About half the number of women in Ireland who take the birth-control pill run the risk of unplanned pregnancies by forgetting to take it or by taking it incorrectly.
Doctors attending the WONCA conference in Dublin were told that 55 per cent of women surveyed had missed a pill at least once, but only a small fraction of these knew what to do about this or about drug interactions which could make the pill less effective.
Confusion, mystery and fear surround the use of the pill in Ireland, according to Dr Tom O'Dowd, Professor of Community Health and General Practice in Trinity College Dublin. "Irish women are suspicious and fearful in a way which is not warranted. This is reflected in their low knowledge levels about what to do if they miss a pill."
There was also still a level of "Catholic guilt" for women using contraception as well as concern about possible side-effects. This was peculiar to Ireland, Dr O'Dowd explained. "Many feel it is God visiting some awful illness on them because they are on the pill."
He said that the findings of a survey conducted in the North-Western Health Board area fitted in with a recent report on crisis pregnancy. "Some women in Ireland have an odd attitude to contraception and feel if they are seen to be taking precautions it gives an unwarranted licence for sexual activity."
Women who forgot to take a pill might not realise that they were putting themselves at risk of pregnancy. "There is a lack of knowledge combined with fatalism and hoping for the best", he said.
The survey found that over two-thirds of women did not have difficulty in taking the pill. However, Dr O'Dowd said, a significant minority of women had unwarranted fears about side-effects.
Eighty women were questioned in the survey. Almost 60 per cent had taken antibiotics while on the pill. Of those, 66 per cent knew that extra precautions were needed because of the possible interaction which could reduce the pill's effectiveness. However, they did not follow guidelines outlined by the Irish Family Planning Association.
The survey found that two-thirds of women took the pill "as part of their daily routine"; almost a quarter remembered to take it by "placing it in a prominent position"; one in 20 "hoped for the best" on whether they would remember to take it; while the same proportion were "reminded by their partner".
It also revealed that women aged between 21 and 25 or those who had benefited from third-level education were more likely to consult the booklet enclosed with the pill rather than go to their doctor with queries.
The survey concluded that a need existed for ongoing education of women on the pill at individual and public health level.