Initiating Contraception Conversations With Patients


Drs Jenna Beckham and Thomas Kimble share their thoughts on initiating conversations surrounding contraception options with patients.

Jenna Beckham, MD, MSPH, FACOG: When you're talking about contraceptives with your patients, how do you initiate these conversations?

Thomas Kimble, MD: I don't have a set script. It varies from patient to patient. But some of the things I want to address are what are her future goals. Some women want to make sure they get that certificate first, or that degree, or they're waiting to get that big promotion before they want to start or extend their family. I ask them things about that, what are her thoughts, what has been her experience with birth control. What are some of the potential misconceptions that she has about contraception? Those are some of the very basic initial things I address first. Then we get into it a little bit more. How does she feel about her period, does she want to have a period every month, does she want to have a period once every 3 months, would that be more convenient for her and her lifestyle? Would she be OK if she was on a method where maybe she doesn't have a period at all? These are some of the things we start to delve into. And then I get a little further well, what are your, what's your medical history? What type of things have you experienced outside of your gynecologic history in the past? What type of medications are you on as well? Because those all come into play. What are the risk factors like smoking or other environmental exposures that may affect contraception use? Those are all the things that kind of play into that initial conversation.

Jenna Beckham, MD, MSPH, FACOG: I agree. It's best not to have a set script because as we both know, and anyone who cares for patients, every single one is completely different. And what works best for them is individual. And I do have a similar approach and I start with an open-ended question. And often will ask them what your thoughts about contraception are. And I find that gives them a lot of space to sort of share those things that you mentioned and then some follow-up questions. But it is helpful to know what, if any, have they used in the past, what positive or negative experiences have they had or a close friend or a family member. As you and I both know sort of that I compare it to patients of the one negative Yelp review for a restaurant, it can just ruin it for someone. And sometimes if their cousin or sister or friend had a particular experience, it can really sort of color the way they approach it. And then obviously as you said, those other sort of medical things that we need to think about, their medical history and medications. If there are some that are better or not at all really recommended for those patients.

Transcript edited for clarity

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