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Quick starting contraception after emergency contraception: have clinical guidelines made a difference?
Janine Simpson1, Julie Craik2, Louise Melvin3
1ST1, Community Sexual and Reproductive Health, NHS Greater Glasgow and Clyde, Sandyford Sexual Health Service, Glasgow, UK.
Summary
Quick starting (QS) contraception significantly increased after new guidelines, but hormonal contraception provision remains low. This audit assessed immediate contraception initiation post-emergency contraception.
Area of Science:
- Sexual Health
- Contraception Research
- Public Health Policy
Background:
- Traditionally, contraception initiation after emergency contraception (EC) involved waiting for the next menstrual cycle.
- UK guidelines updated in 2010 to endorse quick starting (QS) contraception, allowing immediate initiation upon request.
Purpose of the Study:
- To audit clinical practice regarding contraception initiation after EC before and after the 2010 QS guidance publication.
- To assess the impact of new guidelines on contraception provision in an Integrated Sexual Health Service.
Main Methods:
- A full cycle audit of clinical notes for women seeking EC in 2010 and 2011.
- Data collected from the National Sexual Health database in Scotland.
- Statistical analysis using SPSS V.17.
Main Results:
- Quick starting (QS) practice increased significantly from 20.8% in 2010 to 37.1% in 2011 (p=0.011).
- There was a corresponding decrease in traditional hormonal contraception (HC) initiation (24% to 14.6%) and delayed initiation (55.2% to 49%).
- A notable percentage of women advised to return for HC initiation had no further contact with the service.
Conclusions:
- The implementation of UK guidelines led to increased quick starting (QS) contraception practices.
- Despite the rise in QS, the overall provision of hormonal contraception (HC) remains suboptimal.
- Further strategies may be needed to improve consistent contraception provision post-EC.
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