Original research articleUse of contraceptive methods and contraceptive recommendations among health care providers actively involved in contraceptive counseling — results of an international survey in 10 countries☆
Introduction
Women currently enjoy a range of contraceptive options. How they choose the method most suited to them and their life situation is still not completely understood. Preferred methods differ significantly in different countries, and while this may reflect cultural influences, cost and accessibility, availability or perceived risk to benefit ratios of different methods may also influence contraceptive choice. Just how much health care providers’ (HCPs’) personal experience with contraceptive methods influences the dialogue is little known. We were able to identify only two studies which explore this topic in the literature, both from the United States. The first, a recent study on postabortion contraception, reported that personal intrauterine contraceptive (IUC) use by clinic staff members was independently associated with the decision to use an IUC [1]. In an earlier study, physicians' personal oral contraceptive or postmenopausal hormone therapy (HT) use was shown to affect their patient counseling practices [2]. Postmenopausal physicians who took HT and premenopausal OC-using physicians intending to take HT were significantly more likely to counsel their patients to use HT [2]. Thus, presently, there are little data to address whether personal contraceptive choices and experience of HCPs could influence contraceptive counseling.
In other clinical encounters, physicians’ personal behaviors have been found to influence their counseling practices. Patients seen by a physician who is a cigarette smoker were less likely to report stop-smoking advice than patients seen by a nonsmoking physician [3]. Physically active internists were more likely to counsel about the importance of physical activity than those not physically active, and nonsmoking internists were more likely to counsel about smoking cessation than those who smoked [4]. Primary care physicians who ate a low-fat diet and had had their cholesterol checked were more likely to recommend dietary modification to patients with mild cholesterol elevation than those who did not do so [5]. Each of these examples shows that the personal practices of HCPs influence their advice and prescription to patients.
Due to the paucity of data regarding this issue, the present survey was designed to examine current contraceptive choices and recommendations in a diverse international population of HCPs and to see if personal choices were concordant with practice recommendations.
Section snippets
Subjects and methods
An anonymous online survey was conducted between August and October 2011 and involved 1001 male and female HCP contraceptive prescribers: obstetrician/ gynecologists (OB/GYNs, N= 672), general practitioners (GPs, N= 314) and midwives (N= 15, in Sweden only). GPs were not recruited in the following countries, where contraceptives are primarily prescribed by OB/GYNs: Brazil, Germany, South Korea and Spain.
To be eligible, HCPs had to be aged between 25 and 55 years, involved in contraceptive
Results
To reach a sample of 100 HCPs per country (101 in the UK), 5888 HCPs were contacted. The baseline characteristics of HCPs who participated in the survey (N= 1001) are shown in Table 1. There were slightly more female than male participants, and the average time spent in direct patient care was more than 90%. The gender distribution did not differ between the two HCP groups (GPs and OB/GYNs), but more GPs belonged to the youngest age group (25–35 years) than the OB/GYNs (25.2% vs. 15.5%), and
Discussion
To the best of our knowledge, this is the first survey to report HCPs’ personal contraceptive use and contraceptive recommendations in an international setting.
In this multinational survey of HCPs involved in contraceptive counseling, the LNG-IUS was the most used method in all countries, except for Canada and Australia, where COCs were more commonly used, and Mexico, where condoms were the most frequently used method. Among the HCPs with current contraceptive use (by themselves or by their
Acknowledgments
The authors thank Ipsos Inc. for providing the survey databank for this publication.
References (15)
- et al.
Effect of shared contraceptive experiences on IUD use at an urban abortion clinic
Contraception
(2012) - et al.
Physician advice to quit smoking: who gets it and who doesn't
Am J Prev Med
(1987) - et al.
Contraceptive usage patterns in North American medical students
Contraception
(2011) Contraceptive use by female physicians in the United States
Obstet Gynecol
(1999)- et al.
Contraceptive practices of female physicians
Contraception
(1986) - et al.
Ethnic Korean women's perceptions about birth control
Contraception
(2006) - et al.
Clinical and personal relationships between oral contraceptive and hormone replacement therapy use among US women physicians
Menopause
(2003)
Cited by (34)
Intrauterine Contraception: Underestimated and underutilized
2017, Journal of Obstetrics and Gynaecology CanadaDifferences in contraceptive use between family planning providers and the U.S. population: Results of a nationwide survey
2015, ContraceptionCitation Excerpt :For three decades, it has been widely cited that female physicians choose intrauterine contraceptives (IUCs) at a higher rate than the general population [1,2]. A 2012 international study of physicians and midwives generated similar findings, with 36.9% reporting use of an IUC [3]. Various factors, including contraceptive access and knowledge, have been suggested to explain providers' higher use of these methods.
Understanding the barriers and myths limiting the use of intrauterine contraception in nulliparous women: Results of a survey of European/Canadian healthcare providers
2014, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :The strengths of this survey included the following: it was designed for simultaneous administration in different countries; the questionnaire was translated into local languages and tested locally for comprehension before roll out; only healthcare providers who were active in the provision of contraceptive counseling were surveyed; and in each country different types of healthcare provider were recruited in ratios that reflected the types of provider who provide contraceptive counseling. The methods of contraception that HCPs and their partners use themselves and the methods of contraception that they recommend to their patients has been studied in a multinational online survey [28]. Among 1001 male and female HCPs involved in contraceptive counseling, the method they/their partner most commonly used personally was the LNG-IUS.
The use of LNG-IUS-19.5 mg in daily gynecological routine practice in Germany: data from the Kyleena™ Satisfaction Study (KYSS)
2024, Archives of Gynecology and Obstetrics
- ☆
This study was partially funded by Bayer Healthcare; however, the authors did not receive any honorarium or assistance in manuscript preparation.