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Women experience unnecessary delay in accessing emergency contraception

By October 12, 2009News

Press Release – October 13 2009

New research from the Irish Family Planning Association (IFPA) indicates that many women are accessing the emergency contraceptive pill outside the optimal 24-hour time frame.

Almost of half of women (46%) in the new study presented for emergency contraceptive services 24 hours or more after unprotected sex.

The survey also sheds light on the age profile of women requesting emergency contraception services with over half of women (52%) in the study aged 22 or older.

This delay in accessing the emergency contraceptive pill (ECP) is a cause for concern and strengthens the case for making ECP available over the counter in Ireland, according to Dr Caitriona Henchion, Medical Director of the Irish Family Planning Association (IFPA).

“While, the emergency contraceptive pill is licensed for 72 hours after unprotected or under-protected sex, the sooner a woman takes it the more effective it is. The first 24 hours is regarded as the optimal time in which to take ECP,” she explains.

Released in tandem with the publication of the IFPA’s annual report, the survey analyses all new clients (1,351 women) who presented to IFPA’s Cathal Brugha Street Clinic for emergency contraceptive services in 2008. The survey did not include pre-existing clients who requested emergency contraception services in that time or clients presenting for other services.

While 54% of women presented for emergency contraception services within 24 hours of unprotected or under-protected sex, 35% of women only accessed emergency contraceptive services between 24 and 48 hours after unprotected or under-protected sex.

A further 11% experienced a delay of 48 hours or more before accessing emergency contraceptive services.

The emergency contraceptive pill (ECP) is a very safe and responsible method of preventing pregnancy when regular contraception has failed, no contraception was used or in the case of sexual assault. ECP is made out of the same hormones as regular contraception and works in a similar way. There are no serious side effects associated with it and no absolute contra-indications.

ECP is currently available over the counter in 16 countries in the EU. The IFPA believes there is no medical reason why the emergency contraceptive pill should not be available over-the-counter in pharmacies in Ireland.

“Requiring women to visit a doctor to get a prescription to access ECP causes an unreasonable delay in timely use. This unnecessary delay results in an increased risk of unplanned pregnancy.”

The survey also found that a high figure (71%) of women in the study requested ECP because they had used no contraception.“People are clearly not getting the message, we would advise all sexually active women to talk to their GP about long-term contraception needs,” says Dr Henchion.

Finally, the age range of women requesting emergency contraception services puts paid to the notion that only young women take the emergency contraceptive pill, according to Dr Henchion.

If ECP becomes available over the counter it is important that a protocol for pharmacists is developed – this should include requirements that they supply clients with an information pack about sexually transmitted infections and what to do if menstruation does not commence, she concluded.

IFPA’s Emergency Contraception Survey

Time taken to access ECP:

  • 54% of women presented for emergency contraception services within 24 hours of under-protected sex.
  • 35% of women presented for emergency contraception services between 24 and 48 hours after under-protected sex.
  • 11% presented for emergency contraception services 48 hours or more after under-protected sexual intercourse.

Age Profile:

  • Over half of all women requesting the emergency contraceptive pill were aged 22 or older (52%).
  • Four out of 10 (40%) clients were aged between 17 and 21.
  • 8% were under the age of 17.
  • Almost one quarter (24%) were aged between 22 and 25 years of age.
  • 13% were aged between 26 and 29.
  • 12% were aged between 30 and 39 years of age and a further 3% women were aged between 40 and 50.

Reason for Use:

  • 71% of women requesting the emergency contraceptive pill said it was because no contraception was used.
  • 17% said it was because of condom failure.
  • 10% reported pill failure. Forgotten pill was the most common reason given for pill failure (53%). Antibiotic use was the second most common cause of pill failure (9%).

Frequency of Use (from Jan 2008 to August 2009)

  • The vast majority (86%) of women were prescribed ECP only once in the last 20 months.
  • 11% of women were prescribed ECP twice in the last 20 months.
  • 2% were prescribed ECP three times and a further 1% were prescribed ECP on four or more occasions in the last 20 months.

Other findings:

  • Most women (82%) requesting ECP had no previous pregnancies. 6% had experienced one pregnancy and a further 2.66% had been pregnant on two occasions.
  • 1.48% of women did not require ECP.

* NOTE: This sample group only represents new clients from January 2008. Results which include the full cohort of clients might give different results. Research on pre-existing clients seeking emergency contraception is underway.

About the IFPA

Since its foundation in 1969, the Irish Family Planning Association (IFPA) has been to the fore in setting the agenda for sexual and reproductive health and rights.

In 2008 we provided contraceptive, sexual health and crisis pregnancy services to over 27,500 clients.

The IFPA provides medical services from its clinics in Dublin city centre and Tallaght as well as crisis pregnancy and counselling services at 11 centres nationwide.

We deliver family planning courses to doctors and nurses and also provide education and training on reproductive health issues to a variety of groups including service providers, young people, parents and community groups. All of these services are offered on a not-for-profit basis.

IFPA works with partner organisations and civil society to raise awareness of the importance of sexual and reproductive health at home and all over the world.

IFPA operates a dedicated emergency contraception clinic on Sundays at its two medical centres in Dublin. See www.ifpa.ie for more information.