WOMENS KNOWLEDGE OF TAKING ORAL-CONTRACEPTIVE PILLS CORRECTLY AND OF EMERGENCY CONTRACEPTION - EFFECT OF PROVIDING INFORMATION LEAFLETS IN GENERAL-PRACTICE

Background. About one third of all pregnancies are unplanned and 20% o f all pregnancies end in abortion. More than 170 000 legal abortions a re performed in the United Kingdom annually Nearly all general practit ioners provide contraceptive advice; the most commonly used form of re versible contraception is the oral contraceptive pill. Aim. The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contracep tion, and to investigate if their knowledge could be improved in gener al practice by providing women with Family Planning Association inform ation leaflets. Method. An uncontrolled intervention study was perform ed in one rural and one urban English general practice, using a self-c ompletion questionnaire that was initially administered to women atten ding their general practitioner for oral contraception over six months from 1 October 1992. The questionnaire asked for: sociodemographic in formation; knowledge of how late women can be taking an oral contracep tive pill and still be protected against unplanned pregnancy; for how many days after being late with a pill they need to use other precauti ons; sources and methods of emergency contraception; and for how long the methods are effective after the primary contraceptive failure. Aft er completing the questionnaire women were given two leaflets: one abo ut how to take their prescribed contraceptive pill correctly and one a bout emergency contraception. Three to 12 months later the same questi onnaire was administered in the same manner. Results. Of 449 women com pleting the first questionnaire, 233 (52%) completed the second questi onnaire. Initially 71% of 406 women taking an oestrogen/progestogen co mbined pill knew about the '12-hour rule' and 17% knew about the 'seve n-day rule'; giving women information about the pill they were taking increased the extent of knowledge about these rules among 212 responde nts to 82% (P < 0.01) and to 25% (P < 0.05), respectively. The proport ion of respondents who, knew that they could obtain emergency contrace ption from their own general practitioner, from any general practition er and from family planning clinics all increased after they had recei ved the leaflets (from 84% to 92%, from 34% to 47% and from 82% to 90% , respectively, all P < 0.01). There were significant improvements in the proportion of women knowing the duration of effectiveness of emerg ency contraception. However, after receiving the leaflet on emergency contraception the majority of women still did not know for how long af ter unprotected intercourse the high-dose combined pill and the intrau terine contraceptive device were effective (80% and 93% of 233 women, respectively). Improvements in knowledge depended upon women's social class, previous use of emergency contraception and with which practice they were registered. Conclusion. Providing women with leaflets about taking the contraceptive pill correctly and about emergency contracep tion appears to improve significantly their extent of such knowledge. If such practice was adopted elsewhere this increased knowledge might reduce the number of unplanned pregnancies in the UK. The effect of ge neral practitioners personally providing such leaflets, with or withou t verbal instruction, warrants further study.