A thread about contraceptive options:

One of my fave things is providing people w birth control. Whether for heavy periods, acne, PMS, or pregnancy prevention (or more than one reason), my goal is to help interested patients find an option that fits their needs and desires

I’m a @Bedsider stan and I pull out their visual guide and tell patients, “this is the birth control menu. There is no perfect option for everyone, but together, I hope we find one that works for you. Trying a method is also a learning process. If you don’t like it, let’s talk.”

“I can’t look in a crystal ball and tell you if you’ll have side effects and exactly what they’ll be. You and your body are the expert on what does and doesn’t work for you. If you are interested in another method, we can try something else and see how it goes.”

“Here’s what I know: how each one works and the common side effects.” Then I walk them through the options. Some are ready to make a decision day of, others want time to think. I offer accurate websites like @powertodecide and Young Women’s Health to read more and compare options

I take such a broad approach because LARCs are amazing, but they’re not for everyone. I left my med school lecture feeling like IUDs were contraceptive perfection. Super effective, long-lasting, and can induce amenorrhea?! Sign me up! I enthusiastically got one on my GYN rotation

For months, I thought I was just experiencing usual side effects until the strings felt longer. I got an expensive US to discover it was impartially expulsed . My dream contraception failed. Since my expectations were so high, the news led to a breakdown in the doctors office.

Since then, I’ve heard talks about how commonly expulsion can occur and I felt less alone. I ultimately found a birth control option that works for me and I’m satisfied. I want my patients to feel the same way. From my reading and time with pts, I see birth control is personal.

Patients with heavy bleeding +/- cramps often have sisters and mothers who went through the same thing. They have concerns to address & experience with what worked for them. When families ask about how birth control impacts fertility or express concern abt side effects, I listen.

Regardless if research supports their concerns, I know there’s historical trauma behind those inquiries. Laughing them off or dismissing them only adds to that. Instead, I make sure I respond to everyone with patience and our current scientific knowledge. That’s my job.

My dad’s college selection advice applies here. My parents gave me complete control to decide. Why? My dad said, “no matter where you go, you may hit a tough time. That’s life, but you’ll get through it knowing that you made the decision to go there because it was right for you.”

It should be the same for contraception. Patients should make their own choices. Thankfully, many people like what they choose. If they don’t, they can move on knowing they made the best choice for themselves at the time. Any type of provider influence gets in the way of that.

Final thought: the director of a community clinic told me, “your medical knowledge is a privilege. Without it, patients don’t have the info they need to fully care for their bodies. Your job is to level that playing field by giving it to them and letting them make decisions.”

Appreciate the work of @DorothyERoberts, @Reprorightsdoc, @doccrearperry ( #CiteBlackWomen) for their work in this space and @Virginia_B_MD for being an inspiration on how to address these topics in medical education.