Sometimes it’s the little things that can make a big difference.
Here are 7 practical, evidence-based recommendations you and your doctor
can implement now to improve contraceptive care:
Do not require a pelvic examination before prescription of an oral contraceptivef
Both the World Health Organization and the American College of Obstetricians
and Gynecologists recommend doctors consider a pelvic exam optional before
prescribing an oral contraceptive (OC). This removes a barrier to care
for a patient who may fear it, postponing the exam to the near future
when she may be more comfortable with her health care provider.
To encourage continuation, begin now
Starting OC pills immediately—instead of waiting for the Sunday
after the next menstrual period can improve the short-term continuation
rate (Use condoms as back up for first cycle if >7 days since the beginning
of your last period).
Provide more, not less—Dispense at least 3 to 6 months of an OC
This results in a lower discontinuation rate. One study showed that dispensing
a 12-month supply of OCs reduced unplanned pregnancies by 30% and abortions
46% (why aren’t health insurers listening to this?).
Move away from every-day regimens
Forgetting to take your pills? Consider a non daily method, such as Ortho
Evra® patch (weekly) or vaginal Nuva Ring® (monthly).
Make a case for long-acting reversible contraceptives
IUDs and the skin implant Implanon® as first-line contraception more often—convenient,
removes user errors, and much more effective ( 1% vs. 5% pregnancy rate
Emphasize non contraceptive benefits
Hormonal contraception reduces acne, menstrual flow and cramps. Counter
false fears about weight gain or lingering effects on subsequent fertility.
Preemptive prescribing “Morning after pill”
If you are a sexually active woman using nothing, withdrawal, or condoms
then ask your doctor for a prescription for emergency contraception—Plan
B® or Ella. You can fill the prescription and keep it at home in case
of unprotected sex.
Finally, let us reassure you that every method of birth control is safer
for them then the risk of complications during pregnancy—after all
this is the “disease” we are trying to prevent.