Emergency contraception: are pediatric residents counseling and prescribing to teens?
OBJECTIVE
(1) To assess pediatric residents' attitudes and practices related to counseling about and prescribing emergency contraceptive pills (ECPs) for teens. (2) To determine whether attitudes, counseling, and prescribing practices vary among different levels of residency training.


METHODS
Questionnaire.


METHODS
Two large inner-city academic medical centers in New York City.


METHODS
Pediatric residents (PGY 1-3).


METHODS
Attitudes, counseling and prescribing patterns of ECPs by the pediatric residents


RESULTS
101/120 residents participated in the survey; 35% PGY1, 38% PGY2, 28% PGY3. Less than a third (26%) reported counseling teens about the availability of ECPs during routine non-acute care visits and just over half (56%) provided ECP counseling during visits for contraception. Only 6% of pediatric residents reported that they prescribed ECPs often, while 42% never prescribed ECPs. The majority of the residents did not think that prescribing ECPs would encourage teens to practice unsafe sex or would discourage compliance with other contraceptive methods (70% and 68%, respectively). However, the majority (67%) also reported that they did not think that ECPs should be available over the counter, without prescription. Further analysis by year of training showed that more junior and senior residents than interns counseled adolescents about ECPs at both routine health care maintenance visits and at visits for contraception (32% vs 15%; 62% vs 42%, respectively), would provide adolescent girls with ECPs to have on hand prior to an episode of unprotected sex (52% vs 31%), and thought that ECPs should be available over the counter (39% vs 20%), P < 0.05.


CONCLUSIONS
Pediatric residents are missing opportunities to prevent unintended teenage pregnancy but they become more likely to counsel about and prescribe ECPs as they progress through residency training.
Division of Ambulatory Pediatrics, Albert Einstein College of Medicine/Children's Hospital At Montefiore, Bronx, New York, USA. Slim@Montefiore.org
Sylvia W
SW
Lim
Kelechi N
KN
Iheagwara
Lori
L
Legano
Susan M
SM
Coupey
D000293:Adolescent; D001291:Attitude of Health Personnel; D044363:Contraception, Postcoital / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009519:New York City; D010372:Pediatrics / Q000193:education*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011253:Pregnancy in Adolescence