Emergency Contraception Not Offered in Many Assault Cases
Originally published by Reuters Health, May 6, 2002
LOS ANGELES (Reuters Health) — Just one in three hospitals routinely offer emergency contraception to sexually assaulted women, according to a Pennsylvania study. Furthermore, medical staff members at 1 in 10 hospitals never discuss emergency contraception at all with assaulted patients, a survey of 125 emergency rooms showed.
Results of the study were presented here Monday at the annual meting of the American College of Obstetricians and Gynecologists (ACOG).
"It is unsettling that so many victims of sexual assault aren't even being counseled about emergency contraception much less offered it," study author Dr. Ashlesha Patel, an obstetrician/gynecologist at the University of Illinois at Chicago, told Reuters Health.
Both ACOG and the American Medical Association endorse the prescription of emergency contraception to prevent unintended pregnancies.
As many as 5% of sexually assaulted women in the US become pregnant from the attack, leading to an estimated 25,000 unintended pregnancies each year, according to Dr. Patel. Many of those pregnancies could be prevented with emergency contraception, she said.
Emergency contraception is about 75% effective when started within 72 hours of unprotected sex, and the sooner the better, Dr. Patel commented.
Because the pills work by delaying ovulation or by preventing implantation, emergency contraception is controversial. While physicians' organizations define pregnancy as beginning with implantation, religious groups and others may see things differently. This appeared to be a factor in the new study, according to Dr. Patel.
While 38% of non-Catholic hospitals routinely offered counseling and provision of emergency contraception, that figure was 6% for Catholic hospitals, she said. Another factor that may prevent the use of emergency contraception is lack of knowledge about the technique—on the part of both medical staff and patients, Dr. Patel noted.
The study, a telephone survey, was conducted from January to March 2000. Of the 248 hospitals in Pennsylvania, 165 were eligible for the study because they have emergency rooms that treat patients who have been sexually assaulted. Of those, 125 participated in the study. Either an emergency-room nurse, doctor, or medical director answered the 15-question survey.
Overall, 32% of hospitals routinely offered counseling and provision of emergency contraception in sexual assault cases, results showed. Half of hospitals' counseling and provision of emergency contraception was physician-dependent, meaning that it was contingent upon the on-call doctor's belief, motivation, and knowledge about emergency contraception.
In addition, 9% of hospitals had various or unknown patterns of provision for emergency contraception, and the remaining 9% did not offer any counseling on the subject.
"The standard really should be routine [counseling and provision]," Dr. Patel asserted.
