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Annals of Family Medicine 2:345-350 (2004)
© 2004 Annals of Family Medicine, Inc.
doi: 10.1370/afm.105
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The Visit Before the Morning After: Barriers to Preprescribing Emergency Contraception

Alison Karasz, PhD, Nicole Tan Kirchen, MD and Marji Gold, MD

Albert Einstein College of Medicine, Bronx, NY

CORRESPONDING AUTHOR: Alison Karasz, PhD, Albert Einstein College of Medicine, 3544 Jerome Ave, Bronx, NY 10467, akkarasz{at}montefiore.org

BACKGROUND Research suggests that while advance prescription of emergency contraception (EC) increases women’s access, this prescribing model is rarely used. The present study sought to explore attitudes towards EC among patients and physicians, with the goal of understanding potential barriers to advance prescription.

METHODS Qualitative, semistructured interviews were conducted with patients and clinicians in a New York City family practice clinic.

RESULTS Using qualitative interviews, we found that attitudes towards EC among patients and clinicians are complex. Both groups of participants reported favorable attitudes towards EC. There was general agreement that physicians should take a proactive role in educating patients about the method. A notable minority in each group described substantial reservations, however, especially regarding the potential for EC abuse. Such attitudes emerged mainly in the context of discussions about advance prescription. Advance prescription was viewed as greatly facilitating access to EC, but some patients and clinicians feared that ready access would encourage irresponsible sex. Some participants condoned the occasional, accidental, or emergency use of EC; however, habitual use, or the plan not to plan for sex, was viewed as morally indefensible.

CONCLUSION Findings suggest that even when attitudes towards EC are generally favorable, some physicians and patients have substantial reservations about advance prescription. Education and dialogue are needed to overcome these reservations.

Key Words: Contraception • family planning services • health knowledge, attitudes, practice • women’s health • qualitative research




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TRACK Comments:

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1) effects on sexual behavior 2) question about postfertilization concerns
Joseph B. Stanford
Annals of Family Medicine, 12 Sep 2004 [Full text]
EMRGENCY CONTRACEPTION
Riptinder Singh
Annals of Family Medicine, 12 Sep 2004 [Full text]
EC in Russia
Nataliya Sherbakova
Annals of Family Medicine, 23 Sep 2004 [Full text]
response to all three questions/concerns
Alison Karasz, et al.
Annals of Family Medicine, 29 Oct 2004 [Full text]

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