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Thursday, January 14, 1999 Published at 08:16 GMT


Casualties 'waste time' over contraception

Casualty may not be the best place to go for contraceptive needs

Hospital Accident and Emergency departments in the UK are reluctant to prescribe emergency contraceptives, also known as the morning-after pill, despite high demand for the service, according to a study.

Health correspondent Richard Hannaford: "Casualty units regularly asked for emergency contraception"
Contraception advisors warned that although A&E departments are not the ideal place to get such treatment, the reluctance could lead to unwanted pregnancies.

The study raises the question of whether unprotected sex is "an accident requiring emergency treatment".

Many participants in the study thought not, because emergency contraception can be administered up to 72 hours after intercourse has taken place.

However, contraceptive advice clinics and GP surgeries may not always be accessible within this timescale, especially over holiday periods.

Emergency provision

The study, which appears in the Journal of Accident and Emergency Medicine, was conducted by Dr Babatunde Gbolade and colleagues at Manchester University.

It surveyed 355 hospitals with A&E departments to assess what staff thought about the provision of emergency contraception.

  • At 96% of the hospitals, patients had requested the treatment, but only 57% of the 355 provided it.
  • While 56% of the respondents said that A&E departments should provide the treatment, 42% said they were aware of groups within the hospital that were opposed to such provision.
  • Despite the overall reluctance to identify emergency contraception as an A&E service, 62% were against it being available without prescription.
  • Of those who provided the service, 83% said it was worthwhile. Reasons given for this included lack of access to family planning services at weekends and on bank holidays and the availability of the treatment for people, such as teenagers, who would be reluctant to see their own GP.
  • The other 17% said it was not worthwhile because it was a misuse of resources, GPs were better in this role and drugs can be given up to 72 hours after intercourse has taken place.

The authors concluded that there was demand for the service but not enough provision.

They said: "Given the current interest in approaches to reducing unplanned pregnancies, especially in teenagers, the findings of this study argue strongly for an integrated and pragmatic approach."

They said this "would probably engender increased interest in providing the service in A&E departments".

Dr Roger Evans, President of the British Association of Accident and Emergency Medicine, said: "Our members do think it is a waste of their time and resources. There is no need for women to be coming to A&E departments for emergency contraception.

"If family planning clinics are not open they can go to their GPs - that is what they are there for.

He said there was no reason why women who ask for emergency contraception at A&E departments "should not be turned away and told to go to their GP."

However, family planning advisors said women sometimes had no alternative.

Earlier the better

Margaret Jones, Chief Executive of Brooks Advisory Centres, which provides free advice on contraceptive methods service, said: "If there is a long holiday and family planning clinics are closed we have sent people to an A&E department.

"All the signs show that the morning after pill works better the earlier you use it."

"We agree that A&E departments should not have to provide this service, but often they are the only places available.

"Some women, especially younger girls, have had to wait over a weekend before going to their GP on Monday and are then told they won't be able to get an appointment until Thursday.

"They are too worried or shy to insist and the last resort is an accident and emergency department.

"If they can't get help there they are stuck and that can only lead to a rise in unwanted pregnancies."

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