American Society for Emergency Contraception, Lawrenceville NJ, United States.
Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville AR, United States.
Contraception. 2021 Jun;103(6):408-413. doi: 10.1016/j.contraception.2021.01.009. Epub 2021 Jan 27.
The mechanism of action (MOA) of emergency contraceptive pills (ECPs) is frequently mischaracterized. Our objective was to identify how members of the general public understand the mechanisms of ECPs.
We recruited a convenience sample from social media for a survey about reproductive health attitudes and analyzed spontaneous descriptions of how ECPs work. We inductively coded responses to create themes and subthemes, and collapsed subthemes into three MOA categories based on previous research.
Among 1443 respondents, 533 mentioned an MOA in their description of ECPs. While nearly half of these responses (49.5%) stated that ECPs prevent pregnancy before fertilization occurs (in accordance with most biomedical ECP research), over 60% described a mechanism related to preventing implantation of a fertilized egg. Nine percent of responses described a postimplantation mechanism that would be considered abortion by mainstream medical standards. Some respondents conveyed significant confusion about the biological processes involved with pregnancy and pregnancy prevention.
Confusion about how ECPs work was common among our sample. The largest group of responses described a mechanism-preventing implantation of a fertilized egg-listed on the Food and Drug Administration (FDA)-approved ECP labels that does not reflect most relevant biomedical research. Mischaracterizations of ECPs' mechanisms have been used to limit access to EC. These misunderstandings were common in our sample and may reflect poor quality sex education and public information, and confusion introduced by the FDA-approved labels. Additional research should identify whether public perception of ECPs' mechanisms influences policy, health care provision, and use of ECPs.
紧急避孕药（ECP）的作用机制（MOA）经常被误解。我们的目的是确定普通公众如何理解 ECP 的作用机制。
我们从社交媒体上招募了一个方便的样本，进行了一项关于生殖健康态度的调查，并分析了自发描述 ECP 如何发挥作用的内容。我们对回复进行了归纳编码，以创建主题和子主题，并根据先前的研究将子主题归入三个 MOA 类别。
在 1443 名受访者中，有 533 人在描述 ECP 时提到了 MOA。虽然这些回复中有近一半（49.5%）表示 ECP 在受精前防止怀孕（与大多数生物医学 ECP 研究一致），但超过 60%的人描述了一种与防止受精卵着床相关的机制。9%的回复描述了一种着床后机制，按照主流医学标准，这将被视为堕胎。一些回复者对怀孕和避孕所涉及的生物学过程表示出明显的困惑。
在我们的样本中，对 ECP 如何发挥作用的困惑很常见。最大的一组回复描述了一种机制——防止受精卵着床——这在食品和药物管理局（FDA）批准的 ECP 标签上列出，但这并不反映大多数相关的生物医学研究。对 ECP 机制的误解已被用于限制 EC 的获取。这些误解在我们的样本中很常见，可能反映了性教育和公共信息质量差，以及 FDA 批准标签带来的混淆。进一步的研究应确定公众对 ECP 机制的看法是否会影响政策、医疗保健的提供以及 ECP 的使用。
