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

Context: In Brazil, where emergency contraception could play a critical role in reducing unwanted pregnancies, the government has included the method in its family planning guidelines. Yet, little is known about its availability and provision.

Methods: A nationally representative, randomly selected sample of 579 Brazilian obstetrician-gynecologists responded to a 1997 mail-in survey on emergency contraception. The data yield information on these providers' knowledge 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% erroneously believed that it was illegal. However, 49% of physicians who thought that the method induces abortion (which is largely illegal in Brazil) and 46% of those who thought that emergency contraception was itself illegal have provided it to clients. Most surprisingly, while 61% of respondents report having provided emergency contraception, only 15% of these physicians could correctly list the brand name of a pill they prescribed, the dosage and regimen, and the timing of the first dose.

Conclusions: Educational efforts that focus on specific prescription information and the introduction of a dedicated product would greatly improve women's access to this method in Brazil.