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

This paper examines the factors related to emergency contraception (EC) use in the context of contraceptive discontinuation among undergraduate women in Brazil. 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. 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. 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.