PRESSURES ON THE DOCTOR – MEDICAL METHODS OF CONTRACEPTION

Posted on Tuesday, April 7th, 2009 at 6:56 am

It is perhaps inevitable that the doctor identifies or becomes identified with the medical methods of contraception so that when they me rejected he or she feels rejected too. This can lead to a feeling of uselessness and inadequacy with a sense that there is nothing to offer the patient. In this situation there is a risk of a retaliatory response, either dismissing the patient or attempting to impose a method against her wishes. In that case contraceptive pills are likely to be lost, intrauterine devices pulled out or the patient fails to return.

In these days of clinical audit, when successful contraceptive practice is measured against a fall in the number of terminations, the doctor may feel that all unintended pregnancies must be stopped. Acceptance that not all such pregnancies can be prevented nor every child a wanted one is something the doctor will need to come to terms with. Helping a woman to delay her next child by a few months may be a major achievement, especially if she is struggling with serious internal conflicts or a chaotic lifestyle. Taking time to create a relationship of trust and understanding, rather than one of nonproductive authoritarianism, may well pay dividends in the long run, and the doctor should not feel too much of a failure if there are some contraceptive mishaps along the way.

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