reducing infections with STDs.

Adolescent↗
PubMed1986

Epidemiologic assessment of the risks of oral contraception.

Relative risk is the epidemiologic measure of risk presented most often to indicate the benefits and hazards of oral contraception. This measure of risk is prone to distortion and, unlike the attributable risk measure, does not indicate the absolute probability of a hazardous or beneficial effect of oral contraception. Estimates of the risk of cardiovascular disease in oral contraceptive users quoted most often are derived from studies that are at least a decade old. Changes in the formulation of oral contraceptives and selection of healthy women for use of such contraceptives have probably reduced these risks, although precise estimates for currently marketed oral contraceptive formulations in women free of cardiovascular risk factors are not available. Even considering the probably inflated estimates of the risk of cardiovascular disease in oral contraceptive users derived from the older British studies, oral contraception compares favorably with such activities as automobile use in women less than age 35. The hazards of everyday living are the most appropriate framework for interpreting the risks of oral contraception.

Cardiovascular Diseases↗
PubMed1984

The Royal College of General Practitioners' Oral Contraception Study: some recent observations.

The Royal College of General Practitioners' Oral Contraception Study is a continuing cohort survey of the effects of oral contraceptives on the health of users. Neurotic depression is associated with the oestrogen content of combined oral contraceptives, but the risk is small in general, and there is no excess risk associated with oestrogen doses of 35 micrograms or less. It now appears likely that, in the long-term, oral contraceptives are not associated with any increased risk of gallbladder disease, although there is an acceleration of the disease in those women susceptible to it. The progestogen activity of combined oral contraceptives is associated with an increased risk of hypertension and arterial disease. Duration of use no longer seems to influence the occurrence of the latter. Cigarette smoking by oral contraceptive users is the predominant associated risk factor for the occurrence of arterial diseases. Non-smokers using low-progestogen-dose brands may safely use oral contraceptives, probably up to the age of 45 years. In the author's opinion, there is no convincing evidence that oral contraceptive use increases the risk of breast cancer. The evidence for an association with cervical cancer is firmer, but, if confirmed, is unlikely to affect more than one in 3000 users a year. Increased safety in the use of oral contraceptives in future is likely to be achieved through the use of tests which will allow the adjustment of dose to be made to each patient's particular requirements.

Adolescent↗
PubMed2004

Interventions for emergency contraception.

BACKGROUND: In emergency contraception a drug or IUD is used to prevent pregnancy shortly after unprotected intercourse. Except for some Western-European countries and China, emergency contraception is largely under-utilised worldwide. In many developing countries lack of access to emergency contraception may subject women to unsafe abortions, which contribute significantly to maternal mortality and morbidity. Currently, several interventions (IUD, the Yuzpe regimen, levonorgestrel, mifepristone, danazol and some combination regimens) are available for emergency contraception. Information on the comparative efficacy, safety and convenience of these methods is crucial for reproductive health care providers and the women they serve. OBJECTIVES: To determine which emergency contraceptive method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy. SEARCH STRATEGY: The search included the Cochrane Controlled Trials Register, Popline, MEDLINE, Chinese biomedical databases and UNDP/UNFPA/WHO/World Bank Special Programme on Human Reproduction (HRP) emergency contraception database (July 2003). Content experts and pharmaceutical companies were contacted. SELECTION CRITERIA: Randomised controlled trials and controlled clinical trials including women attending services for emergency contraception following a single act of unprotected intercourse were eligible. DATA COLLECTION AND ANALYSIS: Data on outcomes and trial characteristics were extracted in duplicate and independently by two reviewers. Quality assessment was also done by two reviewers independently. Meta-analysis results are expressed as relative risk (RR) using a fixed-effects model with 95% confidence interval (CI). In the presence of significant heterogeneity a random-effect model was applied. MAIN RESULTS: Forty-eight trials with 33110 women were included. Most trials were conducted in China (37/48). Levonorgestrel is more effective than the Yuzpe regimen in preventing pregnancy (2 trials, RR: 0.51; 95% CI: 0.31 to 0.83). Single dose (1.5 mg) administration seems to have similar effectiveness as the standard 12 hours apart split-dose (0.75 mg twice) of levonorgestrel (2 trials, RR: 0.77, 95% CI: 0.45 to 1.30). Levonorgestrel has similar effectiveness to mid-dose (8 trials, RR: 1.64; 95% CI: 0.82 to 3.25) or low-dose (7 trials, RR: 1.38; 95% CI: 0.93 to 2.05) mifepristone. Low-dose (=< 10 mg) mifepristone is similarly effective as mid doses (25-50 mg) when only high quality trials are considered. Delay in the onset of subsequent menses is the main unwanted effect of mifepristone and seems to be dose-related. The Yuzpe regimen can be used when levonorgestrel and mifepristone are not available. Half-dose Yuzpe with single administration is associated with fewer side-effects but it is not clear whether it is as effective as the standard Yuzpe regimen (RR: 1.41; 95% CI: 0.76 to 2.61). REVIEWERS' CONCLUSIONS: Levonorgestrel 1.5 mg (two split doses or a single dose) and low and mid-doses (25-50 mg) of mifepristone offer high efficacy with an acceptable side-effect profile. Single dose simplifies the use of levonorgestrel for emergency contraception without an increase in side-effects. However, mifepristone might delay the following menstruation, which could increase anxiety, particularly in higher doses. The Yuzpe regimen could be used if levonorgestrel or mifepristone are not available. The intrauterine device (IUD) is another effective emergency contraceptive, and can be kept for ongoing contraception.

Contraception, Postcoital↗
PubMed2005

Factors influencing young women's decision making regarding hormonal contraceptives: a qualitative study.

INTRODUCTION: Discontinuation of hormonal contraceptives is correlated with the experience of unwanted effects and is an important cause of unwanted pregnancy. Previous studies have not identified the factors that influence whether a woman will switch to another hormonal contraceptive, switch back to condom use or stop contraception altogether when side effects are experienced. METHODS: This qualitative study used in-depth interviews to explore factors influencing young women's decision making regarding highly effective hormonal contraceptives in 51 women aged 16-25 years living in or just outside London, UK. RESULTS: Young women's decision making regarding hormonal contraceptives is not simply determined by the experience of unwanted effects but reflects the meaning of unwanted effects in relation to underlying beliefs regarding the nature of hormones in contraceptives, 'natural' menses, menstrual control and the importance of avoiding pregnancy. When unwanted effects were experienced, women with no concerns about the nature of hormones tended to switch to other highly effective hormonal contraceptives. Those with underlying concerns regarding the nature of hormones returned to (inconsistent) condom use or stopped using contraception altogether. This was linked to experiencing unwanted pregnancy. CONCLUSIONS: Eliciting attitudes regarding the nature of hormones in contraceptives, menstrual control and natural menses could enable health care practitioners to offer more tailored advice, interventions and contraceptives to women.

Adolescent↗
PubMed2003

Knowledge and perception of emergency contraception among female Nigerian undergraduates.

CONTEXT: The reproductive health hazards of unintended pregnancies and unsafe abortions are well documented. The potential of emergency contraceptives to prevent unwanted pregnancy in developed countries has been described, but in Nigeria, the awareness about the method is poor and no study has looked at efficacy. METHODS: Between September and October 2001, a randomly selected sample of female undergraduate students at the University of Benin, Nigeria, were surveyed about their demographic information, sexual history and contraceptive use, and their awareness and knowledge of emergency contraception. RESULTS: Of the 880 respondents, 43% were sexually active, 39% had ever practiced contraception and 34% had ever had an induced abortion. Overall, 58% of respondents reported knowing about emergency contraception; sexually active respondents were significantly more likely than those who were not and those who had ever practiced contraception were more likely than those who had not to be aware of emergency contraceptives. However, only 18% of respondents who reported knowing about emergency contraception knew the correct time frame in which emergency contraceptives must be used to be effective. CONCLUSION: There is an urgent need to educate Nigerian young people about emergency contraception, emphasizing available methods and correct timing of use.

Adolescent↗
PubMed1982

Biliary lipids, bile acids, and gallbladder function in the human female: effects of contraceptive steroids.

Individuals who take contraceptive steroids or estrogens are at increased risk of developing cholesterol gallstones. The mechanisms of the increased stone formation are incompletely understood. In this study we report biliary lipid composition and secretion, bile acid composition and kinetics, and gallbladder function in a group of healthy, nonobese women taking a contraceptive steroid preparation. A comparable group of healthy women served as controls. Bile-rich duodenal fluid was obtained after stimulation of gallbladder contraction; bile acid, phospholipid, and cholesterol concentrations were determined. Biliary lipid secretion rate was measured by the marker perfusion technique. Bile acid distribution was determined by gas-liquid chromatography. The pool size, FTR, and synthesis rate of each bile acid were measured by using CA and CDCA labeled with the stable isotope of carbon, 13C. In some of the subjects gallbladder storage and emptying were measured during the kinetic study, by real-time ultrasonography. Contraceptive steroid use was associated with a significant increase in biliary cholesterol saturation and in the lithogenic index of bile. The rate of cholesterol secretion in the contraceptive steroid group was 50% greater than in the control (p much less than 0.001) and the rate of bile acid secretion was reduced (p less than 0.02). The total bile acid pool size was significantly increased by contraceptive steroids. The major increase occurred in the CA pool (p less than 0.04). The daily rate of enterohepatic cycles of the bile acid pool was decreased by contraceptive steroids from 6.6 to 4.3 (p less than 0.01). The only effect of contraceptive steroids on gallbladder function was a slower emptying rate in response to intraduodenal amino acid infusion. No index of gallbladder function correlated significantly with any parameter of bile acid kinetics in this small group of subjects. The findings confirm the lithogenic effect of contraceptive steroids and indicate that its causes are an increase in cholesterol secretion and a decrease in bile acid secretion.

Bile↗
PubMed1997

Influence of oral contraceptive use and cigarette smoking, alone and together, on antipyrine pharmacokinetics.

The pharmacokinetics of antipyrine following a single 1-g intravenous dose was determined in 63 healthy women. Subjects were divided into 4 groups as follows: 1) cigarette smokers using low-dose oral contraceptives (n = 15); 2) nonsmokers using low-dose oral contraceptives (n = 12); 3) cigarette smokers not using oral contraceptives (n = 10); and 4) controls, neither cigarette smokers nor oral contraceptive users. Plasma antipyrine concentrations during 24 to 48 hours after dosage were measured by high-performance liquid chromatography. Mean kinetic variables in the nonsmoking, non-oral contraceptive using control group were: volume of distribution, 37.7 L; elimination half-life, 13.2 hours; and clearance, 34.4 mL/min. In cigarette smoking, non-oral contraceptive users versus controls, elimination half-life was reduced (8.0 vs. 13.2 hours, P < 0.05) and clearance increased (56.0 vs. 34.4 mL/min, P < 0.05). In nonsmoker oral contraceptive users, the reverse was true (elimination half-life was significantly increased: 16.6 vs. 13.2 hours, P < 0.05; and clearance was significantly decreased: 24.8 vs. 34.4 mL/min, P < 0.05). In smokers who were using oral contraceptives, values were not significantly different from controls (elimination half-life, 11.2 hours; clearance, 39.5 mL/min). Volume of distribution did not differ among the four groups. Thus the opposing effects on antipyrine clearance of the induction of metabolism by cigarette smoking and the inhibition due to low dose oral contraceptive use in effect negate each other when combined in humans.

Adolescent↗
PubMed1995

A pilot program of contraceptive continuation in six school-based clinics.

PURPOSE: Few school-based health centers (SBHC) in the United States dispense contraceptives on-site and little is known about contraceptive continuation in these health centers. METHODS: An 11-month contraceptive continuation pilot project offering monthly reproductive health assessment and counseling to students enrolled in Baltimore school clinics was evaluated. One hundred-forty-three women voluntarily enrolled in the study over a seven month period. A monthly contraceptive calendar was developed to collect data on contraceptive use, pregnancy and STD risk, sexual behavior and parental support for contraceptive use. Physical assessment was provided as needed to assess the presence of STD's or pregnancy. Data were analyzed for the month prior to enrollment in the program and eleven months after entry into the program. RESULTS: Both contraceptive (OCP) use and abstinence increased over the course of the program. Condom use remained at approximately 30% with frequent use of OCP's and condoms, condoms or abstinence. Program drop-out was common. Thirteen students became pregnant while enrolled in the program and 35% of the students were diagnosed with one or more sexually transmitted diseases. Partner-switching was common, although two or more partners within any one month was rare. CONCLUSIONS: Monthly follow-up provided through SBHCs can improve contraceptive use although dropout rate and contraceptive failure remain high.

Adolescent↗
PubMed1993

Impact of contraception on gynecologic cancers.

In considering the appropriate contraceptive method for a particular woman, the potential effect of that method on her risk of developing cancer of the breast, cervix, endometrium, or ovary is crucial. Among the most closely studied of the risk factors for gynecologic neoplasm has been the potential role of contraceptives, especially oral contraceptives, intrauterine devices, and injectable progestins. Physicians need to consider the potential impact of these agents on the disease process, therapy for the disease, future fertility, and the health of the fetus. Although much of the epidemiologic data is inconsistent and difficult to interpret, most studies find no association between oral contraceptive use and increased risk of breast cancer, except possibly in younger women (< 45 years of age) with prolonged use. Oral contraceptive use may also protect against benign breast disease. Data concerning oral contraceptive use and cervical neoplasm are confounded by several interacting variables, the most important of which is that oral contraceptive users tend to have more Papanicolaou smears than nonusers. Some studies have indicated an increased risk of two- to fourfold after 10 years of use. Oral contraceptive use provides clear protection against endometrial and ovarian cancer, an effect that persists for years after discontinuation. Less data have been collected regarding the relationship between intrauterine devices and injectable hormonal preparations and various types of cancer. No evidence suggests that the intrauterine device predisposes to the development of preneoplastic conditions of the cervix, nor to endometrial or ovarian cancer. A reliable form of contraception is indicated in women with cancer of any kind that may require chemotherapy or radiation, because these treatments can have adverse effects on the fetus, especially if given during the first trimester.

Breast Neoplasms↗
PubMedDate not supplied

Measuring contraceptive use patterns among teenage and adult women.

CONTEXT: Measures of contraceptive use at one point in time do not account for its changing nature. A measure that addresses the pattern of method use over time may better predict the cumulative risk of unintended pregnancy. METHODS: Women at risk of unintended pregnancy were selected from the 1995 National Survey of Family Growth, and their contraceptive use patterns were compared across age-groups. Survival analysis was used to validate women's long-term use pattern as an indicator of pregnancy risk, and multivariate regression analyses were used to explore potential covariates of current patterns of contraceptive use. RESULTS: More than two-thirds of women aged 15-19 report long-term uninterrupted contraceptive use, but they are more likely to report sporadic use and less likely to report uninterrupted use of a very effective method than are women aged 25-34. Compared with women aged 25-34, women aged 20-24 have higher rates of sporadic use and lower rates of effective uninterrupted use. Among teenagers, nonusers are 12 times as likely as uninterrupted effective users to experience an unintended pregnancy within 12 months at risk. Women in less stable relationships, those having more infrequent intercourse and women who have recently experienced nonvoluntary intercourse for the first time are more likely than others to have a high-risk contraceptive pattern. Women aged 17 and younger whose current partner is more than three years older are significantly less likely to practice contraception than are their peers whose partner is closer in age. CONCLUSIONS: Long-term contraceptive use pattern is a valid predictor of unintended pregnancy risk. Policies aimed at reducing unintended pregnancies should target women who do not practice contraception and those who are sporadic users. Women in unstable relationships, those having infrequent sex and women who experience sexual coercion need access to methods, such as emergency contraception, that can be used sporadically or after unprotected intercourse.

Adolescent↗
PubMed1990

Oral contraceptives use and liver tumours: a review.

Of the nine epidemiologic controlled studies reporting on the relationship between oral contraceptives use and hepatic tumours, three have findings specifically on the association of oral contraceptives use and hepatocellular adenomas. The strength of this association is reported to be dependent more on long-term oral contraceptive use. Three other studies have reported similar relationships of oral contraceptives use with hepatocellular carcinoma, whereas the remaining three other studies have reported no association between oral contraceptives use and hepatocellular carcinoma. There is however, an increased risk of hepatocellular carcinoma as the duration of oral contraceptives use increases. The risk of developing hepatocellular adenomas is higher in oral contraceptives users over 30 years of age than in the younger age groups. These tumours occur more often in oral contraceptive users taking pills with high doses of estrogens and progestogens; while they are not only associated with oral contraceptives containing mestranol, but also those containing ethinylestradiol.

Age Factors↗
PubMed1989

Noncontraceptive clinical benefits of oral contraceptives.

The contraceptive benefits of oral contraceptives have become well known since the introduction of this birth control method in the 1960s. Since that time, a more sophisticated understanding of the hormonal components of the medication has developed, along with reduction in the dosages of these hormones. During the past decade in particular, the medical literature has documented a number of noncontraceptive benefits delineated by studies conducted in Europe and the United States. Users of oral contraceptives have reduced rates of both endometrial and ovarian cancer, and this protection persists even when oral contraceptive use is discontinued. The risk of ectopic pregnancy is reduced up to tenfold among oral contraceptive users and the risk of pelvic inflammatory disease (salpingitis), two- to fourfold. The necessity for performing surgical excision of benign breast cysts or functional ovarian cysts is substantially reduced in women who take oral contraceptives. There also is evidence that the risk of rheumatoid arthritis is reduced in oral contraceptive users. Finally, women who take oral contraceptives have less menstrual dysfunction, such as menorrhagia and dysmenorrhea, than do nonusers. In the United States, it has been estimated that as many as 50,000 hospital admissions are prevented annually because of the noncontraceptive benefits of these drugs. Accordingly, these benefits should be taken into account when discussing contraceptive methods with patients.

Adult↗
PubMed2000

Emergency contraception: survey of knowledge, attitudes and practice of health care professionals in Ibadan, Nigeria.

This survey was conducted to determine the knowledge, and prescribing attitudes of emergency contraception among healthcare professionals in Ibadan, Nigeria. A questionnaire was administered to 735 health care professionals in selected healthcare facilities in Ibadan. These facilities were randomly selected as part of an ongoing programme designed to introduce emergency contraceptive pills (ECPs) as a clinic based method of family planning in service delivery outlets in the city. The response rate was 87.5%, comprising nurses (59.3%) and physicians (25.0%). Others were pharmacists, social workers and administrators. The results revealed that healthcare professionals' knowledge of various methods that can be used emergency contraception is very low. Less than half (35.1%) of the respondents were aware that combined oestrogen/progestin or progestin-only pills can be used as emergency contraception. Similarly, only 26.7% and 13.3% of the respondents were aware that intrauterine contraceptive devices and mifepristone respectively could be used as emergency contraception. While only 16.3% of the respondents had ever prescribed the combined pills as emergency contraception, 10.9% and 8.2% had prescribed progestin-only pills and intrauterine contraceptive devices for this purpose in the past. Circumstances under which emergency contraception could be used vary among the respondents but 71.4% and 64.4% were of the opinion that condom breakage and sexual assault would be appropriate indications for its use. Two main sources, hospitals (68.4%) and pharmacies (8.8%) were identified by participants. It is apparent that one of the major barriers to frequent use of emergency contraception in Ibadan is the lack of awareness of its use by healthcare professionals. Therefore, there is an urgent need to educate these practitioners and include emergency contraception in the family planning curriculum of nursing and medical schools.

Journal Article↗