Pregnancy intention is extensively examined in the literature and the concept of "unintended" pregnancy is considered a significant health problem. Large efforts have been made to reduce negative health consequences presumably associated with pregnancies that are unexpected, unwanted, or mistimed but have had limited impact. A study was conducted to examine contextual issues surrounding women's experiences with pregnancy intention its intersection with knowledge, perceptions, and use of emergency contraception in a population of female university students. The project was a mixed method study including a survey examining demographic characteristics, sexual history, and knowledge and use characteristics in addition to interviews exploring prospective perceptions of pregnancy intention. An integrative review informed the background of the study demonstrating the need for expansion of current concepts of pregnancy intention that inform measurement and subsequent interventions. Quantitative survey results provide new information including higher rates of use in comparison to previous studies but persistence of misinformation. Qualitative interview findings illustrate a process by which individual agency in terms of sexual and pregnancy decision making is influenced by a precursor of the embodiment of convictions and empowerment. Combined conclusions confirm the need of exploring the role of the social context on pregnancy intention, suggest ways in which nurses can empower women to be their own agents of health, and start discussions of how intervention approaches to pregnancy intention can be improved.