The second time I ever had sex, the condom broke. I was 16, turning 17 the next day, and I wasn't on the Pill. I started panicking. While my high school boyfriend's (very cool) parents tried to calm us down and comfort us, I knew I had to do something to make sure I wasn't pregnant ASAP. I had friends who had been in similar situations and just crossed their fingers until their next period, hoping they wouldn't get pregnant. But I couldn't take that chance. I still had my bottom braces in, I thought, how could I possibly have a child right now? The next day, we went to Planned Parenthood during our lunch break and I took emergency contraception Plan B on my seventeenth birthday during study hall.
Back in 2004, Plan B wasn't available over the counter and there was an age restriction. Had I not known about my options (or had access to a Planned Parenthood), I don't know what would've happened, but I'm so thankful I did. But as a new survey found, too many people still don't. The survey of 3,600 female and male undergraduate and graduate students in the United States, ages 18-25, from Teva Women's Health, the makers of Plan B One-Step, and The Kinsey Institute at Indiana University, found that 62 percent of sexually active college students are not using contraception consistently, and only 15 percent of students felt like they were at a high risk of an an unplanned pregnancy.
But a not-so-fun fact: In the U.S, 45 percent of all pregnancies in the U.S. are unintended — and out of all the unintended pregnancies in the U.S., 41 percent are due to inconsistent use of contraception. So what's up — why aren't we taking advantage of effective birth control options? Is is laziness? Inaccessibility? Lack of comprehensive sex ed?
62% of college students surveyed incorrectly believed they have to be at least 18 years of age or older to purchase OTC EC.
"I was surprised to see nearly three out of five sexually active college students in the study reported using contraception inconsistently," Justin Garcia, PhD, Associate Director for Research and Education with the Kinsey Institute. "It’s hard to say why exactly, as we didn’t specifically ask participants in the current study about their reasons for contraceptive use and non-use. But our study did find that college students surveyed held a considerable amount of misinformation about contraceptive-related issues, so it’s possible that knowledge gaps related to sexual and reproductive health contribute to these relatively high rates of inconsistent use. Other research has also pointed to a variety of factors, including socio-demographics, relationship factors, arousal, alcohol and other drug use, so those are all factors that we will need to further investigate in future research specifically on college students’ knowledge, attitudes, and practices with contraception, including EC."
So why do so few students think they're at risk for pregnancy? Is it misinformation? The — totally false — "it can't happen to me" attitude that people also have over contracting STIs? "Based on the scientific literature there are likely a variety of reasons related to individual knowledge about sexual and reproductive health, attitudes, and experiences," Dr. Garcia says. "The data from the current survey isn't able to tease that out, but it's definitely one of the primary questions that could be addressed in future research."
How Much College Students Really Know About Emergency Contraception
The survey also looked into students' emergency contraceptive knowledge aka "EC IQs" to see if lifestyle factors, like political party affiliation and dating app usage, were affecting whether they felt at risk for pregnancy or not. The survey found that students with more sexual partners in the last year had a lower EC IQ than those with fewer sexual partners, and while 69 percent of students felt an unintended pregnancy would be highly disruptive to their life, those who felt more at risk have a lower EC IQ than those who felt less at risk.
And women — especially bisexual women — were the most knowledgeable over EC. "Our findings show that on average, women know more about EC than men," Dr. Garcia says. "The differences in knowledge we found across sexual orientations, however, was quite interesting. While we might assume that straight women would know the most about EC, because their behaviors might be more likely to include heterosexual intercourse, our data suggest that on average bisexual women know more. There are a variety of possibilities for why that may be the case. This survey is a great start because it allows us to identify some of the major knowledge gaps about OTC EC, but understanding why bisexual women know the most about OTC EC requires more research to understand the factors shaping differences in knowledge gaps between particular groups of women and men."
So how can we increase students' knowledge about contraception? It's all about communication. "I believe it begins by increasing the frequency with which we discuss these topics with students, including education around human sexuality and reproductive health, Garcia Says. "It can be easy for myths and misinformation to spread, and it’s important we give students the resources and educational opportunities they need to gain accurate information about contraception and unintended pregnancy." And speaking of misinformation and myths — let's address those, because clearly, knowledge is power.
The Biggest Misconception About Emergency Contraception
Common misconceptions about EC could prevent people who need it from going to get it. "What I found particularly interesting from the survey results is the misconception students have about access to OTC EC," Dr. Garcia says. "In the overall sample, one of the most commonly missed questions was if there was an age restriction to purchase OTC EC: 62 percent of college students surveyed incorrectly believed they have to be at least 18 years of age or older to purchase OTC EC. When in fact there is no age restriction, and both women and men may purchase it. The second most commonly missed question was whether or not an ID is needed to purchase OTC EC: 53 percent of participants incorrectly believed you need an ID to purchase OTC EC, when actually OTC EC has been available for purchase without an ID or age restriction since 2013."
Another myth we need to stop believing? "The survey revealed nearly one in 10 college students surveyed believe OTC EC could protect against sexually transmitted infections or diseases (STIs/STDs), which it does not do," Dr. Garcia says.
Is Sex Ed To Blame?
Sexual stigma, whether it's over STIs, sexual dysfunction, or the morning after pill, is constantly preventing us from being sexually healthy. Granted I was in high school before EC was available over the counter, but even in my progressive high school's sex ed classes, I don't ever remember hearing about it. And I can only imagine what's being discussed (or not being discussed) in sex ed classes in other parts of the country.
"There is still stigma associated with EC use, which can influence ideas about what EC is, how it works, and why it’s important."
"Personally, as a professor who teaches about gender and sexuality, I think there is definitely a need for more education on these issues, including sexual and reproductive health," Dr. Garcia says. "But in terms of whether and how these issues are being discussed on college campuses throughout the U.S., it's hard to say as we don't have specific census data on that. However, findings from the current survey do show that having open and honest conversations about EC is important. There is still stigma associated with EC use, which can influence ideas about what EC is, how it works, and why it’s important. We are in need of more open discussions about reproductive health and EC, including educational programs that debunk myths and misconceptions."