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Breaking the Contraceptive Barrier: Techniques for Effective Contraceptive Consultations

(Published September 2008)


Health care providers fill an important role in helping women break contraceptive barriers that can and do lead to unintended pregnancies. The first step is to recognize the barriers—various types of personal or partner beliefs, contraceptive knowledge, the media, sexual education in the United States, and barriers in the health care system such as delayed start of contraception and costs. With an awareness of these barriers, health care providers can incorporate strategies for addressing them into the health care services they provide. These strategies, tailored to the individual, can help women make the best contraceptive choices and avoid experiencing an unintended pregnancy.

Top 10 strategies for breaking contraceptive barriers

  1. Use Quick Start for appropriate patients as often as possible to help women start contraception and prevent unintended pregnancy.
  2. Ask patients about insurance limitations when writing Contraceptive prescriptions. Write oral contraceptive (OC) prescriptions to dispense three months at a time and give refills for one year.
  3. Screen all patients for rape and violence, especially as it may affect rates of unintended pregnancy and abortion.
  4. Use active listening—allow patients to speak without being interrupted so that they can state their concerns.
  5. Address barriers to availability of information and services. Provide attractive take-home materials at an appropriate reading level and a welcoming office or clinic environment with after-school and after-work appointments, when possible.
  6. Educate patients about the most effective contraceptive methods, including emergency contraception.
  7. Think of every interaction with patients, not just annual visits, as an opportunity to discuss contraception.
  8. Encourage both partners to be active participants in contraception; this creates shared responsibility, joint decision making, effective contraception, and some protection from sexually transmitted infections (STIs).
  9. Recognize that stopping or changing contraceptive methods can lead to an increase in the risk of unintended pregnancy. Many women change from using an effective method to using a method they cannot or do not use effectively, or to no method at all.
  10. Don’t be afraid to be “prescriptive”. If the patient asks for your advice, give her a recommendation.