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Provision of emergency contraception in general practice and confidentiality for the under 16's: Results of a postal survey by general practitioners in Avon
  1. Anna Graham, MSc, MRCGP, DFFP, Clinical Research Fellow1,
  2. Laurence Moore, MSc, PhD, Senior Research Fellow2 and
  3. Deborah Sharp, PhD, FRCGP, Professor of Primary Health Care3
  1. Division of Primary Health Care, University of Bristol, Bristol, UK
  2. Cardiff University School of Social Sciences, Cardiff, UK
  3. Division of Primary Health Care, University of Bristol, Bristol, UK
  1. Correspondence Dr A Graham, Clinical Research Fellow, Division of Primary Health Care, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR. Tel: 0117 928 7205. Email: a.graham{at}bristol.ac.uk

Abstract

Objective To describe the provision of emergency contraception and confidentiality for the under 16's by general practitioners (GPs) in Avon, in order to inform the development of a health promotion intervention in schools in Avon.

Design Confidential postal questionnaire survey.

Setting All principals in general practice in Avon Health Authority, South West England.

Subjects Five hundred and eighty general practice principals were sent the questionnaire.

Results Four hundred and eighty-six (84%) principals in general practice responded to the questionnaire. Only three (0.6%) GPs did not provide hormonal emergency contraception. Nearly half (232, 47.7%) would fit the intrauterine device (IUD) as emergency contraception. Fitting an IUD was associated with female gender of the GP (OR = 2.34, 95% CI 1.53-3.71), and whether the GP had a family planning qualification (OR = 4.55, 95% CI 2.41-8.60). Three hundred and fifty-two (72%) respondents would provide emergency contraception on a Sunday if requested to do so by a 14-year-old who reported having had unprotected sex the night before.

Practice nurses in 26 (5%) of the respondent's practices were available to provide advice and tablets for patients requesting hormonal emergency contraception. However, 74 (21%) respondents employed a family planning trained practice nurse who was not involved in any way in the provision of emergency contraception. Practice nurses remain an under used resource in this area.

Conclusion Our findings suggest that most GPs provide hormonal emergency contraception. Only eight (1.6%) of respondents would need to ask for parental consent prior to providing hormonal emergency contraception to a 14-year old-girl. Young people need to be informed of GPs widespread adherence to current confidentiality guidelines.

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