Conversations about contraception : GPs, and access to the Pill

The Pill is amazing. Increased sexual freedom and a super low risk of unplanned pregnancy? Yes please. It can also help irregular and painful menstrual cycles, reduce acne, control weight gain, and assist in managing the effects of PCOS (polycystic ovarian syndrome). See? Amazing. But making decisions about contraception is not always easy. With more contraceptive options appearing every few years, we rely on health care professionals to give us the right information so we can make the best choices. I spoke with some wonderful women this week and, like me, their experiences navigating this tricky issue have been mixed.

I was eighteen, with a newly acquired provisional license, newly acquired access to a parental vehicle and a newly acquired ‘serious’ boyfriend. I believed I had the whole adulthood thing well under control. My boyfriend and I had been having sex for a few months, always using condoms, and being properly adult about it. Then, we decided that perhaps condoms weren’t the best option for us. I don’t recall this conversation exactly, it probably involved condoms being inconvenient, mood-killers, embarrassing to buy and presenting considerable risk of discovery by snoopy mums (both of them knew the entire time. Of course). The Pill presented almost none of these problems, so I made the final decision to get a prescription.

It was a very windy, rainy, grey day. My boyfriend and I had an argument about parking, and there was the customary twenty-minute wait in a room with a loud, mostly empty fish tank that made me need to pee. Finally, I was called in. I left my boyfriend with the annoying fish tank. This was my family doctor; he had come to my house when I was four to give me needles, I’d known him for as long as I could remember. He was very tall, curly red hair going grey, tiny glasses with no rims, and a frown. He began by asking about my career goals. A degree in Japanese and politics did not impress him, ‘what job do you think you’ll get with that?’, I wondered how this was relevant. Then he asked what I was there for and I told him I wanted to go on the Pill. ‘Do you know how it works? No?’ an exasperated sigh, followed by a cursory explanation, and a list of possible side effects, none of which seemed relevant to me. This doctor scoffed when I told him my boyfriend was in the waiting room instead of in the appointment with me, he congratulated me on only having had sex with one person, he asked if I wanted a pill that helped with weight gain, looked me up and down and said, ‘probably not necessary’. I left with my prescription, feeling equal parts defiant and belittled, wondering if all GPs were like this when it came to contraception.

I had some amazing and enlightening conversations with a wonderful group of women this week. Most were a little taken aback when I asked them about contraception, but they all had stories to share and were very happy to discuss them with me. The interaction I had with that GP was unusual. Most of these women’s experiences were overwhelmingly positive, and most of the health care professionals were exactly that – professional. But, it did seem as though this habit we are in, of contraception being a secret act, hidden in our handbags and stuffed in bedside tables, might be damaging to women when we deal with doctors. Almost all of the women I spoke to had to go through a lot of trial and error to find the right contraceptive method for them, a process which could be considerably shorter if the discourse between women and their GPs was a more open one. One woman told me that she was on one type of the Pill for almost two years, then went to a GP because she was suffering from migraines. This new doctor told her to immediately stop taking the Pill because she was drastically increasing her risk of stroke. This is an extreme example, but it shows the huge importance of us being able to ask the right questions, and GPs giving women the necessary information.

Amongst the women I spoke with, there did seem to be an underappreciation of the potential severity of side effects from the Pill, especially about one of the most common side-effects; an increased risk of blood clots. This is the side-effect that could have given my friend a stroke, and there seemed to very little awareness of it. A couple of women described having their blood pressure taken, but weren’t sure why GPs did this. Until recently, I was the same. I too had felt I wasn’t at risk of blood clotting – that’s only for older people right? And yet, in a recent appointment I was told I should be very careful on my upcoming long-haul flight because of this high risk of blood clots. Baby aspirin and flight socks, you are my future, my very near future. I am very grateful that this GP was able to give me this information, and it made me seriously consider stopping taking the Pill.

Since I was eighteen I have been on and off many different types of the Pill and I’ve dealt with different symptoms with almost every one. I still don’t think I’ve found the right one for me. We rely on our health care professionals to treat us respectfully and to give us the information we need, and this requires openness and willingness to discuss different options, on both sides. Writing this article made me realise that this attitude needs to start with our friends. I learned a lot from these great women, and sharing our experiences with different contraception will be better for us all in the long run. Who knows, perhaps I’ve even inspired someone to purchase some flight socks for their next adventure.

Image: Jamie


One Comment

  • Saskia Ascui commented on June 29, 2016 Reply

    Thank you Hannah. Even I didn’t know the side effect of blood clots.

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