Doctors and Birth Control

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I think I would try to find another doctor if I would constantly hear the advise of taking the pill for contraceptive reasons, as I would doubt the medical skills of this person - I don´t need to be religious to be against a hormonal bomb with huge side effects.
I was never ask to take the pill for contraception.
 
I had hard time explain why…and don’t explain my religious convictions.

I faced insitent and too deep questions for the midwife after the birth on the topic of birth control, sex and previous relationship.
And the unfunded assumption that we can have 2 babies in 1 year… because of LAM/NFP
 
Anicette said:
And the unfunded assumption that we can have 2 babies in 1 year… because of LAM/NFP
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LAM is not a guarantee, some women follow every single LAM rule and their fertility returns in a few weeks. This is not an “unfounded assumption”.
 
Professional ethics guidelines say that doctors, nurses, and midwives must respect and work with the values of the patient. (At least, this is the case for American and Canadian practitioners.) If your practitioner continues to press you about birth control after you’ve made it clear that you don’t want to discuss it, you can complain to the practice or switch practices. You should never feel intimidated about discussing your needs and wishes with your doctor or nurse.

If you don’t bring values into it, if you say something like “I don’t want to dump a bunch of hormones into my body,” the doctor might discuss the risks and benefits of various hormonal methods (some of which are very low-dose), might point you toward nonhormonal methods such as the copper IUD or condoms or diaphragms, or might otherwise continue the conversation because they are trying to act in your best interests (as they perceive them). It is much better to explain upfront that you simply are. not. interested, and shut the conversation down if they keep pushing.
 
heidi_storage said:
Actually, I think keeping the conversation to “These are my values, this is what I find acceptable” is going to be a lot more effective than arguing about medical detriments. If your practitioner doesn’t treat you with proper respect for your decisions, find another. Doctors and nurses are supposed to work with the patient’s values, not impose their own; an ob can think you’re a dummy for not getting an IUD, but it would be grossly unethical to attempt to pressure you into one.
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Right.

And you don’t even need to talk about values. You can just say, “This is what I’m doing.”

I’ve had non-NFP OB/GYNs for the last 16+ years, and NFP/not using birth control has never been a big deal. It helps a lot if you look confident and contented.
 
The Little Lady,

I want to say “unfunded assumption” in my life, because it wasn’t the case.

The professional didn’t speak of LAM, but NFP. She know of course LAM, but like the majority of praticionners in the Western contries (or at least mine) don’t see it as a method. Or just something for undevelopped contries, and not adapted for our way of live.
They just don’t see the point of letting a couple choose this temporary method.

And even if she didn’t know how NFP works, she believes that it was risky. And she made her due in writting it in my medical file to protect herself.

For LAM efficiency,
  • it’s pretty the same efficiency as NFP (98% for preventing PREGNANCIES for sexually active women. NOT for preventing fertility return! - it makes a difference!). (source: WHO).
  • of course we all know a woman who breatfeeding and follow every single rules of LAM and have her period come back after less than 2 mouths…
  • the method stopped when period returned. And one of the efficacity of this method, is that it in great majority suppressed ovulation prior the first period before the 7th month. After 6 months, there is greater chance of ovulatrion prior the first period. LAM is plan A. And the woman, who should have in mind a plan B could now act differently, or see her health pratitionner for a prescription.
  • the rate of sexaully active women who fall pregnant before the first period while brestfeeding in natural situations (in societies with no contraception) is of 5 or 6%.
    Because pregnancy requires an ovulation, but also a adequate luteal phase, and this phase could be too short, for the first months.
    Of couse, we all know a woman who had fallen pregnant before her first period…
  • when the woman is not suprised her a period very short after the birth (and she could also take a post-partum bleeding, that occurs during the 56 days post-partum, for a period, as for me), and she already familiar with self-observation, she will feel signs that indicate that her follicular activity become to resumes, even before having an ovulation: mucus, end of dryness, libido…(for me, more than 1 mounth before period). So she will don’t be surprised. And if she is carrefully, she can also see signs of fertility.
    And even a woman who had never practice NFP can see thoses signs.
  • It seems that women in developped contries have fertity that come back shorter than in others countries. (hyothesis of a link with food available). And it is establised that in traditionnal societies the annhenorhea can be much more longer (link with mothering, and particular way of life, food, activity).
  • proximal mothering offers the best chances for breastfeeding success and even fertility delay. But it is not a guarantee.
  • for the women who had very quick period come back, recently a link had been found with a particular hormonal profile since the pregnancy.
I will not give my sources here, because they are in French. But I can quote some LLL links, and John and Sheila Kippley research.
I can give others sources on request by PM.
 
I have a solid understand of LAM.

It is not something that happens for every woman.
 
A lot of GP/Family Practice physicians defer GYN care as they consider it a specialty. It’s really common in areas with a wide availability of specialists, just like it’s common in areas with limited specialty care for them to offer limited GYN care. Internists are the same way - they might or they might not. Most don’t.

GPs usually have such a busy schedule that GYN care can add too much to the load.

OB care is rife with liability, usually requires or highly recommends a separate malpractice policy (and it’s expensive!), and is usually referred out.

Wanted to add that it really annoys me when I hear about pushy health care colleagues on any front, for any reason. Patients have rights, and the provider should listen to whatever it is the patient has to say on any subject regarding their own care.
 
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Pup7 said:
A lot of GP/Family Practice physicians defer GYN care as they consider it a specialty. It’s really common in areas with a wide availability of specialists, just like it’s common in areas with limited specialty care for them to offer limited GYN care. Internists are the same way - they might or they might not. Most don’t.

GPs usually have such a busy schedule that GYN care can add too much to the load.

OB care is rife with liability, usually requires or highly recommends a separate malpractice policy (and it’s expensive!), and is usually referred out.

Wanted to add that it really annoys me when I hear about pushy health care colleagues on any front, for any reason. Patients have rights, and the provider should listen to whatever it is the patient has to say on any subject regarding their own care.
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Yeah. If you’re pregnant in my area the GP’s won’t even see you for a cold. I went to urgent care while pregnant because of a minor laceration and urgent care almost sent me to the ER because they did not want the ‘liability’ if something happened. In areas with “good” medical care, primary and generalists get really touchy about treating anything that could be a specialty. Often to the point of silliness…
 
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With OB it’s not silliness. It’s a reluctance to assume risk that they’re not covered for and may not be trained to assume.

People are sue-happy. Entire OB departments have disappeared because the malpractice costs are too high. I can’t blame a GP for being hands off of a pregnant woman. Same with an awful lot of specialty care. Some of it is ridiculous - but a lot is driven by fear of liability.
 
Pup7 said:
People are sue-happy. Entire OB departments have disappeared because the malpractice costs are too high. I can’t blame a GP for being hands off of a pregnant woman. Same with an awful lot of specialty care. Some of it is ridiculous - but a lot is driven by fear of liability.
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I suspect it’s a pretty serious job to stay on top of what is supposed to be dangerous to pregnant women–the list is ever-growing.
 
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Xantippe said:
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Pup7:
People are sue-happy. Entire OB departments have disappeared because the malpractice costs are too high. I can’t blame a GP for being hands off of a pregnant woman. Same with an awful lot of specialty care. Some of it is ridiculous - but a lot is driven by fear of liability.
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I suspect it’s almost a pretty serious job to stay on top of what is supposed to be dangerous to pregnant women–the list is ever-growing.
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You just hit the nail on the head. An OB will know the very latest. A GP might not, because that’s not their area of expertise.

I used to see similar things within oncology. Once you’re diagnosed with cancer, your oncologist pretty much becomes your Everydoctor. We managed transplant drugs, chemotherapy, lab values, electrolytes - and all of that can be affected by whatever crud you’ve caught this week, whether you’re actively receiving therapy or are in remission.
 
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Pup7 said:
With OB it’s not silliness. It’s a reluctance to assume risk that they’re not covered for and may not be trained to assume.

People are sue-happy. Entire OB departments have disappeared because the malpractice costs are too high. I can’t blame a GP for being hands off of a pregnant woman. Same with an awful lot of specialty care. Some of it is ridiculous - but a lot is driven by fear of liability.
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I didn’t say the OB was silliness but a good part of it is. Liability fear is one, but in my area love of specialists means that GP’s just lose the skills in–well general diagnosis. They’ve basically set up a system where a GP is almost more of a care manager–able to pull the data from the other doctors and oversee everything. This is especially the case for my elderly grandparents. The GP and oddly enough the pharmacist are the ones who ensure that all the specalist care works well together.
 
Xantippe said:
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Xanthippe_Voorhees:
The GP and oddly enough the pharmacist are the ones who ensure that all the specalist care works well together.
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I suppose for pregnant ladies, the OBGYN is that person.
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Pretty much. My OBGYN has always acted more like a pregnancy GP. They sent me to their own specialists when I needed more care. Not sure my GP would have even known of those specialists.
 
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A GP is a care manager for certain. Current systems are modeled on patient centered care to ensure there’s continuity of care and an avoidance of care duplication. We do this inside the military as well.

I didn’t mean you thought OB was silly…that came across terrible, and I didn’t mean that as pejorative as it seemed.

Clinical pharmacists run Coumadin clinics, immunizations, and as the drug experts are now central to a medical care team (as well they should be). When you’re managing sicker and sicker folks and folks with more and more complex problems, you need to balance medications effectively. The pharmacist is the expert here, and they’re finally getting their day in the sun.
 
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So I had my appointment and birth control did come up, but I froze and didn’t mention that I don’t want it. I’ll do it at a future visit though. The doctor seems to think it’s the best way to regulate cycles. Is this true? Why are they so quick to push birth control on women?

I’m thinking of going to a Napro Dr. for my fertility in the future, but for now, I’m just going to do my own research.
 
I’m sorry. You do have to speak up. Maybe bring someone else with you to the appointment? You should do what you need to do for your health.

Doctors are quick to push birth control on women because it has several benefits:

–Periods are more regular, and often heavy or painful periods are improved.
–Although hormonal contraceptives increase the risk of breast cancer, they decrease the risk of other cancers that are more problematic to find and treat.
–They are pretty reliable birth control, and they don’t require too much effort (as NFP does)
–They are pretty safe for most women, especially nonsmokers (they do raise the risk of heart attack, stroke, and blood clots, but not by much)

Now, don’t everyone descend to explain why hormonal contraception is bad for you–I’m not pushing hormonal contraception myself–I’m just explaining why doctors like to promote it.
 
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