Case Studies in Emergency Contraception From Six Countries. (ARTICLES).

In countries where emergency contraception is offered, its availability and use vary widely, according to such factors as regulations and policies regarding the method, providers' and women's understanding of and attitudes toward it, and cost. The experiences with the method in six countries--the United Kingdom, the Netherlands, Malaysia, China, Mexico and Nigeria--illustrate a range of issues involved in introducing and encouraging the acceptability of emergency contraception.

Emergency contraception first became available in most of these countries in the late 1960s and early 1970s. Today, in the United Kingdom and the Netherlands, the method is an accepted part of family planning practice and is well-known among doctors and women. This acceptance may be partly due to the method's inclusion in the health insurance systems of these countries.

Another factor explaining the established role of emergency contraception, at least in the Netherlands, is the lack of moral debate surrounding the method. Only its side effects and efficacy seem to engender controversy; the need for emergency contraception is acknowledged and accepted even for teenagers, for whom sexual activity is socially sanctioned.

By contrast, in Malaysia, as in other countries where abortion is strictly regulated, emergency contraceptive methods are marketed legally, but family planning organizations shy away from offering them.

In China, postcoital methods have long been offered by the government family planning service. However, these methods have not been separated into those advocated for emergency use only and those recommended for ongoing use.

Finally, in Mexico and Nigeria, awareness of emergency contraception continues to be low among both health care providers and the public.

Research, both on a way to create knowledge of emergency contraception and on a way to publicize the methods, has been largely concentrated in European countries; many developing countries, and even many developed ones, have yet to conduct any research on this topic. For example, Mexico's first clinical trial of an emergency contraceptive method (a combination of levonorgestrel and ethinyl estradiol, administered orally or vaginally) is under way, fully 30 years after the original research on the method was conducted.