Purpose. This study describes emergency contraceptive pill (ECP) use among women attending a university in New York City, including the situations that led to use and patterns of use, subsequent contraceptive practices, and perceptions of partners' attitudes regarding use of contraception.; Significance. Almost half (49%) of all pregnancies in this country are unintended, resulting in enormous social and economic costs. Emergency contraception could radically reduce the number of unintended pregnancies and abortions; however, barriers exist to increasing its access. Some of these barriers include medical provider and policymaker attitudes that increased access to ECPs will lead to contraceptive risk-taking.; Methods. Ninety-two women who requested ECPs from a university health center participated in a structured telephone survey within one week of their ECP request and were contacted for follow-up one month later.; Results. There was no evidence of increased contraceptive risk-taking following use of ECPs, and subjects were less sexually active at follow-up. The most commonly reported reasons for ECP requests were method failure (47%), followed by method misuse (29%), and no method used (24%). Almost 26% reported that alcohol played a role during the episode of sexual activity that led to their ECP request. The majority of subjects used ECPs as a back-up method and did not use ECPs repeatedly in place of ongoing contraception. Most subjects in monogamous relationships who informed their partners of their ECP use believed their ECP use would influence their partner to be more responsible about using contraception.; Conclusions. ECP use among this sample did not appear to increase contraceptive risk-taking behaviors. On the contrary, this study suggests that ECPs may have a larger role to play in preventing unplanned pregnancies as well as sexually transmitted infections [STIs] by possibly increasing use of reliable methods of contraception and reducing sexual activity.; Implications. These findings suggest that wider access to ECPs through provision of advanced supplies, pharmacy access, and/or over-the-counter access would not lead to increased contraceptive risk-taking. Increased access to ECPs could lower unintended pregnancy and abortion rates and possibly lead to behaviors that could further prevent unintended pregnancies as well as STIs.
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