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Aims and Objectives: To assess women’s attitudes towards the mechanisms of action of birth control methods. Background: When addressing women’s knowledge of and attitudes towards birth control methods, researchers frequently focus on side effects, effectiveness or correct use. Women’s opinions about mechanisms of action have been much less investigated and research is usually concentrated on the EC pill. Design: Cross-sectional study. Methods: Women, aged 18-49, from Germany, France, the UK, Sweden and Romania were randomly selected (N=1137). They were asked if they would use a method that may work after fertilization or after implantation and if they would continue using it after learning it may have such effects. Logistic regression was performed to evaluate the influence of certain characteristics on women’s attitudes. Results: Almost half of women in Romania and Germany would not use methods with postfertilization effects, while the lowest percentages were found in Sweden and in France. Regarding methods with postimplantation effects, higher percentages were found in all the countries. Highly educated women and those using a highly effective method were more likely to use methods with postfertilization effects. On the contrary, married women, those who stated that human life begins at fertilization and women with middle/high religiosity were less likely to consider using methods that may act after fertilization. Conclusions: One third of European women reported that they would not consider using a method that may have postfertilization effects. Relevance to clinical practice: Given that postfertilization effects may not be acceptable to some women, informing them of which methods may have these effects is essential to obtaining complete informed consent and to promoting women’s autonomy.

Objective: Some methods of family planning may occasionally work after fertilization or implantation. These effects may be important to some women. We explored Spanish women’s attitudes towards these potential mechanisms of action of family planning methods. Study design: Cross-sectional study in a Spanish representative sample of 848 potentially fertile women, aged 18-49. Data were collected using a 30-item questionnaire about family planning. Logistic regression was used to identify variables associated with women’s attitudes towards postfertilization effects. Results: The majority of women were married, held an academic degree and had at least one child. Forty-five percent of women would not consider using a method that may work after fertilization and 57% would not consider using one that may work after implantation. Forty-eight percent of the sample would stop using a method if they learned that it sometimes works after fertilization, increasing to 63% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization, those who believe it is important to distinguish between spontaneous and induced embryo losses and women who report having a religion were less likely to consider the use of a method with some postfertilization effects. Conclusion: The possibility of postfertilization effects may influence Spanish women’s choice of a FP method. Information about mechanisms of action of birth control methods should be disclosed to women so that they can make informed choices.

Background: Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. Methods: Cross-sectional survey in a sample of 755 potentially fertile women, aged 18–49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, selfadministered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. Results: The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. Conclusion: Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.