22 October 2018
Nearly half of Hong Kong women don't know emergency contraception exists, a recently published study in the Hong Kong Journal of Gynaecology found. Photo: internet
Nearly half of Hong Kong women don't know emergency contraception exists, a recently published study in the Hong Kong Journal of Gynaecology found. Photo: internet

Why do so many Hong Kong women panic after unprotected sex?

Sexually transmitted diseases (STDs) aside, it can happen to anyone.

The condom breaks.

You forgot to take your pill or change your patch, or your shipment of vaginal rings from the United States or Britain is stuck in customs.

Or maybe you just got caught up in the heat of the moment and didn’t use a condom or birth control.

When this happens in most places around the world, women turn to emergency contraception — birth control you can use after sex.

That’s not the case in Hong Kong, where as many as 45.6 percent of women don’t even know emergency contraception (EC) exists, a recently published study in the Hong Kong Journal of Gynaecology reported.

Worse, a majority of women who claimed to have heard of EC — through friends and mass media rather than from a doctor or women’s health clinic — aren’t really sure what it is.

Seventy-five percent incorrectly think that the “morning after” pill, one of the forms of EC common in over 140 countries — causes an abortion.

Clearly, local women’s awareness and knowledge of EC, simply described as a safe and effective way to prevent pregnancy after unprotected intercourse, can stand some improvement.

In the mainland, where a state-enforced one-child policy had been in place for three decades until it was recently phased out, EC was embraced early by Beijing as another tool in the country’s birth control kit.

The drug has been available in China since the early 1990s, and in ’96 — before the method was approved by the US Food and Drug Administration — the state-backed China Family Planning Association was training pharmacists across 12 provinces in teaching customers how to use it, Time magazine reported in 2011.

Today, Yuting, the most popular emergency contraception brand in China, costs a little over US$2 for a two-pill dose.

To underscore the information gap and urgent need to improve women’s awareness of EC in Hong Kong, studies show awareness and knowledge levels at 94 percent in the United States and Britain and 83 percent in Sweden.

As defined by the World Health Organization, there are two methods of emergency contraception: emergency contraceptive pills (ECPs) — most commonly a dose of the synthetic hormone levonorgestrel that can prevent fertilization within three to five days — and copper-bearing intrauterine devices (IUDs).

The copper IUD is extremely effective at preventing pregnancy (in a review of 42 studies between 1979 and 2011, the pregnancy rate was just 0.1 percent when women used an IUD for emergency contraception), a BuzzFeed Life report said, citing James Trussell, senior research demographer at the Office of Population Research at Princeton University.

ECPs, available in the US without a prescription at pharmacies and grocery stores, make it much less likely that you will get pregnant if they are taken within the first few days after you have sex, Princeton’s EC website says.

How much the pill reduces your chances of getting pregnant depends on which kind of ECP you use and how quickly you take it after unprotected intercourse.

In general, the sooner you take the pill after sex, the better it will work, reducing your risk of pregnancy by 88 to 95 percent.

Neither EC method, pill or IUD, works if you’re already pregnant, and neither will protect you from STDs.

Despite the name, morning after pills can be taken right away or up to five days after sex if you think your birth control failed, you didn’t use contraception, or you were made to have sex against your will.

Part of the EC awareness problem in Hong Kong appears to stem from doctors.

In a 2007 study, Hong Kong doctors scored only 6.08 out of 12 in a simple test of their knowledge of EC.

More telling, the study also examined doctors’ attitudes and prescription practices, with many practitioners thinking EC morally unacceptable and tantamount to promoting promiscuity.

The study is old, to be sure, but may explain why only 14 percent of respondents in the Hong Kong Journal of Gynaecology report cited doctors as a source of their EC knowledge.

You’d also think that the Family Planning Association of Hong Kong would be a big source of information, but it isn’t; only 18 percent of respondents cited it as a source.

By comparison, media, at 37 percent, and friends (35 percent) were the main sources for EC information.

Unsurprisingly, the majority of respondents (70 percent) believed that EC should be more widely advertised.

At present, morning after pills are only available in Hong Kong by prescription.

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A strategist and marketing consultant on China business

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