Knowledge and usage of Emergency Contraception among pregnant teenagers, a
Jieshuang Xu, MD; Yi Chen, Linan Cheng, MD, Prof.
Shanghai Institute of Family Planning Technical Instruction, Shanghai International Peace MCH hospital of
China Welfare, Shanghai
Objective To determine the level of knowledge and usage of emergency contraception
(EC) among pregnant teenagers.
Design Cross-sectional survey. Setting 3 district, 2 municipal MCH hospitals and 1
municipal general hospital in Shanghai. Participants 591 pregnant teenagers who
volunteer to request termination of pregnancy.
Results The average age of subjects was 17.86±0.99 years. 49.1% previously
experienced contraception failure, 99.3% already had sex without any contraception in the
past, and 92.6% reported being “worried” about pregnancy when these happened. Backup
‘methods' they previously used included EC 36.1%, urinating 32.1%, shower 15.4%,
vaginal douche 10.5%, and jumping up and down 5.9%. 47.7% of the girls had heard of
EC, among them 44.1% had already used it at least once. 91.4% of the girls used no
contraception, and 8.6% experienced contraception failure within the pregnancy cycle, but
only 8.3% of them actually used EC. Among the latter, 81.6% correspond to user failure,
the other 18.4% to method failure. Girls who were aware of EC were more likely to use EC
in the past, or to prevent current pregnancy, than those who were not_P<0.01_. They were
also more likely to use a contraceptive method, and less likely to have sex without any
contraception_P<0.01_, but not more likely to use unreliable contraception_P>0.5_.
Conclusions: The awareness of EC among adolescents doesn’t have negative impact on
their contraceptive behavior. Unawareness of EC and underestimating the risk of being
pregnant are the main reasons for not using it after unprotected intercourse. Most
teenagers are willing to use EC in the future if needed after health education. Pharmacy is
their first choice for confidentiality reasons. Training pharmacists is critically important, as
they are the first EC provider in direct contact with sexually active adolescents and should
take the responsibility to offer information about correct usage of EC and other more
reliable contraceptive methods.