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Women Seeking Emergency Contraceptive Pills by Using the Internet

From the ¹Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey; ²Department of Family Medicine, Oregon Health and Sciences University, Portland, Oregon; ³Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; ⁴Center for Health and Wellbeing, and ⁵Office of Population Research, Woodrow Wilson School, Princeton University, Princeton, New Jersey; and ⁶Department of Family Medicine, University of Rochester/Highland Hospital, Rochester, New York.

OBJECTIVE: To assess barriers and attitudes related to emergency contraception access among women seeking emergency contraceptive pills by using the Internet.

METHODS: We conducted quantitative surveys and qualitative interviews of 200 women seeking emergency contraceptive pills from The Emergency Contraceptive Website (http://ec.princeton.edu). Main outcome measures included barriers to and attitudes toward emergency contraception access.

RESULTS: Participants were predominately white, college-educated, urban residents. Women most frequently cited structural barriers to obtaining emergency contraceptive pills, such as inconvenient office hours. Although women supported advanced prescription of emergency contraceptive pills, there was less enthusiasm for nonprescription access because of concerns that others (but not they) would engage in risky sexual behavior. Women valued the consultation with a health professional; 42% stated they would still speak with a clinician even if nonprescription access was available.

CONCLUSION: The Internet as a resource for emergency contraception appears limited to women of high socioeconomic status in our sample. There is a need to address beliefs that increased access to emergency contraception promotes risky sexual behavior because current evidence refutes this concern. Clinicians should still be prepared to discuss emergency contraception with patients, despite the fact that emergency contraceptive pills are now available to most (but not all) women without a prescription.

LEVEL OF EVIDENCE: III