Obstet Gynecol. 2015 May;125 Suppl 1:74S.

Measuring Adherence to Birth Control Pills Among College Women

Wiltjer CA, Duff P, Williams K and Shuster JJ


Background: Oral contraceptive pills (OCP) are the most commonly used method of birth control among college women. Those who vary from the prescribed directions have a risk of contraceptive failure up to 9%.

Methods: Between April and December 2014, a one-time written survey was administered in a university women's health clinic. Key questions addressed the students' OCP regimen and variables often encountered by college women which could affect adherence to an OCP regimen.

Results: One hundred seventy completed surveys were collected. Data indicated that 89% of surveyed women were educated on the importance of maintaining a strict OCP-taking regimen. However, 73.5% did not take the pill at the same time daily; 52% of respondents skipped at least one dose of the pill within the month preceding the survey; and of these women, 19% skipped two or more doses. Over half of surveyed women indicated that they have been concerned about becoming pregnant while on the pill. Additionally, approximately 22% used emergency post-coital contraception while on OCPs.

Conclusions: Variance from perfect use of OCPs is common among college women. The use of contraceptive methods that do not require such strict compliance should be offered to women in this population.

Comment: This study shows once again that women need to be very well educated about the use of daily contraceptive pills: almost half of the women studies, skipped at least one pill in the month! We also need to tell them that forgetting a pill in the middle of the “cycle” is not as risky as skipping a pill at the beginning or at the end of the strip, which would lengthen the pill-free interval. (HMV)