Use of Post-Coital Strategies to Prevent Pregnancy: Findings from a National Sample of Adolescents and Young Adults in the United States

Abstract

In the context of increasing restrictions on sexual and reproductive health care, inadequate sex education, and increasing antihormonal contraceptive sentiment, we examined post-coital pregnancy prevention behavior among a nationally representative sample of U.S. adolescents and young adults (AYA). We developed a novel measure of post-coital contraceptive strategies (i.e., actions taken after sexual intercourse with the intent of reducing the likelihood of pregnancy) and fielded this measure for the first time as part of a 2025 online, population-based survey of English-speaking 15–29-year-olds assigned female at birth (n = 1,259). Of the 633 AYA who reported having ever had penile-vaginal sex and were not currently pregnant, 25.0% used at least one post-coital strategy to prevent pregnancy the last time they had sex. While methods with established effectiveness (i.e., emergency contraception and copper intrauterine device) were used by 8.9% respondents, 16.1% reported using a non-medically evidenced post-coital strategy, the most common being praying (9.4%). Post-coital strategy use varied by age, race and ethnicity, and number of contraceptive methods used. In multivariable analyses, contraceptive knowledge was negatively associated with post-coital strategy use. Regardless of effectiveness, post-coital strategies are common enough to warrant inclusion in behavioral surveillance and attention in health education and clinical practice.