Global landscape of pre‐ and peri‐coital contraception: A qualitative study of gynecologists

Objective Pre‐ or peri‐coital contraception may offer a more flexible and user‐centered option to current regimens. However, the extent to which providers discuss pre‐ and peri‐coital contraception with patients and their opinions on the practice remains unknown. This study aimed to understand the knowledge and practicing patterns of expert gynecologists related to emergency (EC), pre‐ and peri‐coital contraception. Methods Utilizing an 11‐item semi‐structured interview guide administered to gynecologists, interviewees were asked about the landscape of emergency contraception in their country and opinions on pre‐ and peri‐coital contraception. Purposive sampling and reputational case selection were used to identify interviewees. Interviews were conducted in English, Spanish and French and thematically analyzed using Dedoose. Results A total of 31 experts were interviewed. The most commonly available EC methods included LNG pills and the intrauterine copper device (IUCD) with many reporting over‐the‐counter access to some form of EC. Most respondents noted that patients use EC as their regular method of contraception although there were mixed opinions as to whether this was safe and reliable. Among respondents, there were mixed opinions regarding the safety, feasibility, and practicality of pre‐ and peri‐coital contraception. While many felt pre‐ and peri‐coital methods would be safe and advocated for it to increase options for patients, others raised concerns about resulting menstrual irregularity, cultural taboos, and feasibility of anticipating sexual intercourse. Half of participants cited a lack of literature on this topic and a desire to see additional evidence. Conclusion There remains a lack of consensus regarding pre‐ and peri‐coital contraception with outstanding concerns around side effects and feasibility.