Abstract
Objective
The mechanism of action (MOA) of emergency contraceptive pills (ECPs) is frequently
mischaracterized. Our objective was to identify how members of the general public
understand the mechanisms of ECPs.
Study design
We recruited a convenience sample from social media for a survey about reproductive
health attitudes and analyzed spontaneous descriptions of how ECPs work. We inductively
coded responses to create themes and subthemes, and collapsed subthemes into three
MOA categories based on previous research.
Results
Among 1443 respondents, 533 mentioned an MOA in their description of ECPs. While nearly
half of these responses (49.5%) stated that ECPs prevent pregnancy before fertilization
occurs (in accordance with most biomedical ECP research), over 60% described a mechanism
related to preventing implantation of a fertilized egg. Nine percent of responses
described a postimplantation mechanism that would be considered abortion by mainstream
medical standards. Some respondents conveyed significant confusion about the biological
processes involved with pregnancy and pregnancy prevention.
Conclusion
Confusion about how ECPs work was common among our sample. The largest group of responses
described a mechanism—preventing implantation of a fertilized egg—listed on the Food
and Drug Administration (FDA)-approved ECP labels that does not reflect most relevant
biomedical research. Mischaracterizations of ECPs’ mechanisms have been used to limit
access to EC. These misunderstandings were common in our sample and may reflect poor
quality sex education and public information, and confusion introduced by the FDA-approved
labels. Additional research should identify whether public perception of ECPs’ mechanisms
influences policy, health care provision, and use of ECPs.
Keywords
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Article info
Publication history
Published online: January 25, 2021
Accepted:
January 20,
2021
Received in revised form:
January 15,
2021
Received:
August 10,
2020
Footnotes
Declaration of competing interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
