Emergency contraception: Knowledge, attitudes and practices among Brazilian obstetrician-gynecologists

Context: In Brazil, where emergency contraception could play a critical rol e in reducing unwanted pregnancies, the government has included the method in its family planning guidelines. Yet, little is known about its availabil ity and provision. Methods: A nationally representative, randomly selected sample of 579 Brazi lian obstetrician-gynecologists responded to a 1997 mail-in survey on emerg ency contraception. The data yield information on these providers' knowledg e about attitudes toward and practices regarding emergency contraception. Results: Nearly all respondents (98%) had heard of emergency contraception, but many lacked specific knowledge about the method. Some 30% incorrectly believed that emergency contraception acts as an abortifacient and 14% erro neously believed that it was illegal. However, 49% of physicians who though t that the method induces abortion (which is largely illegal in Brazil) and 46% of those who thought that emergency contraception was itself illegal h ave provided it to clients. Most surprisingly, while 61% of respondents rep ort having provided emergency contraception, only 15% of these physicians c ould correctly list the brand name of a pill they prescribed, the dosage an d regimen, and the timing of the first dose. Conclusions: Educational efforts that focus on specific prescription inform ation and the introduction of a dedicated product would greatly improve wom en's access to this method in Brazil.