The role of sources in contraceptive knowledge and use in Eastern Europe What is the problem? Family planning – the ability to decide if and when to have children by using effective methods of contraception – is a human right. Yet today, 250 million women between 15 and 49 years old who want to avoid pregnancy are not using any contraception. This leads to unintended pregnancies that disrupt lives and often have lasting effects on both women and their children. For many women an unintended pregnancy means dropping out of school or leaving their jobs, which limits their future opportunities. These women are also more likely to experience depression, stigmatization and health complications during birth. Children of an unintended pregnancy have higher chances of malnutrition, poor development and child mortality. While global attention often focuses on regions with high birth rates, Eastern Europe is often forgotten. Despite lower birth rates, many women in the region do not use contraception or rely on less effective traditional methods like withdrawal and fertility tracking rather than effective modern methods such as hormonal methods or condoms. In fact, 1 in 4 women who want to avoid pregnancy in Eastern Europe are not using any modern method. What did we study? Our study set out to understand why women in Eastern Europe are not using modern contraception. We focused on the first step in any behavior change: knowledge. Misbeliefs, fears of side effects or simply no knowing about the existence can prevent women from using modern contraception. We looked at two types of knowledge: (1) Method knowledge – knowing about different contraceptive options and (2) Conceptual knowledge – understanding how contraceptives work and why they matter. We also explored where women get their information, form schools, healthcare providers, personal connections or media and internet. What did we learn? Knowledge about contraception alone did not make women more likely to use them. Even women who understand why they are important and how they work don’t always use them. This was expected as knowledge is only the first step towards contraceptive uptake. What source women rely on for contraceptive information matters. Schools learn women about different methods, when sexuality education is included, but they do not contribute to a correct understanding of mechanisms and effects. Healthcare providers are an important source in some regions like Bosnia and Herzegovina where they increase method and conceptual knowledge. However, in other areas they are not successful in increasing knowledge, this probably reflects regional differences in quality and accessibility of healthcare services. Media, internet and personal connection contribute to the spread of confusion and misinformation. What needs to happen now? Unintended pregnancies are not just a personal issue, they are a societal challenge. They affect employment, public health and gender equality. By improving how and where women learn about contraception, we can empower them to make informed decisions on their bodies and futures. To achieve this we must act on multiple fronts: 1. Strengthening sexuality education in schools so it extends beyond listing methods but learns about the necessity and corrects false beliefs. 2. Train healthcare providers in offering clear and supportive contraceptive and countering misinformation. 3. Raise awareness of the spread of unreliable information online, especially for young women who more often rely on (social) media for health information. 4. Challenge outdated social knowledge that continues to circulate, by providing sufficient reliable trustworthy information sources like schools and healthcare providers that can tackle these. This research provides evidence for policymakers, educators and health professionals. It shows where interventions are needed and how we can build a future where every woman has the knowledge and information to make informed decisions about family planning. Knowledge is power but only if it is accurate, so investing in accurate information sources is crucial.