Contraception failure--what remains to be done? Knowledge and attitudes regarding the use of emergency contraception among Austrian women and men during reproductive phase.
Effective hormonal methods for preventing pregnancy after unprotected intercourse are known since the early seventies of the twentieth century. In 1974 Yuzpe et al published a pilot study in which the effectiveness of the application of two doses of ethinylestradiol and levonorgestrel levonorgestrel /le·vo·nor·ges·trel/ (-nor-jes´trel) the levorotatory form of norgestrel; used as an oral or subdermal contraceptive.
n. within 72 hours after the unprotected intercourse was described. (1) Today emergency contraception Emergency Contraception Definition
Emergency contraception or emergency birth control uses either emergency contraceptive pills (ECPs) or a Copper-T intrauterine device (IUD) to help prevent pregnancy following unprotected vaginal intercourse. (EC) is available in many countries and represents an important contraceptive contraceptive /con·tra·cep·tive/ (-sep´tiv)
1. diminishing the likelihood of or preventing conception.
2. an agent that so acts. option because it is the only form of hormonal contraception Hormonal contraception refers to birth control methods that act on the hormonal system.
Currently, all hormonal contraceptives are designed for use by women rather than men, though research on a male hormonal contraceptive (“the male Pill”) has been underway for that can reduce the risk of pregnancy after unprotected intercourse or when a planned contraceptive method Noun 1. contraceptive method - birth control by the use of devices (diaphragm or intrauterine device or condom) or drugs or surgery
birth control, birth prevention, family planning - limiting the number of children born fails. (2,3) However, emergency contraceptives remain relatively unknown and are discussed controversially in many countries. (4-10) Several factors are thought to contribute to the low awareness und restricted utilization of EC, including a lack of knowledge and the requirement for a prescription. (11-13) In several countries such as Sweden, France, Norway, Portugal, South Africa South Africa, Afrikaans Suid-Afrika, officially Republic of South Africa, republic (2005 est. pop. 44,344,000), 471,442 sq mi (1,221,037 sq km), S Africa. and the United Kingdom, EC has been reclassified to a non-prescription drug and is available as an over the counter product. (14)
In Austria emergency contraception, also called "morning after pills" is available since 2000, a prescription of a physician or an outpatient department of a hospital is still required. In 2005, the Austrian Ministry for Health permitted pharmacists This is a list of notable pharmacists.
- Dora Akunyili, Director General of National Agency for Food and Drug Administration and Control of Nigeria
- Charles Alderton (1857 - 1941), American inventor the soft drink Dr Pepper
- George F.
The process of changing the class of mutual funds once certain requirements have been met. These requirements are generally placed on load mutual funds. Reclassification is not considered to be a taxable event. of emergency contraceptives to non-prescription drugs are not satisfied with this change. They still claim that emergency contraceptives should be available over-the-counter for all women every time. But what do Austrian women and men of reproductive age think and know about EC?
The main purpose of this study was to assess the knowledge about EC and attitudes about using EC among Austrian women and men of reproductive age.
In total 349 subjects ranging in age between 17 and 39 years (x=24.8 +/- 4.3) were enrolled in the present study. The sample comprised 247 female participants ageing between 17 and 39 years (x=24.1 +/-3.9) and 102 male participants ageing between 19 and 39 years (x=26.4+/- 4.7). The recruitment of the study participants took place at the University of Vienna History
The University was founded on March 12, 1365 by Duke Rudolph IV and his brothers Albert III and Leopold III, hence the additional name "Alma Mater Rudolphina". After the Charles University in Prague, the University of Vienna is the second oldest university in Central and via the snowball snowball: see honeysuckle. system. All participants originated from Austria. The majority of them were unmarried (more than 90%) and childless (about 90%). Nearly the 80% of the respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. were University students or had already completed their studies.
The questionnaire was developed by the authors based on the 2003 Henry Kaiser Henry Kaiser may refer to:
- Henry J. Kaiser (1882–1967), American industrialist
- Henry Kaiser (musician) (born 1952), grandson of Henry J. Kaiser
KFF Kenya Football Federation
KFF King Faisal Foundation
KFF Kerrville Folk Festival
KFF Kung Fu Fighting
KFF Key Flexfield (Oracle)
KFF Kellogg's Frosted Flakes (cereal) ) Survey. (15) The questionnaire was divided into two parts. The first part comprised questions regarding socioeconomic so·ci·o·ec·o·nom·ic
Of or involving both social and economic factors.
of or involving economic and social factors
Adj. 1. parameters such as educational level, professional training and marital status marital status,
n the legal standing of a person in regard to his or her marriage state. . Additionally, a reproductive history reproductive history Obstetrics A set of 4 numbers that may be used to define a woman's obstetric Hx–eg, 4-3-2-1, would mean 4 term infants delivered, 3 preterm infants, 2 abortions, 1 child currently living and the participants' experience with contraception contraception: see birth control.
Birth control by prevention of conception or impregnation. The most common method is sterilization. The most effective temporary methods are nearly 99% effective if used consistently and correctly. were documented. The second part included 34 multiple choice questions on the knowledge and attitudes towards emergency contraception (EC). The study was conducted in compliance with the "Ethical principles for medical research involving human subjects" of Helsinki Declaration Helsinki declaration (accords),
n.pr a declaration signed by the representatives of member nations of the Conference on Security and Cooperation in Europe in Helsinki, Finland. .
Statistical analyses were carried out using SPSS A statistical package from SPSS, Inc., Chicago (www.spss.com) that runs on PCs, most mainframes and minis and is used extensively in marketing research. It provides over 50 statistical processes, including regression analysis, correlation and analysis of variance. for Windows version 15.0. Also, [chi square chi square (kī),
n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] tests were computed to calculate group differences with respect to their statistical significance. Additionally, regression analyses were performed to assess the impact of sex, age, educational level, religion, knowledge and previous experiences with EC on attitudes against EC. The critical value for testing significance was p <0.05.
The socio-demographic characteristics of the respondents are shown in table 1.
Knowledge of emergency contraception
The 100% of the female and 98% of the male respondents reported that they have heard of emergency contraception before. Although nearly all respondents have already heard of EC, only 83.4% of the female and 64.7% of the male subjects know that EC is legal available in Austria. How EC is available in Austria was correctly answered by only 54.3% of the female and 36.3% of the male respondents. While 100% of the female and 93.1% of the male respondents know the recommended timing of emergency contraception, only 12.7% of the female and 8.2% of the males gave correct answers regarding the mechanism of action of EC. Up to which week of gestation GESTATION, med. jur. The time during which a female, who has conceived, carries the embryo or foetus in her uterus. By the common consent of mankind, the term of gestation is considered to be ten lunar months, or forty weeks, equal to nine calendar months and a week. an induced abortion in·duced abortion
Abortion caused intentionally by the administration of drugs or by mechanical means.
induced abortion is legal in Austria, this was correctly answered by the 84.6% of the female and the 67.6% of the male subjects. Only a 48.6% of the female and a 21.6% of the male respondents know that the emergency contraception and the abortion pill abortion pill See Contragestive, Oral contraceptive, RU-486. RU-486 are different ways to interrupt A signal that gets the attention of the CPU and is usually generated when I/O is required. For example, hardware interrupts are generated when a key is pressed or when the mouse is moved. Software interrupts are generated by a program requiring disk input or output. pregnancy (for more detailed information see table 2).The sources of information regarding EC are listed in table 3.
Experience of emergency contraception
The 30% of the female respondents have previously used emergency contraception of whom, the 5.7% has used the method more than once. Women younger than 30 years were more frequent users than women older than 30 years (31.1% versus 18.1%). The 22.2% of the male subjects reported that their partner had used EC previously. Individual experiences with EC were documented for female subjects only. The 86.4% of women with EC experience was satisfied with the effect of EC. Only a 24.2% reported side effects Side effects
Effects of a proposed project on other parts of the firm. such as nausea nausea, sensation of discomfort, or queasiness, in the stomach. It may be caused by irritation of the stomach by food or drugs, unpleasant odors, overeating, fright, or psychological stress. It is usually relieved by vomiting. (10.8%), depressive disorder depressive disorder Psychiatry Any of a number of conditions characterized by one or more depressive episodes–major DD, depressed mood–dysthymic disorder and adjustment disorder with depressed mood, and those that do not fit the criteria of other (9.5%) or abdominal pains Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem. (8.1%). The 16.2% (n=12) reported that they suffered from a sense of guilt after using EC.
Attitudes towards EC
Attitudes towards EC are listed table 5. Significantly more female respondents (11.7%) reported ethical or religious doubts for the use of EC. This was only true for the 3.0% of the male respondents. In contrast, more male respondents interpreted EC as a kind of induced abortion (15.7% versus 13.8% in women). This difference however was not of statistical significance. Nevertheless, significantly more male subjects think that EC should be available as a prescription free over-the-counter product (32.7% versus 30.0%). Significantly more men regarded contraception as an exclusively female task, 3.0 versus 0.4%. Only few factors influencing attitudes towards EC were identified (see table 6). Sex and the opinion that "EC and induced abortion are the same thing" were related significantly with ethical or religious doubts against EC. Neither religion nor age, educational level or the previous experience with EC influenced the attitudes towards EC significantly.
The awareness about emergency contraception is extremely high among the respondents of the present study although not only University students were included in the sample. All women and 98% of the men who participated have already heard about emergency contraception. This percentage is extremely high and only comparable to the results of a Finnish study, which yielded an awareness of 100% of EC among teenage girls. (16) Other comparable studies yielded lower or much lower percentages of ever hearing about EC. (4,13,17) A relatively high frequency of awareness of EC (94%) was reported by Vahratian et al (18), who analyzed an·a·lyze
tr.v. an·a·lyzed, an·a·lyz·ing, an·a·lyz·es
1. To examine methodically by separating into parts and studying their interrelations.
2. Chemistry To make a chemical analysis of.
3. students at the University of Michigan (body, education) University of Michigan - A large cosmopolitan university in the Midwest USA. Over 50000 students are enrolled at the University of Michigan's three campuses. The students come from 50 states and over 100 foreign countries. and by Corbett et al (19) who reported that the 96% of a college student population had heard about EC previously. Extremely low is the awareness of EC even among students in African countries and India. (20-23)
Regarding knowledge it turned out, that in the present study, men were generally less well- informed about EC. Although nearly all respondents have previously heard about EC and all women and more than 90% of the men know the recommended timing of EC, only the 12.7% of women and the 8.2% of men know how emergency contraception prevents pregnancy. Furthermore, there is a lack of knowledge regarding the availability of EC in Austria. Again men are themselves hesitant hes·i·tant
Inclined or tending to hesitate.
hesi·tant·ly adv. to be informed on contraception issues. Furthermore nearly 50% of the male participants were not aware of the high- risk period for pregnancy during the menstrual cycle menstrual cycle
The recurring cycle of physiological changes in the uterus, ovaries, and other sexual structures that occur from the beginning of one menstrual period through the beginning of the next. . Interestingly, this also happened to almost a 20% of the female sample. This lack of knowledge is in accordance with the results of others studies. (20,21,24)
The general lack of knowledge may be attributed to the sources of information. Both sexes reported that media, school and friends were the main sources of information. The gynaecologist or physician was considered information source only by a minority of respondents. This observation is also in agreement with those of previous studies. (5,6,21) Nevertheless, the amount of women who had personal experience with the use of EC was rather high. The 30 % of the female respondents used EC in the past, although EC is not available over the-counter in Austria.
The use of EC was not statistically associated with age, educational level and religion. The majority of women who used EC were satisfied with EC and did not suffer from a sense of guilt. Side effects were also only reported by a minority of women. Regarding attitudes towards EC, male and female respondents differ significantly. In particular, more female respondents reported ethical or religious doubts against EC.
Focusing now to the initial question: should be EC available over- the- counter in Austria, as recommended by several gynaecologists and women's health Women's Health Definition
Women's health is the effect of gender on disease and health that encompasses a broad range of biological and psychosocial issues. centres in Austria? As indicated out in the introduction section in Austria EC is available over- the- counter, only during night hours or weekends, when women who forgot to use a contraceptive have no access to a gynaecologist or a hospital outpatient department. In this case, it depends on the pharmacist pharmacist /phar·ma·cist/ (fahr´mah-sist) one who is licensed to prepare and sell or dispense drugs and compounds, and to make up prescriptions.
n. whether EC is sold over- the- counter without prescription or not.
Furthermore, it was reported that physicians have refused to write a prescription for EC because of moral or religious doubts. There is no doubt that this situation is a very unsatisfying one. Therefore women's health centres and some gynaecologists demand a new, more liberal, regulation of EC distribution. In the present study, about 30% of the respondents have previously used EC nevertheless more than 50% of the respondents confused EC with abortion pills, a misconception mis·con·cep·tion
A mistaken thought, idea, or notion; a misunderstanding: had many misconceptions about the new tax program. that was found in many previous studies and which seems difficult to change. (14,25)
Regarding the question if EC should be available as non prescription drug prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, over-the- counter in Austria about 30% of female as well as male respondents agreed. Significantly more women were against this idea, 57.1% versus 40.6% of men. Significantly more men than women had no opinion to this question 26.7% versus 13.0%. The attitude towards EC available over -the- counter was not significantly influenced by religion, educational level, age or experience with EC. Only a third of the respondents plead plead v. 1) in civil lawsuits and petitions, the filing of any document (pleading) including complaints, petitions, declarations, motions, and memoranda of points and authorities. for a prescription free availability of EC in Austria. In a Swedish study all participants appreciated an over the counter availability of EC, however this investigation was performed after EC was approved as an over- the- counter product. (14) Apparently, much more women would appreciate an over- the-counter availability of EC in Austria, when this possibility would be legal. On the other hand a more detailed information campaign would improve knowledge and attitudes towards EC, because we found a high frequency of misconceptions Misconceptions is an American sitcom television series for The WB Network for the 2005-2006 season that never aired. It features Jane Leeves, formerly of Frasier, and French Stewart, formerly of 3rd Rock From the Sun. and a lack of knowledge concerning EC in our sample. Although this study has limitations such as the relatively small sample size and especially the small number of male respondents, it may initiate further discussion concerning EC in Austria and other countries as well.
The authors would like to express their gratitude to the participants of the study.
Conflict of interest: None declared
(1.) Yuzpe AA, Thurlow HJ, Ramzy I, Leyshon JI. Post coital co·i·tus
Sexual union between a male and a female involving insertion of the penis into the vagina.
[Latin, from past participle of co contraception--A pilot study. J Reprod Med 1974; 13: 53-58.
(2.) Trussell J, Ellerson C, Dorflinger L. Effectiveness of the Yuzpe regimen Yuzpe Regimen
A two-dose treatment with combined ECPs to prevent pregnancy after unprotected intercourse; the first dose is taken as soon as possible and the second dose is taken 12 hours after the first.
Mentioned in: Emergency Contraception of emergency contraception by cycle day of intercourse: implications for mechanism of action Contraception 2003;67:167-171.
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1. A chain or shackle for the ankles or feet.
2. Something that serves to restrict; a restraint.
tr.v. fet·tered, fet·ter·ing, fet·ters
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MHH Mast Head Height
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1. The young of herring and similar fish.
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Claudia Mayerhofer, Sylvia Kirchengast
Department of Anthropology anthropology, classification and analysis of humans and their society, descriptively, culturally, historically, and physically. Its unique contribution to studying the bonds of human social relations has been the distinctive concept of culture. , University of Vienna
Corresponding author: Sylvia Kirchengast, Department of Anthropology
University of Vienna
A-1090 Vienna, Austria
Table 1. Demographic characteristics of the study sample Characteristic All subjects Males (n = 349) (n = 102) n (%) n (%) Age (years) < 30 a 307 (88.0%) 82 (80.4%) 30-40a 42 (12.0%) 20 (19.6%) Highest level of education Primary school 2 (0.6%) 1 (1.0%) Professional training 30 (8.6%) 12 (11.8%) College 240 (68.8%) 65 (63.7%) University degree 41 (11.7%) 17 (16.7%) Others 36 (10.3%) 7 (6.9%) Religion None 121 (35.0%) 40 (40.4%) Roman-Catholic 202 (58.4%) 52 (52.5%) Protestant 17 (4.9%) 6 (6.1%) Others 6 (1.8%) 1 (1.0%) Civil status Single 111 (31.8%) 42 (41.2%) Married 21 (6.0%) 7 (6.9%) Unmarried, steady relationship (> 1 year) 171 (49.0%) 40 (39.2%) Unmarried, short 1 relationship (< 1 year) 46 (13.2%) 3 (12.7%) Civil status none 315 (90.5%) 86 (85.1%) 1 21 (6.0%) 9 (8.9%) 2 8 (2.3%) 5 (4.0%) 3 2 (0.6%) 1 (1.0%) 4 1 (0.3%) 1 (1.0%) 7 1 (0.3%) 0 (0.0%) Characteristic Females Significance (n = 247) n (%) Age (years) < 30a 225 (91.1%) <0.01 30-40a 22 (8.9%) Highest level of education Primary school 1 (0.4%) n.s. Professional training 18 (73%) College 175 (70.9%) University degree 24 (9.7%) Others 29 (11.7%) Religion None 81 (32.8%) n.s. Roman-Catholic 150 (60.7%) Protestant 11 (4.5%) Others 5 (2.0%) Civil status Single 69 (27.9%) n.s. Married 14 (5.7%) Unmarried, steady relationship (> 1 year) 131 (53.0%) Unmarried, short relationship (< 1 year) 33 (13.4%) Civil status none 229 (92.7%) n.s. 1 12 (4.9%) 2 4 (1.6%) 3 1 (0.4%) 4 0 (0.0%) 7 1 (0.3%) Table 2. Knowledge about EC: Absolute and relative amount of correct answers according to gender Knowledge All subjects Males (n = 349) (n = 102) Heard of EC? 347 (99.4%) 100 (98.0%) Is EC available 272 (77.9%) 66 (64.7%) in Austria? How is EC in Austria 171 (49.0%) 37 (36.3%) available? Know the mechanism 39 (11.4%) 8 (8.2%) of action Identifying the 342 (98%) 95 (93.1%) recommended timing of EC Know when in the 256 (73.6%) 52 (51.5%) menstrual cycles risk/possibility of pregnancy Know how long 277 (79.6%) 69 (67.6%) induced abortion is legal in Austria Is EC the same 142 (40.7%) 22 (21.6%) like the abortion pill RU-486? Knowledge Females Significance (n = 247) Heard of EC? 247 (100.0%) n.s. Is EC available 206 (83.4%) < 0.001 in Austria? How is EC in Austria 134 (54.3%) <0.001 available? Know the mechanism 31 (12.7%) n.s. of action Identifying the 247 (100.0%) <0.001 recommended timing of EC Know when in the 204 (82.6%) <0.001 menstrual cycles risk/possibility of pregnancy Know how long 208 (84.6%) <0.005 induced abortion is legal in Austria Is EC the same 120 (48.6%) <0.001 like the abortion pill RU-486? Table 3. Sources of information of EC by sex Source All subjects Males (n = 349) (n = 102) n (%) n (%) TV 72 (20.6%) 25 (24.5% Media (incl Internet) 114 (32.7%) 26 (25.5%) Friends 104 (29.8%) 18 (17.6%) Relatives 21 (6.0%) 6 (5.9%) School 83 (23.8%) 22 (21.6%) Gynecologist 33 (9.5%) 5 (4.9%) Source Females Significance (n = 247) n (%) TV 47 (19.0%) n.s. Media (incl Internet) 88 (35.6%) n.s. Friends 86 (82.7%) <0.001 Relatives 15 (6.1%) n.s. School 61 (24.7%) n.s. Gynecologist 28 (11.3%) n.s. Table 4. Experiences with ECP (females only) Questions n (%) Have you ever use EC? never 173 (70.0%) One 60 (24.3%) Several times 14 (5.7%) Do you know somebody yes 155 (62.8%) who has used EC? no 74 (30.0%) I don't know 18 (7.3%) What was the reason for EC use? Contraception failure 58 (78.4%) unprotected intercourse 16 (21.6%) Were you satisfied with EC Yes 64 (86.4%) No 5 (6.8%) I don't know 5 (6.8%) Did you suffer from Yes 18 (24.2%) side effects of EC? no 56 (75.8%) Experienced side effects Nausea 8 (10.8%) Vomiting 0 (0.0%) Head aches 1 (1.4%) Depression 7 (9.5%) Abdominal pains 6 (8.1%) others 0 (0.0%) Did you suffer from sense no 60 (81.1%) of guilt? yes 12 (16.2%) I don't know 2 (2.7%) Table 5. Attitudes towards contraception and EC according to sex Questions males females Significance n (%) n (%) Would you have Yes 3 (3.0%) 29 (11.7%) <0.03 ethical or No 88 (87.1%) 200 (81.0%) religious doubts I don't know 10 (9.9%) 18 (7.3%) to use EC? Should be EC be Yes 33 (32.7%) 74 (30.0%) <0.003 available over No 41 (40.6%) 141 (57.1%) the counter? I don't know 27 (26.7%) 32 (13.0%) Is EC an induced Yes 16 (15.7%) 34 (13.8%) n.s. abortion? No 73 (71.6%) 189 (76.8%) I don't know 13 (12.7%) 23 (9.3%) Should Yes 3 (3.0%) 1 (0.4%) <0.04 contraception be No 87 (96.0%) 246 (99.6%) an exclusively I don't know 1 (1.0%) 0 (0.0%) female task? Table 6. Regression analyses Coefficient Significance 95% confidence interval Ethical or religious doubts Sex -0.14 <0.01 -0.23-0.03 Religion 0.05 n.s. -0.05-0.13 Educational level 0.03 n.s. -0.09-0.14 Age -0.03 n.s. -0.01-0.01 Experience with EC -0.08 n.s. -0.09-0.01 EC is a kind of induced 0.17 <0.001 0.06-0.23 abortion Should EC be available over the counter? Sex -0.06 n.s. -0.26-0.08 Religion -0.05 n.s. -0.21-0.09 Educational level -0.04 n.s. -0.25-0.12 Age 0.04 n.s. -0.01-0.02 Experience with EC 0.01 n.s. -0.08-0.09 EC is a kind of induced 0.01 n.s. -0.13-0.16 abortion Is EC a kind of induced abortion? Sex -0.02 n.s. -0.15-0.10 Religion -0.01 n.s. -0.12-0.11 Educational level 0.03 n.s. -0.09-0.17 Age 0.01 n.s. -0.01-0.01 Experience with EC -0.06 n.s. -0.09-0.03
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|Author:||Mayerhofer, Claudia; Kirchengast, Sylvia|
|Publication:||International Journal of Health Science|
|Date:||Apr 1, 2009|
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