Jamieson M A, Hertweck S P, Sanfilippo J S
Department of OB/GYN, Queen's University, Kingston, Ontario, Canada.
J Pediatr Adolesc Gynecol. 1999 Feb;12(1):11-5. doi: 10.1016/S1083-3188(00)86614-0.
Emergency contraception, otherwise known as postcoital contraception, refers to a group of birth control modalities that, when used after unprotected intercourse within defined time constraints, can markedly reduce the risk of a resultant unintended pregnancy. The English literature, using British and American awareness data, consistently claims that these contraceptive options are underutilized in the United States because of a lack of patient and physician awareness of their existence. The objective of this study was to determine the level of awareness of postcoital contraceptive techniques in a population of American women who were presenting for pregnancy termination. The secondary goal was to calculate (theoretically) how many of these surgical terminations could have been prevented through the use of postcoital contraception.
A questionnaire was administered to patients presenting to an abortion clinic. It was intended to anonymously identify patient demographics and knowledge of the various emergency contraceptive options and, in hindsight, to determine what percentage of these women would have been willing candidates for one of these medical modalities. On completing the questionnaire, all patients received an emergency contraceptive information sheet for future consideration.
Eighty-three patients completed the study. They ranged in age from 15 to 44 years (mean, 24 years). Forty-six percent of the patients were 21 years of age or younger. A total of 71% of all patients had no real knowledge of the existence of emergency contraceptive options; 26% had some limited knowledge, and only 3% had somewhat complete and valuable information. Fifty-one percent of the patients would have been appropriate, realistic, and willing candidates for at least the emergency contraceptive pill. Assuming at least a 75% effectiveness rate for the emergency contraceptive pill, 38% of the surgical pregnancy terminations performed on this population of women could have been avoided.
Our data confirm that emergency contraceptive options are underutilized because of a lack of patient awareness. Contraception education, especially directed toward adolescents, should include disseminating enhanced information about postcoital contraception options.
紧急避孕，也被称为性交后避孕，是指一组避孕方式，在规定的时间限制内于无保护性交后使用时，可显著降低意外怀孕的风险。英文文献利用英国和美国的知晓率数据，一直声称这些避孕选择在美国未得到充分利用，原因是患者和医生对其存在缺乏了解。本研究的目的是确定前来终止妊娠的美国女性群体对性交后避孕技术的知晓程度。次要目标是（从理论上）计算通过使用性交后避孕可避免多少此类手术终止妊娠。
对到堕胎诊所就诊的患者进行问卷调查。该问卷旨在匿名识别患者的人口统计学特征以及对各种紧急避孕选择的了解情况，事后确定这些女性中有多大比例愿意选择这些医疗方式之一。完成问卷后，所有患者都会收到一份紧急避孕信息表以供日后参考。
83名患者完成了研究。她们的年龄在15至44岁之间（平均24岁）。46%的患者年龄在21岁及以下。所有患者中，共有71%对紧急避孕选择的存在一无所知；26%有一些有限的了解，只有3%有较为完整且有价值的信息。51%的患者至少适合、实际且愿意选择紧急避孕药。假设紧急避孕药的有效率至少为75%，那么对这群女性进行的手术终止妊娠中有38%本可避免。
我们的数据证实，由于患者缺乏了解，紧急避孕选择未得到充分利用。避孕教育，尤其是针对青少年的教育，应包括传播有关性交后避孕选择的更多信息。
