title: Choice of Emergency Contraceptive and Decision Making Regarding Subsequent Unintended Pregnancy.
abstract: OBJECTIVE
  To prospectively evaluate (1) pregnancy desirability, (2) stated intentions should pregnancy occur among emergency contraception (EC) users, and (3) explore differences between women selecting the copper T380 intrauterine device (Cu IUD) or oral levonorgestrel (LNG) regarding hypothetical pregnancy plans and actual pregnancy actions during subsequent unintended pregnancies.
  
  
  METHODS
  In this prospective observational trial, women received the Cu IUD or oral LNG for EC without cost barriers. At baseline, participants completed a visual analogue scale measuring pregnancy desirability (anchors: 0, "trying hard not to get pregnant"; 10, "trying hard to get pregnant") and self-reported plans (abortion, adoption, parenting, and unsure) if the pregnancy test were to come back positive. Pregnancies were tracked for 12 months, and actions regarding unintended pregnancies were compared between EC method groups.
  
  
  RESULTS
  Of 548 enrolled women, 218 chose the Cu IUD and 330 the oral LNG for EC. Pregnancy desirability at baseline was low, with no difference between EC groups (IUD group: 0.51, SD ± 1.60; LNG group: 0.68, SD ± 1.74). Fifty-four (10%) women experienced unintended pregnancies. Pregnancy plans from baseline changed for 27 (50%) women when they became pregnant. EC groups did not differ in hypothetical pregnancy intention (p = 0.15) or in agreement of hypothetical pregnancy intention with actual pregnancy action (p = 0.80).
  
  
  CONCLUSIONS
  Women presenting for EC state high desire to prevent pregnancy regardless of method selected. When considering a hypothetical pregnancy, half of women had a plan for how they would respond to that situation, but when confronting an actual unintended pregnancy, half altered their plan.
  
  
  BACKGROUND
  Clinicaltrials.gov identifier NCT00966771.
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah , Salt Lake City, Utah.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Royer
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah , Salt Lake City, Utah.
authors.forename: David K
authors.initials: DK
authors.lastname: Turok
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah , Salt Lake City, Utah.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Sanders
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah , Salt Lake City, Utah.
authors.forename: Hanna M
authors.initials: HM
authors.lastname: Saltzman
mesh_terms: D000293:Adolescent; D000328:Adult; D044363:Contraception, Postcoital / Q000379:methods*; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage*; D003657:Decision Making; D005260:Female; D006801:Humans; D033182:Intention; D007435:Intrauterine Devices, Copper; D016912:Levonorgestrel / Q000008:administration & dosage*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D018873:Pregnancy Rate; D049168:Pregnancy, Unplanned; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014589:Utah; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D003280:Contraceptives, Oral, Synthetic; D016912:Levonorgestrel
keywords: emergency contraception; pregnancy intentions; unintended pregnancy