Emergency Contraception: Knowledge, Attitudes and Practices Among Brazilian Obstetrician-Gynecologists

traception as part of their routine services.4 In Brazil, where 26% of births in the early 1990s were unplanned and 22% were unwanted,5 emergency contraception could play an important role by averting pregnancies attributable to contraceptive failure, nonuse of contraceptives, lack of knowledge about or access to methods, or coercive sex. It also could reduce levels of unsafe abortion. In 1991, an estimated 1.4 million women in Brazil had an abortion, and many of these procedures were unsafe.6 Recognizing the potential contribution of emergency contraceptive methods, in March 1996, Brazil’s Ministry of Health convened a national meeting, in collaboration with the Population Council, to discuss this issue. The main conclusions were that emergency contraception should be included in the ministry’s official family planning program guidelines; that educational and dissemination activities should be developed for the general public and health providers; and that additional research was needed about emergency contraception in the context of Brazil.7 In March 1997, the Yuzpe regimen of emergency contraception was included in the family planning program guidelines.8 Although a levonorgestrel-only dedicated emergency contraceptive became available in Brazil in July 1999, at the time of the survey, women had to make up the Loren Galvão is program associate, and Juan Díaz is senior program associate, Population Council, Campinas, Brazil; Margarita Díaz is director of the Department of Education and Communication in Sexual and Reproductive Health, and Maria José Osis is director of sociomedical research, Center for Research and Control of Maternal and Child Diseases, Campinas, Brazil; Shelley Clark is staff program associate, Population Council, New York; and Charlotte Ellertson is director of reproductive health for Latin America and the Caribbean, Population Council, Mexico City. This study was conducted with the support of the U.S. Agency for International Development, the William and Flora Hewlett Foundation and the Robert H. Ebert Program. The authors thank the Brazilian Federation of Societies of Gynecology and Obstetrics for its logistical support in the study implementation; Schering/Brazil for providing the prize that was used as an incentive to participate in the survey; Beverly Winikoff and Martha Brady for technical support during the planning stages of the study; and the survey participants. Emergency Contraception: Knowledge, Attitudes and Practices Among Brazilian Obstetrician-Gynecologists