Female college students' experiences with and perceptions of over-the-counter emergency contraception in the United States

• The incidence of unintended pregnancy and induced abortions worldwide continues, despite advances in contraception.
• Regardless of its availability over the counter (OTC), barriers to EC use exist, particularly related to awareness and access.
• Women need more information on various methods to prevent unintended pregnancy.
• Sexual and reproductive health is an essential component of well-woman care. .
• Sexual and reproductive health services may not be adequate in college health centers.

BackgroundUnintended pregnancy continues to be a major public health concern, particularly among women 19–24 years of age. Emergency contraception became available for purchase without a prescription in the United States in 2006; however, its use among women at risk for unintended pregnancy has not been adequately explored. Therefore, the purpose of this project was to gain insight into the perceptions and experiences of college women regarding over-the-counter emergency contraception, since its change in status.MethodsThis study used a descriptive, exploratory qualitative design. Small group interviews were conducted in early 2009 to obtain data from 24 women between the ages of 19 and 24 who were currently attending college and had purchased EC. Data were analyzed using content analysis.FindingsParticipants were aware of emergency contraception and its availability over the counter, although certain gaps in knowledge exist. Decision-making related to use of EC was driven by the recognition of pregnancy risk and a strong desire to prevent unintended pregnancy. Confidentiality was a major concern, as was lack of access to EC for women under the age of 17. Participants noted limitations in the health services both in provision of and education about EC.ConclusionsAlthough women have an awareness of EC and its availability, more comprehensive knowledge is needed. Barriers to use exist, particularly confidentiality and age related restrictions. Increasing awareness of personal risk of unintended pregnancy, particularly among college women, is important.