Deregulating emergency contraception. Service should reflect greater demand after the weekend.

In his editorial James Owen Drife calls for improvements in family planning services whether or not emergency contraception is deregulated. He also mentions that unprotected intercourse often happens at weekends; as far as we know there are no published data on this. In our semirural general practice the number of requests for emergency contraception continues to rise each year (18 requests in 1989 rising to 55 in 1992). The trend mirrors what is happening elsewhere: Brook Advisory Centers saw a threefold increase in prescriptions for emergency contraception between 1985 and 1992 (Brook Advisory Centers personal communication 1993). We looked at the day of the week on which 155 patients requesting emergency contraception were seen during 1989-92. 91 were seen on a Monday or Tuesday (58 on a Monday and 33 on a Tuesday). If Sunday is excluded as there is no surgery the expected number of requests for emergency contraception each day would be 25.8. The actual number of 91 on Monday and Tuesday combined is significantly higher than expected (95% confidence interval 79-103; p < 0.0001). Clearly as for other problems practices must be prepared to allocate more time for emergency work on Mondays and to a lesser extent Tuesdays than is needed on other weekdays. A "walk in" facility to allow patients to see a practice nurse is desirable. Most women were seen within three days of unprotected intercourse. Only one was seen beyond this: she was a 16 year old who was offered an IUD but declined it and did not become pregnant. (full text)