Awareness and usage of emergency contraception among teenagers seeking abortion: A Shanghai survey

ObjectiveThe objective was to determine the level of awareness and usage of emergency contraception (EC) among pregnant teenagers.Study designA cross-sectional survey was conducted through face-to-face interviews using a structured questionnaire, which was distributed to 600 pregnant teenagers with an unwanted pregnancy who requested an abortion at the MCH and general hospitals in Shanghai. Before the interview, the interviewer provided a short explanation of the purpose of the study and of EC, and then collected information on the respondent’s previous awareness, usage, and reason for failure.ResultsThe average age of the participants was 17.86 ± 0.99 years. Almost half (49.1%; 290/591) had experienced contraception failure and almost all (99.3%; 587/591) had already had sex without any contraception in the past. Backup “methods” previously used included EC in 36.1% (110/305), urinating in 32.1% (98/305), showering in 15.4% (47/305), vaginal douching in 10.5% (32/305), and jumping up and down in 5.9% (18/305). Almost half (47.7%; 282/591) of the girls had heard of EC; among them 44.0% (124/282) had already used it at least once within the 6 months before the pregnancy. Almost all (91.4%; 540/591) of the girls had used no contraception, 8.6% (51/591) had experienced contraception failure within the pregnancy cycle, but only 8.3% (49/591) had actually used EC. Among the latter, 81.6% (40/49) correspond to user failure, the other 18.4% (9/49) to method failure. Girls who were aware of EC were more likely to use a contraceptive method, and were less likely to have sex without any contraception (P < 0.01), but were not more likely to use unreliable contraception (P > 0.05).ConclusionsBoth advocacy of EC and the awareness of the risk of unprotected sex should be improved through sex education programs in schools in China. Pharmacists, being the main EC providers in direct contact with sexually active adolescents, should receive systematic training and take the responsibility for offering information about the correct usage of EC and other, more reliable contraceptive methods.