Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review

Abstract Background Exposure to domestic violence and abuse (DVA) results in a reduction of women’s use of regular contraceptives. This evidence suggests that women exposed to DVA are more likely to have unprotected sexual intercourse and therefore may use more emergency contraception (EC) than thos...

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Main Authors: Natalia V. Lewis, Theresa H. M. Moore, Gene S. Feder, John Macleod, Penny Whiting
Format: Article
Language:English
Published: BMC 2018-09-01
Series:BMC Women's Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12905-018-0652-7
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author Natalia V. Lewis
Theresa H. M. Moore
Gene S. Feder
John Macleod
Penny Whiting
author_facet Natalia V. Lewis
Theresa H. M. Moore
Gene S. Feder
John Macleod
Penny Whiting
author_sort Natalia V. Lewis
collection DOAJ
description Abstract Background Exposure to domestic violence and abuse (DVA) results in a reduction of women’s use of regular contraceptives. This evidence suggests that women exposed to DVA are more likely to have unprotected sexual intercourse and therefore may use more emergency contraception (EC) than those women who are not exposed to DVA. We aimed to test this hypothesis through evaluating the evidence for an association between exposure to DVA and use of EC. Methods We systematically searched eight electronic databases from inception until December 2017, checked references and citations, and contacted corresponding authors. Primary studies that evaluated the association between exposure to DVA and use of EC were included. Two reviewers were involved in screening, data extraction, quality assessment and analysis. We evaluated the quality of included studies with the adapted Newcastle-Ottawa Scale. We used tables and descriptive text to summarise and synthesise the data. Odds ratios (ORs) and 95% confidence intervals (CIs) for each estimate of the association between DVA and use of EC were plotted on a forest plot. Results Our search retrieved 1216 records of which six studies with 15,297 women were included. Five studies were observational; one study included intervention on the outcome (advance supply of EC). All studies were at high risk of bias. Four studies provided evidence of an association between DVA and EC use – ORs from 1.51 (95% CI 1.13, 2.02) to 6.50 (95% CI 4.15, 10.17). Two studies found no evidence of a such association – ORs 0.46 (95% CI 0.11, 1.96) and 0.76 (95% CI 0.29, 1.98). The latter differed by how the authors recruited participants, measured EC use and adjusted for confounders. Conclusions This systematic review provides some evidence of increased use of EC among women exposed to DVA. Request for EC can indicate possible exposure to DVA. Therefore, each consultation for EC could be an appropriate context for clinical enquiry about DVA and signposting/referral to specialist DVA services. Protocol registration PROSPERO CRD42017058221.
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spelling doaj.art-8d07c26558b9412492eb35e3873a647e2022-12-22T00:40:09ZengBMCBMC Women's Health1472-68742018-09-011811810.1186/s12905-018-0652-7Use of emergency contraception among women with experience of domestic violence and abuse: a systematic reviewNatalia V. Lewis0Theresa H. M. Moore1Gene S. Feder2John Macleod3Penny Whiting4Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West, Whitefriars, Lewins Mead, Bristol BS1 2NT and Bristol Medical School, University of BristolCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of BristolCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West, Whitefriars, Lewins Mead, Bristol BS1 2NT and Bristol Medical School, University of BristolAbstract Background Exposure to domestic violence and abuse (DVA) results in a reduction of women’s use of regular contraceptives. This evidence suggests that women exposed to DVA are more likely to have unprotected sexual intercourse and therefore may use more emergency contraception (EC) than those women who are not exposed to DVA. We aimed to test this hypothesis through evaluating the evidence for an association between exposure to DVA and use of EC. Methods We systematically searched eight electronic databases from inception until December 2017, checked references and citations, and contacted corresponding authors. Primary studies that evaluated the association between exposure to DVA and use of EC were included. Two reviewers were involved in screening, data extraction, quality assessment and analysis. We evaluated the quality of included studies with the adapted Newcastle-Ottawa Scale. We used tables and descriptive text to summarise and synthesise the data. Odds ratios (ORs) and 95% confidence intervals (CIs) for each estimate of the association between DVA and use of EC were plotted on a forest plot. Results Our search retrieved 1216 records of which six studies with 15,297 women were included. Five studies were observational; one study included intervention on the outcome (advance supply of EC). All studies were at high risk of bias. Four studies provided evidence of an association between DVA and EC use – ORs from 1.51 (95% CI 1.13, 2.02) to 6.50 (95% CI 4.15, 10.17). Two studies found no evidence of a such association – ORs 0.46 (95% CI 0.11, 1.96) and 0.76 (95% CI 0.29, 1.98). The latter differed by how the authors recruited participants, measured EC use and adjusted for confounders. Conclusions This systematic review provides some evidence of increased use of EC among women exposed to DVA. Request for EC can indicate possible exposure to DVA. Therefore, each consultation for EC could be an appropriate context for clinical enquiry about DVA and signposting/referral to specialist DVA services. Protocol registration PROSPERO CRD42017058221.http://link.springer.com/article/10.1186/s12905-018-0652-7Domestic violence and abuseIntimate partner violenceEmergency contraceptionHormonal contraceptionSystematic review
spellingShingle Natalia V. Lewis
Theresa H. M. Moore
Gene S. Feder
John Macleod
Penny Whiting
Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review
BMC Women's Health
Domestic violence and abuse
Intimate partner violence
Emergency contraception
Hormonal contraception
Systematic review
title Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review
title_full Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review
title_fullStr Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review
title_full_unstemmed Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review
title_short Use of emergency contraception among women with experience of domestic violence and abuse: a systematic review
title_sort use of emergency contraception among women with experience of domestic violence and abuse a systematic review
topic Domestic violence and abuse
Intimate partner violence
Emergency contraception
Hormonal contraception
Systematic review
url http://link.springer.com/article/10.1186/s12905-018-0652-7
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