Abstract
BackgroundEmergency contraception (EC) is an effective postcoital contraceptive method for reducing the risk of unwanted pregnancy after unprotected intercourse. The estimated effectiveness of EC is between 70 and 89% if taken within 72 h following intercourse. Most of the studies carried out in Spain are quantitative and from the perspective of health professionals. In this study, we intend to explore the knowledge of, attitudes towards and discourse regarding the use of EC in women aged 15 to 25 years.MethodsSample: A qualitative study including in-depth interviews with 19 women between 15 and 25 years of age was performed. Inclusion criteria: Participants were natives of Spain or of a Latin American country. Segmentation criteria: Participants had experience in the use of EC.Data collectionParticipants were selected by health care informants and by the snowball technique among university students.Data analysis: A thematic analysis was performed. Preliminary analyses were made during the course of the field work to adapt the script and to assess data saturation. A preliminary code tree was developed by two researchers, and the coding of the text was done with the Atlas.ti 5.0 software.ResultsEC is perceived positively by women. They do not express issues with taking it, although some feel guilty. The reason for taking EC is to avoid unwanted pregnancy and abortion. Women also feel that EC should be used in moderation. False beliefs and misconceptions regarding EC are held: EC delivers an excess of hormones, induces abortion and causes severe side effects. Women mention that the health professionals who provide EC have moral beliefs. Women use it because of condom breakage associated with their first coital relations.ConclusionsThe results of this study have public health implications: The sexual-affective health education received by young people should incorporate clear information about the mechanism of action of the EC pill and its side effects together with empowerment strategies addressing guilt and moralistic messages. Programmes and training activities for health professionals must be designed to prevent the communication of inappropriate messages such as those that exaggerate the side effects of EC and those that promote fear and guilt, because they represent a barrier to the responsible use of this medication.
Highlights
Emergency contraception (EC) is an effective postcoital contraceptive method for reducing the risk of unwanted pregnancy after unprotected intercourse
Women mention that the health professionals who provide EC have moral beliefs
The results of this study have public health implications: The sexual-affective health education received by young people should incorporate clear information about the mechanism of action of the EC pill and its side effects together with empowerment strategies addressing guilt and moralistic messages
Summary
Emergency contraception (EC) is an effective postcoital contraceptive method for reducing the risk of unwanted pregnancy after unprotected intercourse. In Spain, over-the-counter dispensation in pharmacies began in 2009 [8] These methods of increasing women’s access to EC are of positive value because they decrease the amount of time necessary to obtain it, thereby ensuring its effectiveness [9]. The belief that EC is an abortion-inducing drug as well as the exaggeration of the side effects causes some women to decide not to take it [10, 11] Factors such as the cost and the sense of intimidation generated by the possible moral judgements of the health professionals or pharmacists who dispense the pill must be considered [10, 12, 13]. Women state moral or religious reasons for not using EC, while others decline use because they think or expect that they will not get pregnant [12]
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