title: Emergency contraception: why can't you give it away? Qualitative findings from an evaluation of advance provision of emergency contraception.
abstract: The Lothian Emergency Contraception Project (LECP)--a primary care-based intervention to offer advance supplies of emergency contraception (EC) to women aged 16-29 was not associated with a reduction in abortion rates. We undertook case studies, utilizing qualitative and quantitative methods, to evaluate the intervention. In this article we present findings from qualitative interviews with 44 primary care professionals working at case study sites and 22 women who had received advance supplies to explain this failure. Professionals reported that women rarely asked for advance supplies of EC and they were reluctant to offer supplies to women because of concerns about contradictory sexual health messages implied by the offer, a perceived association of EC use with chaotic behavior by women, views about the sort of women suitable for advance supplies and practical difficulties making the offer. Women were reluctant to ask for advance supplies because of misgivings about the appropriateness of offering advance supplies to everybody and concerns about being judged by health professionals as morally inadequate. If advance provision of EC is to be successful in reducing abortion rates, professionals must address their concerns about EC and develop imaginative ways of encouraging women most at risk of unwanted pregnancy to take supplies home.
authors.affiliation: Division of Community Health, Sciences (General Practice), University of Edinburgh, 20 West Richmons Street, EH8 9DX, United Kingdom. Karen.Fairhurst@ed.ac.uk
authors.forename: Karen
authors.initials: K
authors.lastname: Fairhurst
authors.forename: Sue
authors.initials: S
authors.lastname: Ziebland
authors.forename: Sally
authors.initials: S
authors.lastname: Wyke
authors.forename: Peter
authors.initials: P
authors.lastname: Seaman
authors.forename: Anna
authors.initials: A
authors.lastname: Glasier
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D003281:Contraceptives, Postcoital / Q000600:supply & distribution; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D011247:Pregnancy; D015397:Program Evaluation; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D003281:Contraceptives, Postcoital