Contraception Awareness Week – Revealing how little patients really know

It is widely assumed that with today's easy access to information, people are well informed of issues surrounding fertility and reproduction. But a poll by the UK Family Planning Association (FPA) has revealed that most are still very naïve.

Coinciding with the UK FPA’s Contraception Awareness Week, held from 12–16 February 2007, MedWire Reporter Cher Thornhill asks the FPA’s Director of Information Toni Belfield why this is and what healthcare professionals should be doing to better inform people.

Your poll results showed that 30% of respondents thought activities such as exercise, douching, and urinating after sex could stop them from getting pregnant. Where do you think these myths originated?

Myths originate around how we get pregnant because we don’t have good information and education about how our bodies work. The fact that adults think jumping up and down after having sex will stop them getting pregnant is extremely worrying.

The poll also revealed a lack of understanding about some basic sexual health facts:

• Half of the respondents did not know when women are most fertile.

• Almost 90% did not know sperm can survive inside a woman’s body for up to a week.

• Almost a quarter thought pre-ejaculate contains no sperm.

Why do you think sexual health awareness is so poor?

I think it goes back to the fact we don’t talk about sex openly. As we grow up, parents are very inhibited about talking about how men's and women’s bodies change and become adult and sexual. We don’t talk about it in schools, and we’re very hypocritical in society about how we address sexual issues.

What questions do women contacting the FPA helpline usually ask?

The main questions that people ask are: 'How can I access good information about the contraception I want to use and the choices that I have?’ 'What can I do when I haven’t used contraception?' and 'How can I protect myself and have safe sex and unravel the confusions about how my body works?'

How do you think current sexual awareness compares with that in the past?

We clearly have more information about today than we did in the past but what we have now is confusion. In the past, people didn’t talk about it at all so you were just ignorant and you weren’t informed. Now everybody talks about it, it’s in your face every day, but people can’t sort out fact from fiction.

What can health professionals do?

Medical professionals, be they doctors or nurses, need to address some of these issues about how our bodies work when they talk about contraception. To understand how your contraception method works, ie how the pill works, where your IUD fits, why a diaphragm doesn’t fall out, and why condoms should be used to stop sperm reaching the vagina all need to be explained in the context of how men’s and women’s bodies work for us to understand it in a more effective way. If you understand about your fertility, you’re more likely to use your contraception method with much more confidence. Knowing to take your pill every day is vital for it to work.

Are there any other times when healthcare professionals should raise these issues?

There are lots of opportunities for health professionals to raise a conversation about, ‘Do you understand how this works?’ or ‘Would you like to know a bit more about your fertility?’ I think every time a woman goes for any kind of women’s health check. For example, when a woman has a cervical screen; all women have cervical screening. All women should be talked to about breast awareness. When women become pregnant, is again a good time to reinforce what’s going on in a woman’s body.

Can you point toward any specific information materials?

The FPA provides 30 leaflets on issues to do with sexual health. These include leaflets on every method of contraception, leaflets on the main sexually transmitted infections, and leaflets on how the body works, which is a guide to understanding reproduction. The leaflets are available via the website (www.fpa.org.uk).

Do you think the misconceptions that you encounter are similar across the world?

Absolutely identical. I think it’s very well known that if we look at what’s going on around the world, people don’t know how their bodies work. They don’t know about periods, they don’t always take their pills very well. It’s really universal. The fact that people don’t know that your sperm can live for up to seven days, I would say, is absolutely universal, and we know that because people take risks.

Is the situation worse in developing countries?

Not necessarily. Sometimes there can be cultures where there is really good information passed between a mother and her daughter. Sometimes it depends on family relationships. You could argue in developed countries that we have very fragmented family lives. In some areas where countries are developing, they have very close family units.

What do women want to know about the morning-after pill?

We tend to call it emergency contraception now, because if you talk about the hormonal method of the morning after pill, women often think that if it’s the afternoon after, it’s too late. The hormonal emergency contraception is one pill and can be used up to three days after sex. Many women still feel they’re not sure about it, don’t know when to use it, can they access it, and more importantly can they have it in their bathroom cabinet for when they need it.

In addition to the morning after pill, what other issues should healthcare professionals take extra care to communicate?

There’s also another method, which is the use of a copper IUD, which you can use for up to five days after unprotected sex, or within five days of expected ovulation. So for a woman who feels she’s left it too late for whatever reason, there is a second choice. As long as it’s a copper IUD and not a hormonal one, that’s fine.

Are doctors across the board aware that an IUD can be used after sex?

In this country, yes. I think what happens is it doesn’t get through to women so women don’t always know, and certainly the research continues to show that most women know about the pill method but fewer people know about the IUD.

The results of the FPA’s survey and information on Contraception Awareness Week – Reproduction: a quick guide to your body – can be found on their website at www.fpa.org.uk.