Emergency contraception for the South African healthcare professional
Abstract
Unintended pregnancies are very common, and it is estimated that almost 45% of all pregnancies in 2011 in the USA were not planned.1 In South Africa, the situation could even be worse as it is common knowledge that we have a very high teenage pregnancy rate. It puts the already overburdened health system under enormous pressure. The social and financial pressure of an unintended or even unwanted pregnancy can be devastating to a family and even more so to a single mother. It has been reported that the unintended pregnancy rate in Botswana is 52% and that only 22% had ever used emergency contraception (EC).2
Although EC is widely available in the public and private sectors, women are unaware of the options available to them. A study published in 2012 reported that only 50% of female university students had heard about EC.3 In rural populations, this number is even lower as it was previously estimated to be only 17%.4
What is even more concerning is that knowledge of EC amongst pharmacists and doctors is lacking. In Durban, KwaZulu-Natal, only 28% of doctors and 32% of pharmacists could correctly prescribe the Yuzpe regimen. The recognition of side-effects was even worse as only 27% of doctors and 22% of pharmacists could accurately diagnose or identify them.5
One can therefore expect that this lack of knowledge could lead to unsafe terminations of pregnancy and unnecessary maternal deaths. Unfortunately, at the population level, the use of EC has not reduced abortion rates, although the use of EC could be beneficial for individual woman.6
