ABSTRACT
Emergency contraception to prevent pregnancy after episodes of unprotected sexual intercourse has existed since ancient times. Modern medicine began to use hormonal methods in the 1960s, and today emergency contraception is used regularly in many countries. In the United States, providers do not routinely prescribe it, nor do they adequately inform their patients that it is available. This occurs even though sufficient information exists on the safety and efficacy of this method. Because the effectiveness of emergency contraceptive pills relies heavily on prompt administration, better access for patients is essential. Recently, proponents of emergency contraception have attempted to better inform the public of this resource. In addition, two oral contraceptive products are now available and marketed specifically for emergency contraception. The purpose of this article is to discuss the safety and efficacy of emergency contraceptive pills and the potential for them to become available without a prescription.
Subject(s)
Contraceptives, Postcoital/supply & distribution , Nonprescription Drugs/supply & distribution , Contraceptives, Postcoital/adverse effects , Contraceptives, Postcoital/economics , Cost-Benefit Analysis , Emergencies , Female , Health Education , Health Services Accessibility/standards , Health Services Accessibility/trends , Hotlines , Humans , Information Services , Internet , Marketing of Health Services , Nonprescription Drugs/adverse effects , Nonprescription Drugs/economics , Safety , Time Factors , United States , Women's RightsABSTRACT
Our goal was to identify risk factors for substance use during pregnancy for primary care physicians so that we could assess a woman's risk of alcohol or illicit drug use. Participants were 2002 Medicaid-eligible pregnant women with < or =2 visits to prenatal care clinics in South Carolina and Washington State. Structured interviews were used to collect data. Logistic regressions and classification and regression trees identified predictors for pregnant women at high risk for substance use. Approximately 9% of the sample reported current use of either drugs or alcohol or both. Past use of alcohol or cigarettes, including during the month before pregnancy, most differentiated current drug or alcohol users from current nonusers. Our analysis suggests that primary care physicians can ask 3 questions in the context of a prenatal health evaluation to target women for referral to a full clinical assessment for drug and alcohol use.
