Knowledge and use of emergency contraception among women in the Western Cape province of South Africa: a cross-sectional study

We conducted a cross-sectional, interviewer-administered survey among 831 sexually active women at 26 randomly selected public sector clinics in the Western Cape province.Overall, 30% of the women had ever heard of EC when asked directly, after the method was described to them. Only 15% mentioned EC by name or description spontaneously. Knowledge of EC was independently associated with higher education, being married, and living in an urban setting. Four percent of women had ever used EC.These data suggest that knowledge of EC in this setting is more common among women of higher socioeconomic status living in urban areas. For EC to play a role in decreasing unintended pregnancy in South Africa, specific interventions are necessary to increase knowledge of the method, where to get it, and the appropriate time interval for its use before the need for EC arises. Future health promotion campaigns should target rural and low socioeconomic status communities.Expanding the number of family planning options available to women is a critical part of increasing contraceptive coverage, decreasing unintended pregnancies and reducing maternal morbidity and mortality around the globe [1,2]. Hormonal emergency contraception (EC) is an important contraceptive option in both developed and developing country settings. EC is the only form of hormonal contraception that can reduce the risk of pregnancy after unprotected intercourse or when a planned contraceptive method fails; increasing the availability and promotion of EC has the potential to reduce the incidence of unintended pregnancies if used when the need arises and in turn reduce associated social and healthcare costs [3,4]. Data from several settings have shown that increasing hormonal EC knowledge and access does not increase levels of unprotected intercourse [5].Although several contraceptive methods, including EC, are available and free to users at all public sector health facilities across the country, high rates of teenage