Public confusion on emergency contraceptive pills persists

The mechanism of action (MOA) of emergency contraceptive pills (ECPs) is frequently mischaracterized among the general public, according to authors of a recent study published in the journal Contraception. The researchers’ objective was to identify how members of the general public understand the mechanisms of ECPs.

The results may reflect poor quality sex education and public information, and confusion introduced by FDA-approved labels, the study authors said. “Additional research should identify whether public perception of ECPs’ mechanisms influences policy, health care provision, and use of ECPs,” they wrote.

The study design included recruiting a convenience sample from social media for a survey about reproductive health attitudes and analyzing 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,” the authors wrote.

The researchers received 1443 responses, where 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, the authors wrote. Of the responses, 9 percent described a post-implantation 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, they said.

“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,” they said.

Source

Cleland, K; Marcantonio, TL.; Hunt, ME.; Jozkowski, KN. “It prevents a fertilized egg from attaching … and causes a miscarriage of the baby”: A qualitative assessment of how people understand the mechanism of action of emergency contraceptive pills.” Contraception. Published online January 25, 2021. doi.org/10.1016/j.contraception.2021.01.009