Knowledge and Perceptions of Emergency Contraceptive Pills Among a College-Age Population: A Qualitative Approach.

Results from focus-group discussions with a population of university students who have convenient access to emergency contraceptive pills show that basic awareness about this method is high, although specific knowledge on appropriate use, such as the time limit for use, the level of effectiveness and the possible side effects, is lacking. Approval of the method is widespread among both female and male students, although students did voice anxieties about irresponsible use and the lack of protection against the human immunodeficiency virus and other sexually transmitted diseases. Many of their concerns stem from incomplete information about how the regimen works. Students noted how rarely emergency contraceptive pills are discussed, and were curious to know more. They asked for routine education on the method, as well as more general discussion.

(Family Planning Perspectives, 27:149-154, 1995)

Emergency contraceptive pills, also known as morning-after pills, are a postcoital hormonal treatment that appears to inhibit implantation of the fertilized ovum. The typical regimen--the "Yuzpe" method--consists of 200 mcg of ethinyl estradiol and 2.0 mg of norgestrel (or 1.0 mg of levonorgestrel), usually dispensed as four combined estrogen-progestin oral contraceptives; two pills are taken within 72 hours of unproteded intercourse, and two are taken 12 hours later. (*)(1) Oral contraceptives, however, are not specifically labeled by the Food and Drug Administration (FDA) for emergency contraception and are not marketed as such, so access for women in the United States has been restricted.

Since the early 1990s, family planning advocates have sought to expand access to emergency contraceptive pills as a cost-effective measure to prevent unintended pregnancies and abortions. (2) Various groups concerned with women's health and reproductive rights have publicized their positions on the issue, encouraging FDA approval and availability of the method, and even the popular press has begun to run stories. (3)

But what do people with access to emergency contraceptive pills think about this method? Do they consider it a useful and appropriate means of fertility control? A university population presents itself as an optimal group among whom to investigate this question, since many university health centers include emergency contraceptive pills in their reproductive health services. This study examines the knowledge and attitudes of students at Princeton University about emergency contraceptive pills, which were available at the health center for more than 15 years and were advertised frequently on campus for two years prior to the study.

The findings can be used as an indicator of the types of problems and attitudes that might prevail in a context of widespread access to emergency contraceptive pills. Students, however might be expected to look more favorably upon use of emergency contraceptive pills than the larger population, given their general desire to complete their education before having children.

As no research has previously assessed knowledge and opinions about emergency contraceptive pills in the United States, we used both qualitative and quantitative methods to gather as much information as possible. A statistical analysis of survey data, described elsewhere, (4) confirmed our hypothesis that higher levels of knowledge about emergency contraceptive pills (such as knowledge of the ingredients and potential side effects) are associated with more positive attitudes. The survey data also showed political and religious orientation to be significant determinants of student attitudes. This article presents the findings from a series of focus-group discussions, which documented students' opinions on emergency contraceptive pills within a more general context of sexuality.