Part One: What You and Your Doctor Bring to the Table
By Rachel Flink, MD
Imagine showing up at a travel agency, saying you’d like to go on vacation, and then asking the travel agent to recommend a trip. Without any more information, the agent would have a really hard time coming up with specific recommendations, and who knows if you’d be happy with the trip they ended up booking. Do you want to relax on a beach? Would you love to do adventurous activities on the side of a mountain? Does your ideal getaway involve sightseeing in a historical city? A good travel agent will ask you what your desires are, what region and climate you’d prefer, and what things would not be acceptable to you. Then she can use her knowledge and expertise to help you get what you’re looking for.
Choosing a birth control method has a lot in common with planning a vacation. There are a lot of good options without specific right or wrong answers, and different people will have different preferences. Some people use the same method for years, while others need to shop around a bit until they find one that works best for them. People may have different goals at different times in their lives – possibly wanting one thing as a teenager and something else in their thirties. Overall, choosing a birth control method is a personal decision, but your doctor has the knowledge and experience that can help you choose your best option. Ideally, you can work together for the best results.
What your doctor brings to the table:
– Years of professional (and likely personal) experience
– Knowledge about different birth control options – how long they last, how well they work, side effects
– Medical knowledge about which choices are safe or unsafe with medical conditions
What you bring to the table:
– Knowledge about your medical history – especially high blood pressure, migraine headaches,
tobacco use, liver disease, cancer, and personal or family history of blood clots or stroke
– Knowledge about your goals – how long you want to prevent pregnancy, how much you want to prevent pregnancy
– Knowledge about your lifestyle – do you have a hard time remembering to take medications? Do you and your partner have the ability and/or motivation to pause for protection before having sex?
– Knowledge about your body – do you have heavy or painful periods? Do you have irregular periods?
– Knowledge about what is and is not acceptable to you – can you tolerate irregular bleeding? Are you comfortable inserting a vaginal product?
– Everything else – ultimately, you are the expert on you!
When you meet with your doctor to discuss birth control, it’s helpful if you are prepared with all of that information. What your doctor can then do is find out what you’re looking for, so she can use her medical knowledge and expertise to help you come up with the best option for you. In this situation, you and your doctor are engaging in shared decision-making, meaning that both of you are bringing information to the table, and both of you have input on the final decision. Your doctor’s informational role is to provide medical expertise about your options, and her decision-making power is to only prescribe options that are safe for your medical situation. Your informational role is everything else – your priorities, your beliefs, your habits and your goals. You have the final decision-making power, and may choose any of the options your doctor deems safe. But the best physician-patient relationships, and the most satisfied contraceptive users rely on having an open discussion and working together to make a plan. In this scenario, your doctor can help you align your goals with the array of birth control options, and together, you can choose the best option for you.
Hopefully, this article will help you start to understand where your doctor is coming from and it will give you the tools to make the most of your next appointment. Upcoming installments in this series will focus on providing more information about each birth control option in an effort to help you choose the best option for you!
Rachel Flink, MD is an OB/GYN currently practicing in Western Pennsylvania and obtaining her Masters in Public Health at the University of Pittsburgh. Her clinical interests include reproductive health, pregnancy care, family planning, and minimizing barriers to care. Rachel’s research is focused on understanding women’s experiences with and preferences for reproductive health care. Outside of work, she enjoys reading, being active outdoors, and spending time with her husband, two-year-old son, and rambunctious dog.