Knowledge and Attitudes about Emergency Contraception in University Students

Unintended pregnancy continues to be a major problem on U.S. college campuses. An effective means of reducing these high rates could be the use of emergency contraceptive pills (ECP), but levels of usage have been very low. This research explores the knowledge and attitudes of a convenience sample of college students toward ECP. Survey data were collected from 693 university students with results demonstrating that this sample of college students knew very little about ECP, how it works, when to take it, and most important, where to obtain the pills. Researchers conclude that although ECP has the potential to drastically reduce the number of unintended pregnancies on campus, this method will never be effective unless student knowledge and awareness of the issue are greatly increased. Introduction Despite the fact that unintended pregnancy rates among American adolescents have steadily decreased during the past decade (Martin, Hamilton & Ventura, 2002), the United States continues to report the highest adolescent pregnancy rates among industrialized nations (Alan Guttmacher Institute, 2000a). Young women who are of traditional college age (18-24 years) have the highest rate of unintended pregnancy in the United States (Henshaw, 1992) and also represent the largest age group to seek abortions (Alan Guttmacher Institute, 2000b). The Centers for Disease Control and Prevention (1995) estimate that 86% of college students nationwide have had sexual intercourse and that nearly one-third of college women attending four-year institutions have experienced a pregnancy. These consistently high rates of sexual activity, combined with sporadic and inconsistent contraceptive usage, continue to place college students at high risk for unintended pregnancy. In a five-year trend analysis examining women seeking pregnancy tests at a student health center, more than 37% of the women reported using no contraception at last intercourse, with 30% of women testing positive for pregnancy (Sawyer, Pinciaro, & Anderson-Sawyer, 1998). A national study of college student compliance with contraception noted a similar statistic, with 37.7% of undergraduate students reporting a lack of protection at last intercourse (CDC, 1997) Research has also demonstrated that even women aged 18-24 years who do comply with contraceptive use tend to do so less consistently than women in older age groups (Glei, 1999). A much underutilized means of reducing unintended pregnancy is the use of emergency contraceptive pills (ECP). The two major types of emergency contraceptive pills currently available, Preven[TM] and Plan B[TM], received Federal Drug Administration approval in 1998 and 1999 respectively (Federal Register, 1999). Emergency contraceptive pills, often mistakenly called the "morning-after pill" can be at least 75% effective if taken within 72 hours of unprotected intercourse (Trussel, Rodriguez, & Ellerston, 1999). Establishing absolute effectiveness rates is impossible as there is no way to establish whether or not conception has actually occurred at the time of taking ECP. However, ECP's potential for reducing the rate of unintended pregnancy and ultimately abortion is very strong. The National Abortion and Reproduction Rights Action League (NARAL) estimates that emergency contraception could reduce the number of unintended pregnancies and abortions by one-half each year (NARAL, 2001). For college-aged women of 18-24 years, that would equate to potentially preventing almost one million pregnancies and over 600,000 abortions annually (Henshaw, 1992; Alan Guttmacher Institute, 2000b). Regardless of the potential effectiveness of ECP, very few college women have reported using this method of contraception. One of the few studies examining this population suggested that fewer than 6.5% of college students nationally reported that either they or their partner had used ECP (American College Health Assoc. …