This study’s primary purposes were to understand EC knowledge, attitudes, and behaviors among women living in Italy and explore the impact of the 2015 policy.

Researchers conducted 30 interviews with women living in Florence, Italy, and the Italian health care system. Researchers used an expanded grounded theory approach to understand women’s EC experiences, with the DOI serving as a conceptual lens. 

Participants had low awareness of the 2015 EC policy and suggested increased messaging in strategic locations to overcome this barrier. They held positive and negative attitudes towards EC: while some perceived EC’s advantage compared with an unintended pregnancy, others expressed concerns about irresponsible behavior and safety. Finally, conscientious objection impacted access, despite women’s desire for autonomous EC decision making.

This study’s findings offer all practical recommendations to guide EC messaging in Italy to increase women’s access to EC. Suggestions include using theory- and audience-based methods to overcome gaps in policy knowledge and real and perceived EC access barriers. Incorporating DOI as a theoretical framework with women’s voices presents a novel opportunity to enhance policy and EC dissemination.