Forensic Nurses' Understanding of Emergency Contraception Mechanisms: Implications for Access to Emergency Contraception. Academic Article uri icon


  • BACKGROUND: An estimated 25,000 pregnancies result from sexual assault in the United States annually. Numerous professional healthcare organizations endorse offering emergency contraception (EC) as an integrated aspect of post-sexual-assault care. Lack of knowledge surrounding EC's mechanism of action, including misinterpreting ECs as abortifacients, might restrict patient access to this important healthcare option. PURPOSE: We evaluated sexual assault nurse examiners' understanding of the mechanism of action of oral ECs levonorgestrel (LNG) and ulipristal acetate (UPA). METHODS: A cross-sectional survey of practicing sexual assault nurse examiners was conducted through the International Association of Forensic Nurses. RESULTS: Among 173 respondents, 96.53% reported they prescribed/dispensed EC at the time of medical forensic examinations. LNG was prescribed more frequently than UPA (57.80% vs. 38.2%, respectively). When asked if they agreed or disagreed if LNG and UPA can disrupt an established pregnancy, 83.2% selected disagree/strongly disagree for LNG versus 78.6% for UPA, which were not significantly different. When asked whether the Supreme Court ruling overturning Roe v. Wade would change their EC prescribing, 79.77% reported it will have no change, 6.94% said it would increase, and 12.72% reported they were unsure. Several commented they were concerned whether state laws would prohibit EC and at least one program stopped prescribing EC because of their state laws. IMPLICATIONS: Addressing misinformation regarding EC's mechanism of action and increasing access to oral EC options after sexual assault have the potential to reduce the incidence of rape-related pregnancy.

published proceedings

  • J Forensic Nurs

altmetric score

  • 1

author list (cited authors)

  • Downing, N. R., Avshman, E., Valentine, J. L., Johnson, L. M., & Chapa, H.

citation count

  • 0

complete list of authors

  • Downing, Nancy R||Avshman, Elaine||Valentine, Julie L||Johnson, Luke M||Chapa, Hector

publication date

  • March 2023