Emergency contraception provision: a survey of emergency department practitioners.
OBJECTIVE
To determine emergency department (ED) practitioner willingness to offer emergency contraception (EC) following sexual assault and consensual sex, and to compare responses of practitioners from states whose laws permit the refusal, discussion, counseling, and referral of patients for abortions (often called "opt-out" or "abortion-related conscience clauses") with those of practitioners from states without these laws.


METHODS
Using a structured questionnaire, a convenience sample of ED practitioners attending a national emergency medicine meeting was surveyed.


RESULTS
The 600 respondents were: 71% male, 29% female; 34% academic, 26% community, and 33% resident physicians; and 7% nurse practitioners and physician assistants. Many respondents (88%) were inclined to offer EC to those sexually assaulted by unknown assailants. More practitioners said they were willing to offer EC if the assailant was known to be HIV-infected rather than if the assailant had low HIV risk factors (90% vs. 79%, p < 0.01). More respondents would prescribe EC after sexual assault than consensual sex (88% vs. 73%, p < 0.01). The rates of willingness to offer EC were the same for practitioners in states with "abortion-related conscience clauses" and those from other states.


CONCLUSIONS
Most ED practitioners said they were willing to offer EC. Although the risk of pregnancy exists after consensual sex, practitioners were less willing to prescribe EC after those exposures than for sexual assault. "Abortion-related conscience clauses" did not seem to influence willingness to offer EC.
Keshavarz
Reza
R
Department of Emergency Medicine, the Mount Sinai School of Medicine, New York, NY 10029, USA. reza.keshavarz@mssm.edu
Merchant
Roland C
RC
McGreal
John
J
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003281:Contraceptives, Postcoital / Q000008:administration & dosage* / Q000600:supply & distribution; D003625:Data Collection; D004630:Emergencies; D004635:Emergency Medicine / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006306:Health Surveys; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D012742:Sex Offenses / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D003281:Contraceptives, Postcoital