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PubMed1993

Information needs on emergency contraception not being met.

During the 1980s, there was 2 prominent changes in family planning: more women went to general practitioners (GPs) for contraceptive advice and there was an upturn in the use of condoms due to safer sex campaigns in the mid-80s. In this study of 769 women requesting a pregnancy termination, the author's found that the greater use of condoms had appeared to increase the need for information about emergency contraception, but this was not being met. Patients advised by their GPs seemed to have a lower level of knowledge than those who obtained their contraception from clinics. The study, carried out at St. James's University Hospital in 1991-92, is compared with several studies in the 1970s and 80s which look at contraceptive usage by women with unwanted pregnancies. Differences were found between those receiving contraceptive advice from different sources (i.e. GPs, clinics, no medical source). Failure of the pill was more frequent in the GP-advised group, but failure of the diaphragm was more frequent in the clinic-advised group. Failure of non-use of condoms did not differ according to the source of advice. Knowledge of and use of emergency contraception was low. Only 14.5% of those using no contraception or recognizing a condom failure attempted to use a secondary or emergency method. Condoms should be used as well as rather than instead of other methods of contraception, and knowledge and availability of emergency contraception should be increased and promoted, recommend the authors. They concluded that problems arising from family planning provision by untrained and uncommitted doctors should be addressed urgently. (Bromham and Cartmill, British Journal of Family Planning, vol. 19, 1993, pp179-183). Commenting on the study findings, FPA Medical Information Office Jane Urwin said: "This study has furthered our knowledge in this area. It also highlights the need for further study of risk-taking behavior in relation to contraceptive use's.

Ambulatory Care Facilities↗
PubMed1978

Distribution - on or off prescription (of oral contraceptives)?

Restrictions on sale of oral contraceptives (OCs) in Australia are based on their classification as Schedule 4 poisons; as such they are "restricted substances" and obtainable only on a prescription. In general only a medical practitioner can prescribe OCs and only a chemist or a licensed person can dispense them. Doctors at Family Planning Clinics and Hospital Outpatient Departments may also supply OCs. There are arguments for and against a relaxation of restrictions controlling the distribution of OCs, many of these views were stated in submissions to the Royal Commission on Human Relationships. At present in Australia, a nurse must work under the supervision of a medical practitioner when providing family planning services. A doctor may delegate certain functions to nursing staff but remains ultimately responsible. The Royal Commission "suggests that steps should be taken to enable nurse practitioners to take a wider role in prescribing oral contraceptives." They also think "that the pill should be available only through a person trained to give information and advice on its proper use. (They) would not necessarily restrict the categories of such persons; they might include nurses, or other specially trained personnel, at family planning clinics, specially trained social workers, pharmacists, and possibly others. It would be important to establish proper standards for training these personnel and for their competence to be recognized by the Commonwealth and States under appropriate legislation. This would require cooperation. The Family Planning Associations or other recognized training bodies could be authorized to issue certificates of competence to persons who have received the appropriate training; this would in turn authorize those persons to prescribe OCs. When more is known about the OC it is hoped that it will be possible to make it available without restriction.

Australia↗