VO Artist: The following program has been created and paid for by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., and is intended for health care professionals in the United States.
Dr. Shepherd: As healthcare professionals we all know the importance of an open, two-way contraceptive dialogue, but have you ever wondered what your patients think about this discussion?
Hello, and welcome to Conversations in Contraceptive Care, a podcast series all about counseling patients on contraception.
I’m your host, Jan Shepherd, a Clinical Associate Professor in Obstetrics and Gynecology at the University of Colorado School of Medicine. And I’m here with Erica, who will be providing a patient’s perspective on an effective contraceptive dialogue.
Erica: So nice to be here with you!
Dr. Shepherd: Let’s start with a typical discussion. Erica, how does your health care provider normally talk to you about contraception? Do they bring it up, or do you start the conversation?
Erica: Typically, my doctor asks me how I’m doing, whether I’m currently using birth control, and if everything’s going alright. At my last visit, I was looking to try something different, so we also discussed other possible birth control options. We went through the pros and cons of each type and what might be the best option for me.
Dr. Shepherd: Were there any topics that you would have liked to talk about that they didn’t address?
Erica: Yeah, when we went over the different types of birth control, I would have liked to hear more about the side effects: what can I expect, how likely they are, that type of thing. But, overall, it was a very positive experience.
Dr. Shepherd: I think that’s a very common desire for patients to understand more about what they can expect when considering different forms of birth control. In fact, setting expectations is one of the key steps outlined by the Centers for Disease Control and Prevention, or CDC, for providing quality contraceptive counseling.
Under these guidelines, there are several important questions health care providers can ask their patients. For example, we may ask questions to assess reproductive goals, such as: Would you like to become pregnant? If so, when? And how would a pregnancy impact your life right now?
Erica, do you typically get asked questions like these, and do you find them easy or difficult to answer?
Erica: Yah, my doctor usually asks me if I’m planning to get pregnant now or in the future. It’s a pretty easy question for me to answer, because I’m definitely not ready to have kids right now!
Dr. Shepherd: It’s great that they ask you that though. Understanding where you are in planning a family really helps providers consider the most appropriate options to recommend.
Other questions that help us determine appropriate options may relate to contraceptive preferences and history. We might ask: What’s most important to you when it comes to your contraception? Every method can change your periods a bit. Can you deal with that? And what kind of changes would you be ok with?
Do you typically get asked these type of questions, and do you think they help you determine the best fit for birth control?
Erica: Hmm…. My doctor doesn’t usually ask me about my experience with different types of birth control. But, like I said before, I was considering trying something new, so we discussed what I had used before, what side effects I experienced, and what type of birth control I'm thinking about. I do think these questions helped me think about my past and evaluate what I liked and didn’t like about previous methods.
Dr. Shepherd: That’s a great point, because another important aspect of counseling is to learn about the patient’s knowledge and concerns about different contraceptive options. We might ask questions like: Do you have any concerns about your current method? What other contraceptive options have you tried or heard about?
So, Erica, it sounds like you brought this conversation up with your provider, but were there other important questions that helped you have a productive conversation?
Erica: Yes, I liked that my doctor asked me why I was looking into particular methods versus other ones. This made me think about what would fit me best day to day, and what I'm really looking for. I also found out about other possible options and appreciated that my doctor wasn’t trying to push a certain form of birth control on me, or saying, "Oh, why don't you try this, why don't you try that?” I'd rather be the one to get that discussion going.
Dr. Shepherd: Sounds like you had a very productive and collaborative discussion with your provider. In addition to informing patients about all appropriate contraceptive options, the CDC suggests that providers talk to their patients about the possible side effects of the methods they're discussing. Erica, do you feel like your provider discussed this?
Erica: Yes, to some degree. We talked a bit about side effects. I think it gave me an idea of what birth control might fit me best. But, I wish they had walked me through some of the differences between products a bit more, especially when it comes to bleeding changes. They did tell me to call if I had any questions, though.
Dr. Shepherd: I’m really glad you mentioned that last part, because patients should always feel like they can follow-up with any questions, any problems.
Erica, thank you so much for sharing your experiences today. It’s essential for all of us to hear how patients experience these conversations with their health care provider.
Erica: You’re welcome! Thanks for having me!
Dr. Shepherd: For everyone listening, I hope this podcast has provided you with a glimpse into the patient’s perspective in the healthcare provider-patient dialogue. Thanks for joining us today on Conversations in Contraceptive Care!
VO Artist: The preceding program has been created and paid for by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. The information in this presentation is intended for health care professionals in the United States.
The references for the information discussed today are available in the transcript which can be accessed on the site where you have listened to this podcast.
1. Gavin L et al. Providing quality family planning services: Recommendations of CDC and the U.S. Office of Population Affairs. MMWR Morb Mortal Wkly Rep. 2014;63:1‒54.
2. World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update). Baltimore and Geneva: CCP and WHO, 2018.
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