Introduction:

Emergency contraception is a contraceptive method to be used after unprotected intercourse. Despite its high efficacy, availability both at primary health care and private pharmacies in Brazil, it is still underutilized.

Objective:

To identify the reasons and analyze the determinants of emergency contraception non-use when indicated.

Method:

Cross-sectional, quantitative study conducted with a probabilistic sample of pregnant women from 12 Primary Health Facilities at the Health Supervision of Butantã, São Paulo, Brazil (n=515), from March to June 2013. We considered an emergency contraception non-use when indicated women who were either in an unplanned or ambivalent pregnancy according to the London Measure of Unplanned Pregnancy (n=366). In Stata 12.0, we used multinomial logistic regression to analyze the data.

Women who used the method to prevent the current pregnancy were the reference and were compared to two groups of women:

those who did not use emergency contraception, but used another method; and those who used no method at all.

Results:

Although there was a high proportion of emergency contraception awareness (96.7%), only 9.8 % used it to prevent the current pregnancy. The main reason for non-use was believing that she would not become pregnant (47.6%); but wanting to become pregnant in the future and not remembering to use the method were also largely reported. Associated aspects to emergency contraception non-use among women who used a method werenot being aware of pregnancy risk [OR=3,44; IC95%: 1,48-8,03] and cohabitation with a partner [OR=3,23; IC95%: 1,43-7,28]. Among women that did not use any contraception, cohabitation with a partner [OR= 3,19; IC95%: 1,40-7,27], ambivalent pregnancy [OR: 3,40; IC95%: 1,56-8,54] and no previous use of emergency contraception [OR=3,52; IC95%: 1,38-8,97] were associated with the method non-use.

Conclusions:

Living with a partner can make a woman feel less concerned about preventing a pregnancy, which means, less likely to use emergency contraception. Eventually, having skills to recognize pregnancy risk situations, having experience on how to use and when to obtain the pill and a clear pregnancy intention can increase the use of emergency contraception when indicated.