Physician Dispositions Toward Noninvasive Non-Hormonal Contraception

Abstract

Introduction. Evidence-based, nonbiased, counseling on contraceptive options, followed by shared-decision making, is key in facilitating reproductive justice in a diverse population. An estimated 3% of contraceptive users in the United States use fertility awareness-based methods (FABMs) for contraception, and demand for these methods is increasing. FABMs can be a highly effective form of family planning when used in accordance with evidence-based protocols. They are preferred by some patients due to medical contraindications to hormonal contraceptives, lack of side-effects, religious convictions, preference to avoid hormones or contraceptive devices, improved body literacy, or a combination of the above. FABMs are infrequently covered in medical school curricula and are often perceived by physicians to be of low efficacy. There is an opportunity for improvement of physicians’ evidence-based knowledge of FABMs, which has the potential to improve patient understanding of and access to the full menu of family planning options.

Methods. A self-administered, cross-sectional survey was distributed to assess physician knowledge and opinions of FABMs. Univariate and bivariate statistics were calculated for close-ended questions and responses to open-ended questions were analyzed for common themes.

Results. Of questions assessing knowledge of key concepts underlying FABMs, performance by specialty was 55% correct for OB/GYN (n = 16), 55% correct for family medicine (n = 47), 36% correct for internal medicine (n = 10), and 35% correct for pediatrics (n = 6). Negative, neutral, mixed, and positive opinions related to FABMs were represented.

Conclusions. There are opportunities to improve physicians’ evidence-based knowledge of FABMs; this may improve patient-centered contraceptive care.