Abstract
Study Objective
To understand contraceptive behaviors and decision-making in school-based health center
(SBHC) female patients who have used emergency contraception (EC).
Design
Qualitative interviews and questionnaires.
Setting
SBHCs.
Participants
Female adolescents, who self-reported EC use, were recruited from SBHCs.
Interventions
Interviews were conducted until thematic saturation was reached on the following themes:
reasons for selecting EC, perceived EC efficacy, reasons for use, nonuse, or inconsistent
use of nonemergent contraception (NEC), and beliefs surrounding pregnancy risk.
Main Outcome Measures
The team used a modified grounded theory approach and open coding technique to identify
common themes. Participants completed a questionnaire to assess demographic information
and EC knowledge.
Results
Twenty-eight interviews were completed. Reasons for using EC include not using another
contraceptive method, using another method incorrectly, or in combination with another
method for added protection. Reasons for EC preference include ease of administration,
ease of access, minimal side effects, perceived high efficacy, and because it can
be used discreetly. Use of NEC was supported by identifying it as more effective,
increased sexual experience and anticipation of sex, belief that excess EC decreases
efficacy or is detrimental to health, and social interactions. Participants reported
having used EC a mean of 3.5 times. Eighteen of 28 participants (65%) incorrectly
believed that EC is 90%-99% effective, and 15 of 28 participants (53%) correctly identified
ovulation inhibition as the mechanism of action.
Conclusion
EC use is promoted by ease of access and administration, experiencing minimal side
effects, and perceived high efficacy. Compliance issues with NEC and condoms and a
desire for a discreet contraceptive method support EC use.
Key Words
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Article info
Publication history
Published online: October 26, 2018
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
