Emergency contraception: A national, multi-specialty assessment of clinician knowledge and practices

Emergency contraception (EC) provides a last chance to prevent pregnancy after unprotected intercourse. Levonorgestrel EC is now sold over-the-counter, but the most effective methods, the copper intrauterine device and ulipristal acetate, can only be obtained through a healthcare provider. This study assessed knowledge and practice patterns related to all available EC methods among 1,684 healthcare providers (including physicians and advanced practice clinicians), all of whom provide care to women of reproductive age. Nearly all (95%) of providers in this sample had heard of levonorgestrel EC, while only half (49%) were familiar with use of the copper IUD as EC and 29% had heard of the newest EC method, ulipristal acetate. Among all providers, 63% provide or recommend levonorgestrel EC in typical practice, while only 15% provide the copper IUD as EC and 7% provide ulipristal acetate. Data were also analyzed in separate multivariate models for providers who focus on reproductive healthcare and those who do not. Among reproductive health specialists, advanced practice clinicians had lower odds than physicians of being familiar with all methods except levonorgestrel; among non-reproductive health specialists, advanced practice clinicians had lower odds than physicians of having heard of levonorgestrel and the Yuzpe method, as well as lower odds of providing or recommending these methods. For both reproductive health specialists and non-reproductive health specialists, having a practice that is all or most comprised of women of reproductive age was associated with greater awareness and provision of many EC methods.