VIDEO: How to start conversations about birth control with patients

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Hello, my name is Dr. Jamila Perritt. I am a board-certified obstetrician and gynecologist. And one of the most difficult conversations that folks have in our offices is around how best to talk to our patients about birth control.

There is so much stigma and judgment shrouded in reproductive health care decision-making that patients can be nervous, doctors can be nervous when they come in. And then there’s also just a really deep history, often of mistrust of health care providers, specifically and particularly when it comes to reproductive health care. We know that there is a long history of misuse and abuse at the hands of health care providers for many communities, including and in particular, Black, Indigenous and other people of color. And so, when people show up to see us in our offices, they’re bringing all of that history with them, along with often lots of fear around being able to engage in the conversation and get what they need.

When I’m talking to my patients about birth control, I began with an open conversation, seeking to find out what they need and what they’re looking for. As doctors we’re often trained that when someone comes in looking for birth control, then what they want is something that is the most effective, the most efficient, that is going to eliminate their chances to get pregnant for X amount of time. And while for many people, that is an important priority, that is not at the top of everyone’s priority list. And so, beginning those questions about what they’re looking for in birth control is really a critical place to start. For some people, they simply want to lessen the pain and bleeding during their periods, for example. And so, talking about that as a strategy is an important part. For many people, it may be they want to eliminate their period altogether. For others, they want to have a regular period every month. We do not know and will not know unless we are direct and open and make space for our patients to ask questions. And for us to really understand that this person is the expert in their own life. I can certainly offer you medical and scientific information, but I can’t tell you what you need and what you want. I need to hear that from the person that I’m caring for.

So, beginning these conversations in a really open way, in a respectful way, in a non-stigmatized way, is the only way to get what you need as a patient, but also to provide the care that we are here to give as health care providers.