JMIR Publications

ABSTRACT

Background:

Oral Contraceptives (OCs) are a unique chronic medication where a slip of memory may be experienced as a threat that could change the life course of a person. Subjective concerns in women missing doses of OCs have been addressed infrequently. Anonymized queries to internet search engines provide a unique access to concerns and information gaps in a large number of internet users.

Objective:

We sought to quantitate the frequency of queries by women seeking information in an internet search engine after missing one or more doses of an OC, their further queries on emergency contraception, abortion and miscarriage and their rate of reporting a pregnancy timed to the cycle of missing an OC.

Methods:

We extracted all English-language queries submitted to Bing in the US during 2018 which mentioned a missed OC, and subsequent queries of the same users on miscarriage, abortion, emergency contraceptives and week of pregnancy.

Results:

We identified 26,395 Bing users in the US who queried on missing OC pills and the fraction who further queried about miscarriage, abortion, emergency contraceptive and week of pregnancy. Users under the age of 30 who asked about forgetting an OC dose were more likely to ask about abortion (x 1.5) and emergency contraception (x 1.7) (p-value=0.00006 and 0.00001, respectively), while at ages 30-34 queries about pregnancy (x 2.1) and miscarriage (x 5.4) were more likely (p-value= 0.000002 and 0.000004, respectively).

Conclusions:

Our data indicate that many women missing a dose of OC might not have received sufficient information from their healthcare providers or chose to obtain it online. Queries about abortion and miscarriage peaking in subsequent days indicate a common worry of possible pregnancy. These results reinforce the importance of providing comprehensive written information on missed pills when prescribing an OC.