Newspaper article International Herald Tribune

Bridging a Major Gap for Women ; Doctors and Patients Don't Know Enough about Birth Control Options

Newspaper article International Herald Tribune

Bridging a Major Gap for Women ; Doctors and Patients Don't Know Enough about Birth Control Options

Article excerpt

Women often encounter problems when the birth-control method they had been using no longer works well for them.

The United States has one of the highest rates of unwanted pregnancies in the developed world -- nearly half of pregnancies here are unintended, and there has been no improvement in the situation for a decade.

Why? For one thing, women often encounter problems when the birth- control method they had been using no longer works well for them. Many women and their doctors are poorly versed in the wide array of effective choices and how to switch from one method to another without risking pregnancy.

Women choose to switch with surprising frequency. In a study of contraceptive switching rates, researchers at the Battelle Centers for Public Health Research and Evaluation concluded that "many women are probably dissatisfied with their experiences with particular methods." With discontinuation rates as high as 90 percent for some methods, the researchers found that 40 percent of married women and 61 percent of unmarried women in the study had switched methods over two years.

Disturbingly, the researchers also found that "about one in 10 women choose to abandon contraception altogether, even while they are at risk of an unintended pregnancy."

Most women get contraceptives from family doctors and health clinics, not from gynecologists who are presumably well informed about choices and can help women select a method, or two methods, best suited to their circumstances. Without proper guidance on how to make these changes safely, gaps often occur in contraceptive protection that can result in an unintended pregnancy.

A variety of issues can affect a woman's contraceptive choice and prompt her to change it or abandon contraception, said Ruth Lesnewski, a family physician who directs the nonprofit Reproductive Health Access Project in Manhattan. Among them:

- A change in life circumstance, like a new relationship, a new job with different insurance or a move to another city where she has to find a new doctor.

- Among unmarried women, a change from sporadic sexual relations to a more serious relationship, or vice versa.

- Side effects from a current contraceptive, prompting a woman to stop using it, sometimes without telling her doctor or asking for an alternative. …

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