Contraceptive discontinuation and its relation to emergency contraception use among undergraduate women in Brazil

Objective: This paper examines the factors related to emergency contraception (EC) use in the context of contraceptive discontinuation among undergraduate women in Brazil. Study design: This a retrospective cohort study conducted among a probability sample of 1679 undergraduate women in Sao Paulo, Brazil. Data were collected online using a contraceptive calendar. We examined factors related to EC use following contraceptive discontinuation for method-related reasons and contraceptive abandonment. We also analyzed factors related to EC use following inconsistent use of contraception. Analyses were conducted using Pearson's Chi-square tests and logistic regression. Results: More than half (54.6%) of young women reported lifetime EC use and 16.5% had used EC in the 12-months prior to the survey. Last use of EC was mostly related to inconsistent or incorrect use of regular contraception (90.6%). Three quarters of women (76.2%) who discontinued contraception and were at risk of becoming pregnant did not use EC following discontinuation, and only 10.5% used EC after stopping contraception altogether. Women who were younger, who self-identified as Evangelicals, who reported more than four lifetime sexual partners, and who had no pregnancy history had higher odds of using EC following discontinuation for method-related reasons. Conclusion: We conclude that most undergraduate students in São Paulo Brazil do not use EC when needed, such as contraceptive discontinuation, potentially reflecting a lack of pregnancy risk recognition.