Original research article Women’s voices about emergency contraceptive pills “over-the-counter”: a Swedish perspective Gunilla Aneblom a, *, Margareta Larsson a , Louise von Essen b , Tanja Tyde ´n a,b a Department of Women’s and Children’s Health, Uppsala University, S-751 85 Uppsala, Sweden b Department of Public Health and Caring Sciences, Uppsala University, S-752 37 Uppsala, Sweden Received 25 February 2002; received in revised form 27 May 2002; accepted 1 July 2002 Abstract This study aimed to describe women’s experiences with the emergency contraceptive pill (ECP) as a prescription-free over-the-counter (OTC) product. Women (median age 24) who had bought ECP as an OTC product were interviewed in focus groups. Data were analyzed by content analysis. All participants appreciated the OTC availability. Timesaving aspects were seen as important benefits and pharmacies were seen as the right place to sell ECP. The media was the main source of information about OTC, probably due to the debates of the introduction of ECP as an OTC product in Sweden. All women discussed the mechanism of action. The women’s experiences of interacting with the pharmacists were both positive and negative. Inconsistencies in routines with regard to providing ECP and different attitudes toward use of ECP among the pharmacists, were identified. The women expected up-to-date information about ECP and the OTC availability from gynecologists and other health professionals. © 2002 Elsevier Science Inc. All rights reserved. Keywords: Attitudes; Emergency contraception; Focus group; Non-prescription; Sexual behavior 1. Introduction In April 2001, the Medical Product Agency in Sweden approved the progestogen-only pill (Norlevo TM , levonorg- estrel 750 g in two doses) as an “over-the-counter” (OTC) product for emergency contraception (ECP), in an attempt to facilitate its use. The product has been reclassified to a non-prescription drug in France, Norway, Portugal, South Africa, and the United Kingdom. In the United States, a prescription is still required but different measures are being taken to increase access, like provision of pills in advance and prescription by telephone. A recent project in Wash- ington State enabled pharmacies to provide ECP directly to women, which resulted in nearly 12,000 provisions of ECP, possibly preventing 700 or more unintended pregnancies [1]. The use of ECP is, apart from availability, based on the knowledge and the perception of the method. Younger women have been found to be more knowledgeable and more frequent users of ECP than older women [2–7]. The provision and use of ECP is not without controver- sies. Moral and religious norms and values may influence how information about ECP is given. The OTC availability of ECP has turned pharmacists into key persons in this process. We, therefore, conducted a study aimed at describ- ing Swedish women’s knowledge, experiences and attitudes toward purchasing and using ECP as an OTC product. 2. Materials and methods 2.1. Design This study, with a descriptive design, is part of a multi- center project, including Sweden, France, Norway, and Por- tugal. 2.2. Data collection Four focus group interviews with 6 to 8 participants in each group (n = 27) were performed during a period of 2 weeks, at Uppsala University. Each interview lasted approx- imately 60 min and the first and the second author alternated between the role of moderator (leading the discussion) and * Corresponding author. Tel.: +4670-1702664. E-mail address: gunilla.aneblom@spray.se (G. Aneblom). Contraception 66 (2002) 339 –343 0010-7824/02/$ – see front matter © 2002 Elsevier Science Inc. All rights reserved. PII: S0010-7824(02)00367-0