Abstract
BackgroundOral contraceptives (OCs) are a unique chronic medication with which a memory slip may result in a threat that could change a person’s life course. Subjective concerns of missed OC doses among women have been addressed infrequently. Anonymized queries to internet search engines provide unique access to concerns and information gaps faced by a large number of internet users.ObjectiveWe aimed to quantitate the frequency of queries by women seeking information in an internet search engine, after missing one or more doses of an OC; their further queries on emergency contraception, abortion, and miscarriage; and their rate of reporting a pregnancy timed to the cycle of missing an OC.MethodsWe extracted all English-language queries submitted to Bing in the United States during 2018, which mentioned a missed OC and subsequent queries of the same users on miscarriage, abortion, emergency contraceptives, and week of pregnancy.ResultsWe identified 26,395 Bing users in the United States who queried about missing OC pills and the fraction that further queried about miscarriage, abortion, emergency contraceptive, and week of pregnancy. Users under the age of 30 years who asked about forgetting an OC dose were more likely to ask about abortion (1.5 times) and emergency contraception (1.7 times) (P<.001 for both), while users at ages of 30-34 years were more likely to query about pregnancy (2.1 times) and miscarriage (5.4 times) (P<.001 for both).ConclusionsOur data indicate that many women missing a dose of OC might not have received sufficient information from their health care providers or chose to obtain it online. Queries about abortion and miscarriage peaking in the subsequent days indicate a common worry of possible pregnancy. These results reinforce the importance of providing comprehensive written information on missed pills when prescribing an OC.
Highlights
The World Health Organization (WHO) recognized contraceptives and family planning methods as key elements for fulfilling human rights and promoting women's autonomy and wellbeing [1]
We identified 26,395 Bing users in the United States who queried about missing Oral contraceptives (OCs) pills and the fraction that further queried about miscarriage, abortion, emergency contraceptive, and week of pregnancy
Users under the age of 30 years who asked about forgetting an OC dose were more likely to ask about abortion (1.5 times) and emergency contraception (1.7 times) (P
Summary
The World Health Organization (WHO) recognized contraceptives and family planning methods as key elements for fulfilling human rights and promoting women's autonomy and wellbeing [1]. Contraceptive access, choice, and knowledge as well as correct contraceptive use are key elements in increasing compliance to and efficacy of contraception and decreasing the number of unintended pregnancies [2,3]. Age is an important demographic characteristic for OC misuse, as young women and adolescents report forgetting a pill more often than others [5,11,12,13] and have a much higher rate of failure of oral contraception compared to older women [14]. It is important to give clear instructions on the appropriate measures to prevent pregnancy after a missed dose while providing contraception counseling to women, according to their lifestyles, sexual partner status, and health condition [5,19]. Anonymized queries to internet search engines provide unique access to concerns and information gaps faced by a large number of internet users
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