Knowledge and Practices Regarding Emergency Contraception (EC) among Female Healthcare Professionals (Doctors, Dentists, Pharmacists) in Najaf, Iraq

Abstract

Background: Emergency contraception (EC) is a method that women can use as a last resort after unprotected sexual activity and before implantation occurs. This may result from consensual intercourse, sexual assault, or the failure or improper use of other contraceptive methods. Each year, approximately 55 million pregnancies are unintended, and 20 million of these result in unsafe abortions. Objective: To explore knowledge and practices regarding emergency contraception (EC) among female healthcare professionals (doctors, dentists, pharmacists) in Najaf, Iraq.  Participants and method: This was a cross-sectional survey carried out over five months, from November 1, 2024, to April 1, 2025. The tool for data collection was an online self-administered questionnaire, chosen because it is easily accessible and convenient. The target population was defined as married female medical professionals of reproductive age who were actively practicing and provided informed consent. This included doctors, dentists, and pharmacists. A full account of the study's purpose was given in the survey link, stressing that participation was voluntary. Four hundred fifty responses were received, and after the incomplete ones were ruled out, 416 complete questionnaires were included in the final analysis.  Results: The current cross-sectional study aimed to assess knowledge and practice regarding emergency contraception (EC) among 416 married female healthcare providers in Najaf, Iraq. The majority of the participants were doctors (57.5%), while the remaining were pharmacists (30%) and dentists (12.5%). Although self-reported overall knowledge was 72.8%, there was a significant difference among professional categories; dentists showed lower levels (55.8%) compared to doctors and pharmacists, who reported poor knowledge rates of 23% and 23.2%, respectively. Despite the level of knowledge reported, only 41.3% had ever used EC. The most common reason for use among users was found to be the failure of a regular contraceptive method (75%). For non-users, the main barrier to use was said to be ignorance about the method of application and timing of EC (61.5%), thus indicating a wide gap between perceived and actual knowledge.  Conclusion: This study demonstrates a huge gap between knowledge and practice in emergency contraception (EC) among healthcare providers. Although the theoretical knowledge was generally high, the practical application was mostly hindered by one primary barrier — the lack of proper understanding regarding the use and timing of EC, which ultimately led to overestimation of competence. The disparities found across professional groups highlight the fact that knowledge related to EC is not universal but rather shaped by clinical exposure and training. Unlike in settings with high awareness, here, the main challenge is a basic knowledge gap, not misconceptions about safety.