For patients of reproductive potential physicians should initiate conversations about contraception, paper suggests
A new Annals "In the Clinic" provides a detailed summary of contraceptive methods and presents evidence-based discussion points that physicians can use to initiate a dialog with their patients of reproductive potential. The timing of this release is crucial as pregnancy-associated mortality is on the rise, abortion access is decreasing, and the mini pill has just been approved for over-the-counter use in the United States. The "In the Clinic" feature is published in Annals of Internal Medicine.
The paper suggests shared decision making between physicians and patients. It includes reference to the PATH Questionnaire on Parenting and Pregnancy Attitudes and Timing, a brief Q&A tool that provides a framework for discussing reproductive desires.
For patients who desire contraception, the paper outlines the benefits, harms, and efficacy of several available methods. A reference table provides an at-a-glance reference for busy clinicians and an "information for patients" page provides key takeaway messages. The paper includes a section on emergency contraception methods, including counseling on medical and surgical abortion.
According to an editorial from cardiologist Amy A. Sarma, MD from Massachusetts General Hospital, preconception and contraceptive counseling has never been more important. In fact, she emphatically states that "this is our lane" as physicians. She writes that all clinicians who care for patients of reproductive potential should become comfortable discussing pregnancy intent, preconception risk assessment, and contraceptive counseling.
Such conversations should not be restricted to primary care, gynecology, or even Women's Heart Health programs, as many people of reproductive potential never present to such settings. She says that all encounters with patients of reproductive potential present opportunities to help them realize their pregnancy goals and avoid unintended pregnancy.
More information: 1. Amy A. Sarma, Contraception and Reproductive Health Counseling: This Is Our Lane, Annals of Internal Medicine (2023). DOI: 10.7326/M23-1717