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Emergency contraception Microchapters |
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Diagnosis |
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Treatment |
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Emergency contraception cultural apects On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
The current (October 2005) AAP Policy Statement on Emergency Contraception states: "The concern that widespread emergency contraception use would encourage unprotected coitus in teens is not supported in the literature."
The current (December 2005) ACOG Practice Bulletin on Emergency Contraception states: "A prominent concern among both women and health care providers is that making emergency contraception more readily available could encourage irresponsible sexual behavior, which would increase the risks of both unintended pregnancy and sexually transmitted diseases. However, numerous studies have shown that this concern is unfounded."
The latest (April 2007) review by emergency contraception experts Trussell and Raymond states: "Reported evidence demonstrates that making ECPs more widely available does not increase risk-taking[1][2][3][4][5][6][7][8][9][10] and that women who are the most diligent about ongoing contraceptive use are those most likely to seek emergency treatment."[11]
However, the availability of ECPs has not been shown to lower abortion rates. In France, Sweden, and Britain—where Yuzpe-regimen EC had been available by prescription for more than a decade and progestin-only EC has been available without a prescription for 8, 6, and 2 years respectively—the abortion rate was stable or higher during that time period. Another study concluded that distribution of free, advance supplies of EC to large numbers of women in Scotland did not reduce abortion rates.[12] A randomized controlled trial of 2000 women in China compared women with advance access to EC to women without access, and noted that the pregnancy rate was the same between the two groups. The study observed that "...providing EC in advance increases use, but there is no direct evidence that it reduces unintended pregnancy" and concluded that EC may not lower abortion rates.[13]
In September 2006, emergency contraception expert Anna Glasier wrote a BMJ editorial entitled "Emergency Contraception. Is it worth all the fuss?" that said in closing: "So is emergency contraception worth the fuss? If you are a woman who has had unprotected sex then of course it is, because emergency contraception will prevent pregnancy in some women some of the time—and if you don’t want to get pregnant anything is better than nothing. If you are the CMAJ’s editor or FDA commissioner then yes, because scientific freedom is worth the fight. If you are looking for an intervention that will reduce abortion rates, emergency contraception may not be the solution, and perhaps you should concentrate most on encouraging people to use contraception before or during sex, not after it."[14]
Before EC was used in the general population or defined as "emergency contraception," it was used, beginning in the 1960s and 70s, specifically as a treatment for victims of sexual assault.[15][16] Although EC is in wide use as an option for victims of sexual assault, some researchers believe it is underutilized as a public health measure.[17] Abortions because of rape account for less than one percent of all annual abortions.[18]
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