Contraception in the media

Media articles on contraception surveys and how silly teh wimminz are pretty much always bother me. For a whole variety of reasons.

Here’s one of them. There is so much elided, left out, glossed over, ignored, probably not even known by the author. So many opportunities lost to examine the actual issues. So many assumptions made.

Women fear GP contraception chat

Some women fear asking their doctor about contraception as much as a visit to the dentist, a new report has suggested.

A tenth of women admit they find it equally nerve-racking, in the poll conducted by Bayer Healthcare.

Sure. And why is that? Could it be their previous experiences with doctors, slut-shaming, fat-shaming, dismissing, assaulting them? Could it be that having coerced pelvic exams and Pap smears (with scripts withheld till they comply) flashes them back to their rape(s)? That some doctors bring their own religious crap to the consultations instead of being professional? A zillion other reasons?

The report shows almost a quarter of sexually active women have not spoken to their GPs about contraception at all.

And? Maybe some or all of the above. Maybe they’re trying to get pregnant. Maybe they’re only sexually active with women. Maybe they’re partnered with a man who’s had a vasectomy. Maybe they’re using condoms or a cervical cap. Maybe they’re not having PIV sex.

Women spend less than 10 minutes a year talking to their doctor about contraception, the poll also revealed.

And this is my biggest “So?” There is no way in hell I’ve spent an average of ten minutes – one full consultation – every single year of my sexually active life talking with a doctor about contraception. And I’ve been around the contraceptive block- I’ve been on a good half dozen or so kinds of pill, an IUD, used FAM, three different types of barriers, used the lactational amenorrhea method, taken EC once, and had a sterilisation. Not in that order.

Barring complicated medical issues, there really isn’t a huge amount to talk about year-in, year-out. Women often have a fair idea what sort(s) of contraception they’d like; it doesn’t take long to point out salient information, point out where to access more salient information, offer options, and do the relevant checks.

Dr Tina Peers, Consultant in Contraception and Sexual Health, said: “There is more choice than ever for women of all ages – there are actually 15 methods of contraception and as an example, there are over 20 different types of oral contraceptives available, but women in their 20s and 30s seem to be denying themselves the chance to make an informed choice. “

Newsflash: doctors aren’t the only source of information on contraception.

This whole article seems to be assuming that Dr J. Random GP is competent and up-to-date in their contraceptive knowledge in the first place, which is by no means a foregone conclusion. Often, you can access higher quality advice elsewhere.

And if the doctor-patient consultation length is not enough for the woman to make an informed choice, that doesn’t mean she is “denying herself” that chance. It takes two to tango. Are women always in control of medical consultations?

The reticence to speak about contraception with the doctor extends to women talking about it with people a little closer to home.

The research shows more than half of women (56%) say the person they’re sleeping with is not the person they’re most comfortable with discussing contraception.

And? I’d imagine many women are very, very comfortable indeed discussing contraception with their female friends. Or perhaps some are most comfortable discussing the details with their nurse, midwife, or even doctor. Does the sexual partner have to be the person a woman is most comfortable discussing contraception with? So long as it gets discussed in a functional way at some stage, what’s the problem?

There is a huge role for better contraceptive education for all genders, for more sex education for all genders (which is far, far bigger than instructing women about contraception), for discussing ways to achieve these things.

This article? Sneering at women? Making a baseline assumption that longer GP-woman chats are the optimal way to achieve contraceptive ed? No.

But while British women are not comfortable talking about contraception, they appear relaxed enough to go home with a partner relatively early in their relationship. A total of 39% of sexually active women say they went to bed with their most recent partner by the third date.

Now with a bonus slut-shaming sting in the tail! That sort of attitude couldn’t possibly have anything to do with women not sitting down for loooong fireside chats about their bodies and life plans and sex lives with health professionals, could it?

Well, could it?

Note: The Bayer pharmaceutical company is a major producer of contraceptive pills and intrauterine devices, contraceptive methods which require regular medical consultations and prescriptions. This is not noted in the article. “Nursing in Practice” magazine, additionally, appears to offer substantial advertising from pharmaceutical, medical device, and weight loss companies.

Categories: gender & feminism, medicine

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12 replies

  1. also: the quarter of people who haven’t talked to their GPs, did they ask if they’d been in for a routine check up? plenty of people don’t go to their doctor at all unless they’re badly sick because doctors are expensive. And when you are really sick is hardly the best time to say “..oh, and i’m worrying whether the pill is making me gain weight” or whatever.
    Also i don’t talk to my GP, i talk to the people at family planning. Does that count?

  2. ^ Exactly. I rarely go to the doctor at all, maybe twice a year. And I can and do consult family planning/health organisations for information about contraception. Why the hell would I ask my doctor about contraception unless something was going wrong with it? How fucking patronising.

  3. And kudos to the GP who won’t even write the referral for me to go and see someone so I can be sterilised. Apparently being female makes me unable to make THAT contraceptive choice until I am much older. I was sure at 18 in Australia I was considered an adult and fully capable of making my own decisions. Except, of course, when it comes to be a fucking incubator.
    /end rant.
    Sorry… contraception – I’ll invest in it when they invest in it being and equally available treatment.

  4. Bayer’s really been stepping up their advertising lately. I heard an ad of theirs on the radio recently about the ECP. It included the misconception that if you are on the pill and forget to take one, it’s ok as long as you don’t have sex that day. It also implied that it is all your *boyfriend’s fault* if the two of you have sex at any point in time. Hooray Bayer.
    It is good that the ECP is being advertised though.

  5. I live in a rural area and have been told (and know from some experience) there are no OB/GYNs in my town (and there are 3 that practice here) that will do an elective tubal ligation. There is also no one who will terminate a pregnancy unless it is an EMERGENCY (which of course means only if the mother is about to die).
    I had a chat with my Dr re contraception last time I was there. I don’t trust condoms, I don’t want anything put inside me via my cervix, I have seen too many failures of the implant and when I had the injections (years back now) I put on 30kg in 3 months (but of course that was because I am a lazy slob who eats too much, nothing to do with the medication…yeah…). My doctor doesnt want me on the Pill because of my weight and sometimes slightly elevated blood pressure. So what’s left? Not much…

  6. @bri You have nailed my problem right on the head. The pills almost caused me to have kidney failure, the injections tanked my thyroid, and there is no way I could afford to constantly go to the doctor about an IUD.
    So our sex life consists of a lot of frottage and fingers. Because I honestly don’t know if in the next ten years I would want to raise a child. I really wish this were simpler sometimes.

  7. With my Catholic sex ed I’ve found it hard to talk to *anyone* about contraception. Or safe sex. About a year ago I visited my local doctor’s surgery to discuss some other health related issues and I planned to also drop in the whole “I’ve been sexually active for a while – should I/how do I go about getting tested for STIs etc?” I felt like maybe it was time for a checkup but had no idea…
    I walk into my appointment and I have a youngish male doctor. I caught myself thinking “Oh dear…” and then silently reprimanded myself for being stupid. I tell myself he’s a professional, he must hear weirder questions all the time. So I ask. He *smirked*. I got zero information from him and left feeling ashamed.
    Not really a contraception story I know, but I think really indicitive of how difficult it can be as a woman to get any help from the people who should be your default starting point in all health related matters.

  8. Back in NZ, my doctors had several nurse practitioners on their staff, who used to do blood tests and vaccinations and first aid and smear tests and whatever. When I went in for my bi-annual smear test, whichever nurse was doing it would always ask whether I was happy with my contraception. I thought it was an excellent approach. Much less pressured than a doctor’s visit, and much less expensive (free!).

  9. Even when I was getting three monthly injections for contraception I don’t think we would have discussed it for more than ten minutes. We did when I first started because I was still breastfeeding, but once I’d been on it for six months then it was just – is this still working for you? You need the next one on this date and then the injection. You don’t need a deep and meaningful confab every time if it’s working for you.

  10. “plenty of people don’t go to their doctor at all unless they’re badly sick because doctors are expensive. ”
    Probably not a factor here, because it’s a British study, and they have the NHS.
    On a personal note, I don’t think I’ve discussed contraception with a doctor in the last five years, and as I don’t use anything that has to be prescribed at the moment, I don’t see why I *would* discuss it with a doctor.

  11. Medicare in Australia works on a similar vein to the NHS in the UK and seeing a doctor can still be costly here as not all doctors bulk bill, not all women have access to anywhere else to get their contraception (ie where I live there is no where but the dr to get prescribed contraception – no family planning or nurse practitioners or women’s health clinics etc). It can also take WEEKS to get in to see any doctor (let alone a good doctor of your own choosing) which also doesn’t help especially in terms of needing emergency contraception or terminations.

  12. The NHS and medicare are very different. As a patient under the NHS, you register with a GP and then you don’t pay anything. Full stop. You don’t even have to sign anything. (I always felt odd about that – the receptionists used to laugh at me when I finished with the doctor and thought there was something else I needed to do.) I’m also pretty sure NHS GPs are never paid on a fee for service basis, as they are under medicare. That’s a really important difference.
    Like here, it probably is also a lot more difficult in rural areas – but nowhere in the UK is as remote as parts of Australia.
    Another difference: prescribed contraceptives are free in the UK – at least, the pill and the contraceptive implant are, and I assume the depo shots are. Not sure whether IUDs are covered, but given the policy reasons behind the free other scripts, my guess is that they would be.
    However, my GP in the UK did not deal with contraception. Instead, there was a sexual health clinic (also NHS) in the town I was in. It was a little annoying, because it was a little out of town, and I had to have two appointments to get my implant replaced (initial consult and the actual exchange). On the considerable upside, it was completely free – whereas the same thing here would have cost me two consult gap payments (no docs around here bulk bill unless you’re a student, a pensioner or have a HCC) plus a script.
    I suspect the availability of sexual health clinics, EC availability at pharmacies and that sort of thing is also a contributing factor to women not talking to their GPs about contraception – as Lauredhel said GPs are far from the only source of good information (and not necessarily the best source of info).
    I have never spoken to my current GP about contraceptives because I have the implant and I’m happy with it. The only thing I’ve seen my current GP about at all is vaccinations (I updated a bunch over the past 6 months). When I’m due to change the implant, I think I’ll go find a different doctor – partly personal preference, and partly because I strongly suspect that my current one is not trained with the implant.

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