Emergency Contraception Use: The Influence of Awareness, Attitudes, and Beliefs Among Non-Hispanic White, Non-Hispanic Black, and Hispanic Women in the United States

Published:February 20, 2019DOI:



      Given persistent racial/ethnic disparities in unintended pregnancies, this study aims to understand factors associated with emergency contraception (EC) use among non-Hispanic White, non-Hispanic Black, and Hispanic women.


      This study used a nationally representative sample of 1,990 women of reproductive age in the United States who participated in the 2016 Survey of Family Planning and Women's Lives. Logistic regressions were estimated to assess the association of sexual/pregnancy history, attitudes toward pregnancy, attitudes toward contraception, awareness and beliefs about EC, and source of information regarding contraception with ever using EC.


      After adjusting for demographic characteristics, we found no significant differences in ever using EC by race/ethnicity. Among non-Hispanic White women, those who used barrier methods of contraception, reported a previous unplanned pregnancy, reported having heard some or a lot about EC, and believed that EC is somewhat to very effective had higher odds of EC use. Among non-Hispanic Black women, those who reported a previous unplanned pregnancy and believed that EC was somewhat to very effective had higher odds of EC use. Among Hispanic women, those who reported using long-acting reversible contraceptives, having recent male sexual partners, and believing that EC is both somewhat to very safe and effective had higher odds of EC use.


      Awareness and beliefs about safety and effectiveness are modifiable factors that may influence EC use. Population-level interventions can focus on improving awareness and understanding of the safety and effectiveness of EC.
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      Caroline Heller, MPH, is a Data Analyst in the Office of Community and Population Health at Montefiore Medical Center. Her research focuses on health outcomes for vulnerable populations, with a focus on women's health and racial/ethnic disparities.


      Krista M. Perreira, PhD, is a Professor of Social Medicine at the University of North Carolina School of Medicine. Her research focus on racial/ethnic health disparities as well as policies and practices that affect the well-being of immigrant populations.


      Adele Shartzer, PhD, is a research associate in the Health Policy Center at the Urban Institute, where her work focuses on health coverage, access to care, and the health care delivery system.


      Emily M. Johnston, PhD, is a research associate in the Health Policy Center at the Urban Institute. Her research focuses on access to health care, particularly the effects of state and federal policies on the health and well-being of vulnerable populations.


      Brigette Courtot, MPH, is a senior research associate in the Health Policy Center at the Urban Institute. Her work focuses on reproductive health care, public coverage programs, maternal and child health, and access to care for underserved populations.