Women seeking urgent care may need 'Plan B': only 6% of study participants had used emergency contraception in the 6 months before the clinic visit.(Clinical Rounds)

LOS ANGELES -- In a well-educated, urban population, 12% of women seeking urgent care services could have benefited from using emergency contraception at that visit, Dr. Eleanor Bimla Schwarz reported at the annual meeting of the Society of General Internal Medicine.

These women reported that they had unprotected sex during the previous 5 days, but they did not wish to become pregnant, noted Dr. Schwarz, a faculty member at the University of Pittsburgh.

Women who do not have primary care providers may seek care for nongynecologic symptoms in urgent care facilities, and they may also lack contraceptive options. Emergency contraception (Plan B, levonorgestrel) usually is effective if used during the first 5 days after unprotected sex.

In a cross-sectional study that was part of an ongoing clinical trial, the investigators surveyed 446 women (35% of those eligible) aged 18-40 years at two urgent care clinics in San Francisco. Women were asked if they wished to avoid pregnancy and how often they had sex without contraception. Women who were unlikely to become pregnant in the next year were excluded. Information about issues discussed during clinic visits was obtained from medical records.

Of the 1,391 women approached in the waiting room, 583 (42%) agreed to participate, and the final sample included 446 women. This was a well-educated group (48% had college degrees, 34% had some college) of English-speaking women aged 15-45 years (mean age, 29 years) that was also ethnically diverse (44% white, 17% Asian, 14% Hispanic, 12% black, 13% other). Half of the participants (51%) had no usual source of health care. Of those who had health care access, 33% used an urgent care center or the emergency department as their primary source. Nearly half of the participants had been pregnant before; 29% had had an abortion.

Overall, 67% of participants were trying to avoid pregnancy on the day of their visit. On the day they completed the study's computer-based survey, women were most frequently diagnosed with an upper respiratory tract infection (40%), a musculoskeletal problem (20%), or a rash ...