Hum. Reprod. Advance Access originally published online on April 9, 2009
Human Reproduction 2009 24(7):1612-1618; doi:10.1093/humrep/dep064
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Emergency contraceptive use among 5677 women seeking abortion in Shanghai, China
1 International Peace Maternity and Child Health Hospital/School of Medicine, Shanghai Jiao Tong University, 200030 Shanghai, People’s Republic of China 2 Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, 17176 Stockholm, Sweden 3 Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, 17177 Stockholm, Sweden 4 Shanghai Institute of Family Planning Technical Instruction, 200030 Shanghai, People’s Republic of China
5 Correspondence address: Centre for Clinical Research and Training, Shanghai Institute of Planned Parenthood Research, 2140 Xie Tu Road, 200032 Shanghai, People’s Republic of China. Tel: +86-21-64438803; Fax: +86-21-64046128; E-mail: linanc2{at}yahoo.com
BACKGROUND: The increasing use of emergency contraceptive pills (ECPs) does not seem to reduce the number of induced abortions as would be expected, indicating that women use ECPs might also be a strong factor affecting their final efficacy. The study aimed to understand the attitude towards, and use of, ECPs among women seeking an abortion.
METHODS: A cohort study was conducted via face-to-face questionnaire interview among women seeking abortion in Shanghai, China. Logistic regression analysis and 
2 test were performed for statistical analysis.
RESULTS: The response rate was 99.3%. Among all 5677 respondents aged 15–48 years, 48.8% were ECP ever-users. Compared with ever-users, ECP never-users were less likely to have used contraception during the present cycle of conception (P < 0.001). In response to the question on the main reason for non-use of contraception, ECP never-users were less likely to realize the risk of pregnancy and had less contraceptive knowledge (P < 0.001). Among 2773 ECP ever-users, 72.7% did not use ECPs to prevent the current pregnancy, mainly due to lack of awareness of pregnancy risk. Out of 757 women, 437 (57.7%) repeated unprotected sex after taking ECPs during the current pregnant cycle. A pharmacy was the preferred source to access ECPs, for the reason of convenience.
CONCLUSIONS: Non-use of ECPs was correlated to less knowledge on fertility and a lower rate of contraceptive use among abortion-seeking women. Women of reproductive age should have access to ECPs and receive sufficient information on their use. Health care providers and pharmacists should also be trained in contraceptive counselling, including ECPs.
Key words: contraception/emergency contraceptive pills/fertility awareness/induced abortion
These authors contributed equally. Submitted on November 18, 2008; resubmitted on February 11, 2009; accepted on February 13, 2009.