Capturing Emergency Contraceptive Pill Use: Critical Reflections on Measurement and Reporting

Emergency contraceptive pills (ECP) are an essential and unique postcoital method of preventing pregnancy. Trends in supply data show that sales of ECP are increasing at faster rates globally than many other contraceptives. Yet nationally representative survey data suggest that ECP use has remained relatively static overtime, suggesting significant measure and reporting issues. Accurate measurement of ECP use is critical for informing policies and programs that provide people the choice and freedom to exercise their reproductive rights. There is an urgent need for a revision of ECP measurement to better capture the realities of people's contraceptive needs and desires. In this commentary, we outline the key reasons why surveys may be underreporting and misreporting ECP. We focus on issues around current method-specific measurements, definition issues around "use" and problems with survey questions and prompt phraseology. We illustrate the importance of recognizing other postcoital methods and strategies that people use when trying to prevent a pregnancy, and the implications this has for ECP measurement. As ECP use evolves, we offer recommendations for survey revisions and further research that can ensure that ECP measurement is robust and able to provide accurate reporting in the future.