Worldover,
studies have shown that emergency contraception is not a widely-advocated method
for preventing unplanned pregnancy. Various reasons have been cited for this,
such as, lack of awareness among clients, poor and incorrect knowledge of practitioners,
ethical and social issues, unavailability of a dedicated product and many such
others. The results of a KAP survey of emergency contraception amongst general
practitioners and obstetrician-gynaecologists in Delhi are presented below.
Fifty general practitioners employed in Central Government Health Scheme dispensaries
(Group I) and 52 obstetrician-gynaecologists (Group II) including 21 post graduate
students completed the self-administered questionnaire during November 1998 and
March 1999. It was found that while all specialists
were aware of emergency contraception, the awareness amongst general practitioners
was only 40%. Doctors familiar with various EC regimens lacked correct knowledge
of dosage schedule, efficacy, side-effects in both groups and 80% doctors in group
I and 71.2% doctors in group II had never prescribed an EC pill. The Yuzpe regimen
was correctly known to 35% doctors in group I and 42% doctors in group II.The
correct use of copper IUD as an Emergency Contraception was known to 45% and 48%
doctors in group I amd II respectively. Those
doctors who had expressed awareness about emergency contraception were queried
about their perception of the mechanism of action and safety of EC (Table 1 &
2). The misconceptions regarding the mechanism of action and safety of EC, such
as causing early abortion, (15% in group I) prevented many doctors to encourage
use of EC. More GP's thought that EC would encourage promiscuity to a large extent
(70%) and reduce the use of condoms (65%) than the specialists.
The majority of doctors in both groups favoured the sale of EC on prescription
only and stressed the need for education of doctors and potential clients.
Table 1 : Perceptions about mechanism of action
GP OBG Blocks
implantation 20% 37% Interferes with fertilization
30% 23% Anovulation – 13%
Combination 10% 23% Early abortion 15% 2%
Do not know 25% 2% Table
2 : Perception about safety of EC
GP OBG Safe 15% 13%
Not safe for heart disease 45% 14% Some complications,
not serious 15 58% No knowledge about safety
25% 15%
As is evident from this study, providers need to be methodically trained for safe
and effective provision of EC to our women. | 
