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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 93-98    DOI: 10.31083/j.ceog.2020.01.5280
Original Research Previous articles | Next articles
Knowledge and availability of the emergency contraceptive pills: an Italian women survey
U. Indraccolo1, *(), A. C. Castigliego2, R. Di Iorio3, A. Favilli4, P. Greco1, P. Fedeli5, S. R. Indraccolo2
1Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, University of Ferrara, Ferrara
2Department of Gynecological and Urological Sciences, “Sapienza” University of Rome, Rome
3Department of Medical and Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Rome
4Complex Operative Unit of Obstetrics and Gynecology, “Alto Tevere” Hospital of Città di Castello, ASL 1 Umbria
5School of Law, Legal medicine. University of Camerino, Italy
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Abstract  

Aim: Assessing to what extent do Italian women actually know about the emergency contraceptive pills and about their availability. Materials and Methods: A 12-questions questionnaire was organized to investigate the knowledge about the emergency contraceptive pills in a sample of Italian women. The sample was built by sending the questionnaire on time, by using the Computer Assisted Web Interviewing (CAWI). Both open and closed answers were collected. Results: 1, 580 eligible women fully answered the questionnaire. It appears that women still face some difficulties to obtain emergency contraceptive pills and have poor knowledge about how the post-coital pills work, and how they can obtain them in Italy. The difficulties to obtain emergency contraceptive pills seems to be in relation to the pharmacologists’ resistance to provide them. Women’s perception of the pharmacologists’ resistance to provide pills is unspecific. Conclusion: The pharmacologists’ resistance to provide pills should be best investigated, as ethical goals and liability issues could be both involved.

Key words:  Emergency contraceptive pills      Liability      Computer Assisted Web Interviewing (CAWI)     
Published:  15 February 2020     
*Corresponding Author(s):  U. Indraccolo     E-mail:  ugo.indraccolo@libero.it

Cite this article: 

U. Indraccolo, A. C. Castigliego, R. Di Iorio, A. Favilli, P. Greco, P. Fedeli, S. R. Indraccolo. Knowledge and availability of the emergency contraceptive pills: an Italian women survey. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 93-98.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.01.5280     OR     https://ceog.imrpress.com/EN/Y2020/V47/I1/93

Table 1  — List of questions and rates of answers.
Question 1. Do you think is right that the women plan the pregnancy?
-Yes
-No

1541 (97.5%)
39 (2.5%)
Question 2. Are you in favour to the oral contraceptive use?
-Yes
-No

1497 (94.7%)
83 (5.3%)
If no, why?
-Religious believing
-Harmful for the health
-I do not know
-Others

14 (16.9%)
55 (66.3%)
7 (8.4%)
7 (8.4%)
Question 3. Do you know the “post coital” pill?
-Yes
-No

1573 (99.6%)
7 (0.4%)
Question 4. Which “post coital” pill do you know?
-Levonorgestrel pill (trade name)
-Ulipristal acetate (trade name)
-Both levonorgestrel and ulipristal acetate pill
-I do not know
-Others

372 (23.5%)
224 (14.2%)
33 (2.1%)
947 (59.9%)
4 (0.3%)
Detail of answers for “others”:
-Estroprogestinic pills
-RU486

3 (75.0%)
1 (25.0%)
Question 5. How many time did you take the “post coital” pill?
-Never
-1
-2
-3 or more

1000 (63.3%)
366 (23.2%)
144 (9.1%)
70 (4.4%)
Question 6. Do you think that the “post coital” pill is:
-Useful
-Useless
-Others

1146 (72.5%)
287 (18.2%)
147 (9.3%)
Detail of answers for “others”:
-Useful but harmful
-I do not know
-To be used cautiously
-Unnecessary
-To be banned
-It causes abortions

55 (37.4%)
18 (12.2%)
56 (38.1%)
9 (6.1%)
8 (5.4%)
1 (0.7%)
Question 7. In your opinion, is the “post coital” pill easily available?
-Very easily
-Quite easily
-Hardly
-Very hardly
-I do not know

197 (12.5%)
629 (39.8%)
421 (26.6%)
122 (7.7%)
211 (13.4%)
If you answered hardly or very hardly, why?*
-Pharmacologists resistance
-It's hard to obtain the prescription within 24 hours
-Pharmacologists want the prescription
-A pregnancy test is needed
-I do not know
-Conscience objection of the physicians or pharmacologists
-Others

192 (25.5%)

224 (29.7%)
185 (24.6%)
8 (1.1%)
111 (14.7%)

25 (3.3%)
8 (1.1%)
Question 8. In your opinion, how does the “post coital” pill work?
-Causing abortion
-Interfering with ovulation
-Others

545 (34.5%)
638 (40.4%)
397 (25.1%)
Detail for “others”
-I do not know
-blocking the onset of the pregnancy
-causing menstruation
-killing or blocking the spermatozoa
-blocking the pregnancy implant

315 (79.4%)
30 (7.6%)
7 (1.8%)
3 (0.08%)
42 (10.6%)
Question 9. Do you know that, if the pregnancy is implanted on the uterine wall, the “post coital” pill could not work?
-Yes
-No


974 (61.6%)
606 (38.4%)

Question 10. The last available “post coital” pill name is “trade name” (ulipristal acetate). It is also called 5-days pill. From your knowledge, do you know if the medical doctor prescription is needed to buy it?
-Yes
-No
-I do not know



277 (17.5%)
568 (35.9%)
735 (46.5%)
Question 11. In your opinion, do women face resistance by pharmacologists for obtaining the “5-days pill”, despite the medical doctor prescription is not needed?
-A lot of resistance
-Quite resistance
-Little resistance
-No resistance
-I do not know


110 (7.0%)
513 (32.5%)
233 (14.7%)
102 (6.5%)
622 (39.4%)
Question 12. In your opinion, why the pharmacologists make resistance to provide the 5-days pill?
-They are against abortion/conscience objection
-It is harmful
-They want prescription
-Religious believing
-I do not know
-Others


572 (36.2%)
404 (25.6%)
176 (11.1%)
23 (1.5%)
383 (24.2%)
22 (1.4%)
Detail for “others”
-They would that a physician ascertain the health wellness
-Defensive policy
-They do not want to exceed in the assumption
-Because the prescription is mandatory
-To empower in using the drug
-Because it is expensive


2 (9.1%)
2 (9.1%)
11 (50.0%)
2 (9.1%)
4 (18.2%)
1 (4.5%)
Table 2  — Descriptive and inferential statistics. Sub-groups analyses for each question.
Age Place of Italy Education Parity Previous pregnancy interruption
18-24

771 48.8%
25-30

489 30.9%
31-35

168 10.6%
35-40

152 9.6%
North

463 29.3%
Middle

618 39.1%
South

483 30.6%
Foreigner

16 1.0%
Middle school
88 5.6%
Secondary school
770 48.7%
University degree
722 46.0%
Nulliparity

1272 80.5%
Multiparity

308 19.5%
Yes

98 6.2%
No

1482 93.8%
Question 1
Yes
No

756 98.1%
15 1.9%

475 97.1%
14 2.9%

162 96.4%
6 3.6%

148 97.4%
4 2.6%

454 98.1%
9 1.9%

603 97.6%
15 2.4%

469 97.1%
14 2.9%

15 93.8%
1 6.3%

78 88.6%
10 11.4%

754 97.9%
16 2.1%

709 98.2%
13 1.8%

1250 98.3%
22 1.7%

291 94.5%
17 5.5%

92 93.9%
6 6.1%

1449 97.8%
33 2.2%
P=0.267 P=0.825 P<0.001 P<0.001 P=0.038
Question 2
Favored
Unfavored

735 95.3%
36 4.7%

458 93.7%
31 6.8%

163 97.0%
5 3.0%

141 92.8%
11 7.2%

450 95.5%
13 2.8%

586 94.8 %
32 5.2%

446 92.3%
37 7.7%

15 93.8%
1 6.3%

81 92.0%
7 8.0%

731 94.9%
39 5.1%

685 94.9%
37 5.1%

1208 95%
64 5.0%

289 93.8%
19 6.2%

92 93.9%
6 6.1%

1405 94.8%
77 5.2%
P=0.267 P=0.013 P=0.504 P=0.509 P=0.869
Question 3
Yes
No

768 99.6%
3 0.4%

487 99.6%
2 0.4%

166 98.8%
2 1.2%

151 99.3%
1 0.7%

463 100%
0

614 99.4%
4 0.6%

480 99.4%
3 0.6%

16 100%
0

87 98.9%
1 1.1%

767 99.6%
3 0.4%

719 99.6%
3 0.4%

1269 99.8%
3 0.2%

304 98.7%
4 1.3%

98 100%
0

1475 99.5%
7 0.5%
P=0.803 P=0.518 P=0.600 P=0.041 P=0.918
Question 4
Levonorgestrel
Ulipristal
Both
I do not know
Other

153 19.8%
137 17.8%
18 2.3%
461 59.8%
2 0.3%

144 29.4%
64 13.1%
12 2.4%
268 54.8%
1 0.2%

44 26.2%
16 9.5%
3 1.9%
105 62.5%
0

31 20.4%
7 4.6%
0
113 74.3%
1 0.7%

96 20.7%
79 17.1%
12 2.6%
276 59.6%
0

134 21.7%
90 14.6%
8 1.3%
383 62.0%
3 0.5%

139 28.8%
51 10.6%
13 2.7%
279 57.8%
1 0.2%

3 18.8%
4 25.0%
0
9 56.3%
0

10 11.4%
15 17.0%
1 1.1%
61 69.3%
1 1.1%

169 21.9%
116 15.1%
15 1.9%
469 60.9%
1 0.1%

193 26.7%
93 12.9%
17 2.4%
417 57.8%
2 0.3%

313 24.6%
195 15.3%
30 2.4%
730 57.4%
4 0.3%

59 19.2%
29 9.4%
3 1.0%
217 70.5%
0

31 31.6%
12 12.2%
3 3.1%
51 52.0%
1 1.0%

341 23.0%
212 14.3%
30 2.0%
896 60.5%
3 0.2%
P<0.001 P<0.001 P<0.002 P<0.001 P=0.127
Question 5
Never
1
2
3 or more

524 68.0%
155 20.1%
63 8.2%
29 3.8%

267 54.6%
139 28.4%
51 10.4%
32 6.5%

96 57.1%
42 25.0%
23 13.7%
7 4.2%

113 74.3%
30 19.7%
7 4.6%
2 1.3%

288 62.2%
119 25.7%
36 7.8%
20 4.3%

395 63.9%
145 23.5%
56 9.1%
22 3.6%

309 64.0%
99 20.5%
48 9.9%
27 4.4%

8 50.0%
3 18.8%
4 25.0%
1 6.3%

60 68.2%
21 23.9%
6 6.8%
1 1.1%

516 67.0%
158 20.5%
62 8.1%
34 4.4%

424 58.7%
187 25.9%
76 10.5%
35 4.8%

792 62.3%
293 23.0%
124 9.7%
63 5.0%

208 67.5%
73 23.7%
20 6.5%
7 2.3%

40 40.8%
35 35.7%
14 14.3%
9 9.2%

960 64.8%
331 22.3%
130 8.8%
61 4.1%
P<0.001 P=0.010 P=0.006 P=0.059 P<0.001
Question 6
Useful
Useless
Other

559 72.5%
141 18.3%
71 9.2%

357 73.0%
82 16.8%
50 10.2%

126 75.0%
27 16.1%
15 8.9%

104 68.4%
37 24.3%
11 7.2%

363 78.4%
62 13.4%
38 8.2%

447 72.3%
101 16.3%
70 11.3%

324 67.1%
122 25.3%
37 7.7%

12 75.0%
2 12.5%
2 12.5%

59 67.0%
21 23.9%
8 9.1%

556 72.2%
140 18.2%
74 9.6%

531 73.5%
126 17.5%
65 9.0%

933 73.3%
221 17.4%
118 9.3%

213 69.2%
66 21.4%
29 9.4%

77 78.6%
19 19.4%
2 2.0%

1069 72.1%
268 18.1%
145 9.8%
P=0.213 P<0.001 P=0.661 P=0.240 P=0.038
Question 7
Very easy
Quite easy
Hard
Very hard
I do not know

110 14.3%
330 42.8%
195 25.3%
48 6.2%
88 11.4%

56 11.5%
204 41.7%
144 29.4%
41 8.4%
44 9.0%

18 10.7%
52 31.0%
53 31.5%
10 6.0%
35 20.8%

13 8.6%
43 28.3%
29 19.1%
23 15.1%
44 28.9%

66 14.3%
198 42.8%
115 24.8%
32 6.9%
52 11.2%

68 11.0%
236 38.2%
158 25.6%
57 9.2%
99 16.0%

58 12.0%
191 39.5%
142 29.4%
32 6.6%
60 12.4%

5 31.3%
4 25.0%
6 37.5%
1 6.3%
0

12 13.6%
33 37.5%
15 17.0%
4 4.5%
24 27.3%

104 13.5%
321 41.7%
183 23.8%
56 7.3%
106 13.8%

81 11.2%
275 38.1%
223 30.9%
62 8.6%
81 11.2%

159 12.5%
526 41.4%
352 27.7%
94 7.4%
141 11.1%

38 12.3%
103 33.4%
69 22.4%
28 9.1%
70 22.7%

11 11.2%
30 30.6%
32 32.7%
14 14.3%
11 11.2%

186 12.6%
599 40.4%
389 26.2%
108 7.3%
200 13.5%
P<0.001 P<0.001 P<0.001 P<0.001 P=0.041
Table 3  — Descriptive and inferential statistics. Sub-groups analyses for each question (following).
Age Place of Italy Education Parity Previous pregnancy interruption
18-24

771 48.8%
25-30

489 30.9%
31-35

168 10.6%
35-40

152 9.6%
North

463 29.3%
Middle

618 39.1%
South

483 30.6%
Foreigner

16 1.0%
Middle school
88 5.6%
Secondary school
770 48.7%
University degree
722 46.0%
Nulliparity

1272 80.5%
Multiparity

308 19.5%
Yes

98 6.2%
No

1482 93.8%
Question 8
Causing abortion
Interf. with ovulation
Other

251 32.6%
347 45.0%
173 22.4%

157 32.1%
214 43.8%
118 24.1%

62 36.9%
51 30.4%
55 32.7%

75 49.3%
26 17.1%
51 33.6%

127 27.4%
234 50.5%
102 22.0%

252 40.8%
213 34.5%
153 24.8%

162 33.5%
185 38.3%
136 28.2%

4 25.0%
6 37.5%
6 37.5%

30 34.1%
25 28.4%
33 37.5%

271 35.2%
323 41.9%
176 22.9%

244 33.8%
290 40.2%
188 26.0%

414 32.5%
567 44.6%
291 22.9%

131 42.5%
71 23.1%
106 34.4%

42 42.9%
37 37.8%
19 19.4%

503 33.9%
601 40.6%
378 25.5%
P<0.001 P<0.001 P=0.027 P<0.001 P=0.160
Question 9
Yes
No

502 65.1%
269 34.9%

326 66.7%
163 33.3%

78 46.4%
90 53.6%

68 44.7%
84 55.3%

311 67.2%
152 32.8%

344 55.7%
274 44.3%

305 63.1%
178 36.9%

14 87.5%
2 12.5%

45 51.1%
43 48.9%

473 61.4%
297 38.6%

456 63.2%
266 36.8%

844 66.4%
428 33.6%

130 42.2%
178 57.8%

62 63.3%
36 36.7%

912 61.5%
570 38.5%
P<0.001 P<0.001 P=0.090 P<0.001 0.816
Question 10
Yes
No
I do not know

113 14.7%
319 41.4%
339 44.0%

88 18.0%
172 35.2%
229 46.8%

38 22.6%
43 25.6%
87 51.8%

38 25.0%
34 22.4%
80 52.6%

60 13.0%
215 46.4%
188 40.6%

126 20.4%
194 31.4%
298 48.2%

86 17.8%
153 31.7%
244 50.5%

5 31.3%
6 37.5%
5 31.5%

24 27.3%
23 26.1%
41 46.6%

121 15.7%
274 35.6%
375 48.7%

132 18.3%
271 37.5%
319 44.2%

215 16.9%
499 39.2%
558 43.9%

62 20.1%
69 22.4%
177 57.5%

27 27.6%
37 37.8%
34 34.7%

250 16.9%
531 35.8%
701 47.3%
P<0.001 P<0.001 P=0.027 P<0.001 P=0.010
Question 11
A lot of resistance
Quite resistance
Little resistance
No resistance
I do not know

48 6.2%
282 36.6%
147 19.1%
51 6.6%
243 31.5%

31 6.3%
165 33.7%
55 11.2%
32 6.5%
206 42.1%

15 8.9%
39 23.2%
17 10.1%
13 7.7%
84 50.0%

16 10.5%
27 17.8%
14 9.2%
6 3.9%
89 58.6%

35 7.6%
183 39.5%
72 15.5%
29 6.3%
144 31.1%

42 6.8%
181 29.3%
90 14.6%
36 5.8%
269 43.5%

33 6.8%
142 29.4%
71 14.7%
34 7.0%
203 42.0%

0
7 43.8%
0
3 18.8%
6 37.5%

7 8.0%
21 23.9%
16 18.2%
9 10.2%
35 39.8%

43 5.6%
235 30.5%
132 17.1%
59 7.7%
301 39.1%

60 8.3%
257 35.6%
85 11.8%
34 4.7%
286 39.6%

87 6.8%
455 35.8%
200 15.7%
81 6.4%
449 35.3%

23 7.5%
58 18.8%
33 10.7%
21 6.8%
173 56.2%

14 14.3%
27 27.6%
16 16.3%
7 7.1%
34 34.7%

96 6.5%
486 32.8%
217 14.6%
95 6.4%
588 39.7%
P<0.001 P<0.001 P<0.001 P<0.001 P=0.047
Question 12
Against interruption
It is dangerous
Want prescription
Religious believing
I do not know
Others

307 39.8%
222 28.8%
65 8.4%
12 1.6%
156 20.2%
9 1.2%

181 37.0%
116 23.7%
69 14.1%
5 1.0%
111 22.7%
7 23.9%

47 28.0%
39 23.2%
13 7.7%
4 2.4%
61 36.3%
4 2.4%

37 24.3%
27 17.8%
29 19.1%
2 1.3%
55 36.2%
2 1.3%

200 43.2%
108 23.3%
42 9.1%
7 1.5%
90 19.4%
16 3.5%

206 33.3%
146 23.6%
76 12.3%
10 1.6%
177 28.6%
3 0.5%%

162 33.5%
145 30.0%
55 11.4%
6 1.2%
112 23.2%
3 0.6%

4 25.0%
5 31.3%
3 18.8%
0
4 25.0%
0

20 22.7%
19 21.6%
12 13.6%
1 1.1%
34 38.6%
2 2.3%

265 34.4%
215 27.9%
71 9.2%
10 1.3%
199 25.8%
10 1.3%

287 39.8%
170 23.5%
93 12.9%
12 1.7%
150 20.8%
10 1.4%

502 39.5%
341 26.8%
134 10.5%
18 1.4%
258 20.3%
19 1.5%

70 22.7%
63 20.5%
42 13.6%
5 1.6%
125 40.6%
3 1.0%

40 40.8%
22 22.4%
17 17.3%
0
18 18.4%
1 1.0%

532 35.9%
382 25.8%
159 10.7%
23 1.6%
365 24.6%%
21 1.4%
P<0.001 P<0.001 P<0.001 P<0.001 P=0.067
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