The Emergency Contraceptive Pill: Knowledge, Attitudes and Practices of Women in Barbados

Objective: The emergency contraceptive pill (ECP) is a prescription only drug in Barbados. Knowledge, attitudes and practices with regards to ECPs are uncertain. Methods: Women aged 18-44 years attending three public sector polyclinics completed a questionnaire. Quota sampling was done in proportion to clinic size and age distribution of the Barbados population. Results: Of 378 respondents (response rate 91%, median age 31 years), 86% were previously pregnant, 17, 22, 47 and 15% had 0, 1, 2-3 and >= 4 children respectively, 52% had used contraception at last intercourse, 26% would be happy if they became pregnant, 29% reported a termination of pregnancy, 43% were aware that ECPs existed and could be used to prevent pregnancy after intercourse and 14% had used ECPs. Of the 162 women who knew ECPs existed, 32% thought it needed to be used within one day. Women 36 to 44 years of age were less likely to have used ECPs than younger women (p = 0.03). Most users (66%) obtained the pill directly from a pharmacy without a prescription. After receiving information that the ECP exists, 243 women (64%) would or might use it if necessary, with 42% preferring to obtain it without a prescription from a pharmacy. Those concerned that ECPs caused abortions were less willing to use it compared to those who were not (30% vs 74%, p <= 0.001). Conclusions: Awareness and use of ECPs are low. Education on the mode of action and time limit for use and non-prescription access are needed.