Abstract Background and methodology The levonorgestrel- containing emergency contraceptive pill (ECP), amongst other strategies, has the potential to assist in reducing unintended pregnancy and abortion rates. Since the rescheduling of the ECP in January 2004 to over-the- counter (OTC) status from pharmacies in Australia, there is little information about Australian women’s ECP knowledge, attitudes or practice. The aim of the study was to explore Australian women’s knowledge of, attitudes towards and experiences of using the ECP, particularly since it has been available OTC. This paper reports a qualitative study using six focus groups, which were conducted between February and June 2007 in four Australian states with 29 women aged 16–29 years. Results Participants had a lack of specific knowledge about the ECP. Most were positive about the ECP being available OTC, however some expressed concerns about younger women misusing it. Women’s experiences 87 ©FSRH J Fam Plann Reprod Health Care 2009: 35(2) Introduction On 1 January 2004, the emergency contraceptive pill (ECP), containing 1.5 mg levonorgestrel, was rescheduled from S4 to S3 status and became available over-the-counter (OTC) from pharmacies in Australia. As the ECP is more effective the sooner it is taken after unprotected sexual intercourse, and most effective within 72 hours, 1 access is a crucial issue. By rescheduling the ECP, it was hoped that women could obtain it with greater ease within the narrow time frame recommended for its use. Rates of unplanned and unwanted pregnancies in Australia are a public health concern. Teenage women faced with an unplanned pregnancy often decide to terminate the pregnancy; 2,3 at least 50% of unintended teenage pregnancies end in abortion. 4 An Australian population survey indicated that 22.6% of Australian women aged 16–59 years have had one or more abortions, including one in three of those aged 20–29 years. 5 Reducing unintended pregnancy and abortion, particularly in teenage women, is high on the agenda both in Australia and overseas. 4,6,7 The ECP, amongst other strategies, has the potential to assist in reducing unintended pregnancy and abortion rates, although as yet this potential has been unrealised. 8,9 Although emergency contraception has been on the global market for several decades and the ECP available in Australia for over a decade, women have limited knowledge about its use. 10–13 Very few studies in Australia The emergency contraceptive pill rescheduled: a focus group study of women’s knowledge, attitudes and experiences Melissa Hobbs, Angela J Taft, Lisa H Amir ARTICLE Mother & Child Health Research, La Trobe University, Melbourne, Australia Melissa Hobbs, BA, MPH, Research Officer Angela J Taft, PhD, Senior Research Fellow Lisa H Amir, MBBS, PhD, Senior Research Fellow Correspondence to: Ms Melissa Hobbs, Mother & Child Health Research, La Trobe University, 324–328 Little Lonsdale Street, Melbourne, Victoria 3000, Australia. E-mail: melissa.hobbs@latrobe.edu.au obtaining the ECP from the pharmacy were both positive and negative. Most women said they would use the ECP again if required and would recommend it to a friend. Pharmacists were seen as important suppliers of the ECP but women felt it was not their role to provide advice about contraception or sexually transmitted infections. Discussion and conclusions The findings from this study confirm views from other studies, which suggest that although women have some concerns in relation to OTC supply of the ECP, they believe that the deregulation of the ECP is a positive step. The data also suggest that women need to be provided with more information and education about the ECP. Keywords attitudes, emergency contraceptive pill, experiences, knowledge, over-the-counter, qualitative research J Fam Plann Reprod Health Care 2009; 35(2): 87–91 (Accepted 9 December 2008) have examined women’s knowledge, attitudes and experiences of using the ECP prior to its rescheduling, and there have been no published studies in Australia since the ECP became available OTC. Prior to the rescheduling, a study in Melbourne 14 and another in New South Wales 15 with women attending for pregnancy counselling or seeking termination of pregnancy found that although most of the women had heard of the ‘morning after pill’, very few had tried to obtain it in an attempt to prevent the current pregnancy. The aim of this qualitative study was to use focus groups to explore Australian women’s knowledge, attitudes and experiences of the ECP, since it has been available OTC. These qualitative data assisted in the development of a national survey to investigate the knowledge, attitudes and use of the ECP by a random sample of Australian women, conducted in mid-2008. Methods Focus groups were used for this study because they are a particularly useful method to explore people’s knowledge and experiences and can be used to find out not only what people think but also how and why they think the way they do. 16 As this is a sensitive topic, it was considered that a group dynamic could be more likely to generate discussion Key message points ● Women believe that the deregulation of the emergency contraceptive pill (ECP) is a positive step as it improves access, which is viewed as the most important issue. ● Barriers to ECP use reported by the women included embarrassment, lack of privacy, fear of being judged and cost. ● Women need to be provided with more information and education in relation to the ECP but do not wish to have sexually transmitted infection or contraceptive advice delivered by the pharmacist. group.bmj.com on June 13, 2016 - Published by http://jfprhc.bmj.com/ Downloaded from