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What do women really want to know about birth control? Listen up health care professionals—it may not be what you think!
Women know what matters most to them and physicians think they know what matters most to women. However, a recent study from Dartmouth 1 says that patients and their physicians were sometimes on the same page. But, at other times they were not! But, you already knew that, didn’t you!
This study gave an online poll to 417 women and 188 healthcare providers. Each participant rated and ranked 34 questions about birth control. Questions were things like: How does it work? Is it safe? How is it used? Does it hurt to use it? How often is it used?
And the results? A little more than half of the 34 questions were similar in importance for both women and their doctors (18 questions). But, for the lesser half, the questions were not similar in importance (16 questions).
Why is this an issue? Well, with the many choices women have for birth control 2 —permanent vs. reversible, pills vs. IUDs, etc.—you need to discuss your options with your doctor to make an informed choice.
However, it seems doctors tend to think it’s most important to discuss how to use birth control and which methods are most effective at preventing pregnancy—and not safety (maybe because they already know that birth control for a healthy woman is usually safer than pregnancy).
It seems women are more often concerned about safety, side effects, and how the birth control works. In the study, the question rated most important for women was “How does it work to prevent pregnancy?”
Since this study highlights the importance of patient-centered information (what you want to know), and not physician-centered information (what the doctor thinks you should want to know), if your physician is not giving you the information you need, then be proactive and ask questions.
Appointments are short nowadays, so this may be difficult. Go to your appointment with a list so you don’t forget your questions—and also so you don’t get rattled and sidetracked. Keep asking until you get what you need.
It’s important that your doctor answers the questions that are most important to you, whether or not he/she thinks they’re major concerns. So if your doctor isn’t answering all your questions, it might be time to find one that will.
An NPR article quotes Kyla Donnelly, a reproductive health researcher at the Dartmouth’s Institute for Health Policy and Clinical Practice, who led the study: “The main takeaway is really that it’s very important for providers to speak about what’s most important to women.” 5
The study authors say that this research provides insights into what women and their doctors should be discussing. Donnelly is currently working with other researchers to develop guides to help doctors and patients better discuss birth control options.
Reversible methods include:
(1) Hormonal methods—Prevent ovulation (releasing an egg) in the female. Very reliable. Can be delivered in several ways: via pill, injection (shot), patch, implant, and vaginal ring. Hormonal methods use two basic formulas:
(2) Barrier methods—Keep sperm and egg from uniting. Risks for all these methods include incorrect and inconsistent use.
(3) Intrauterine contraception—An intrauterine device (IUD) is placed inside the female uterus to prevent pregnancy. It can cause increased blood flow and cramping. Less than 1% of users get a serious infection called pelvic inflammatory disease (PID).
(4) Natural methods to prevent pregnancy
Irreversible methods include:
(1) Female sterilization—Female tubes are tied, clipped, or blocked so sperm and eggs cannot meet. Surgical risk. Post-sterilization regret. Failure rate 0.5%.
(2) Male sterilization—Vasectomy prevents sperm from reaching the penis. Surgical risk. Post-sterilization regret. Failure rate 0.15%.
A summary chart of effectiveness is available from the CDC.
Your choice of birth control depends on: overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. Planned Parenthood has a comprehensive FAQ. At the very least, you should ask:
NOTE: The best way to reduce the risk of unintended pregnancy is to use effective birth control correctly and consistently. Birth control does not protect against HIV infection and other sexually transmitted diseases (STDs); only a condom will help protect you from STDs. 6
Donnelly KZ, Foster TC, Thompson R. What matters most? The content and concordance of patients’ and providers’ information priorities for contraceptive decision making. Contraception. 2014 Apr 30. doi: 10.1016/j.contraception.2014.04.012. (http://www.ncbi.nlm.nih.gov/pubmed/24863169) ↩