Does structured counselling influence combined hormonal contraceptive choice?

• Published in: The European journal of contraception & reproductive health care 2011-12, Vol.16 (6), p.418-429
• Main Authors: Merckx, Mireille, Donders, Gilbert G., Grandjean, Pascale, Van de Sande, Tine, Weyers, Steven
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Attitude of Health Personnel; Belgium; Birth control; Combined hormonal contraception; Combined oral contraceptives; Confidence Intervals; Contraceptive Agents, Female - administration & dosage; Contraceptive Devices, Female; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Counseling; Counselling; Cross-Sectional Studies; Female; Gynecology; Humans; Male; Middle Aged; Patient Education as Topic; Patient Preference; Portugal; Preferences; Reproductive health; Surveys and Questionnaires; Transdermal Patch; Vaginal contraceptive ring; Womens health; Young Adult
• ISSN: 1362-5187; 1473-0782
• DOI: 10.3109/13625187.2011.625882

ABSTRACT Objective To assess the effect of structured counselling on women's contraceptive decisions and to evaluate gynaecologists' perceptions of comprehensive contraceptive counselling. Methods Belgian women (18-40 years old) who were considering using a combined hormonal contraceptive (CHC) were counselled by their gynaecologists about available CHCs (combined oral contraceptive [COC], transdermal patch, vaginal ring), using a comprehensive leaflet. Patients and gynaecologists completed questionnaires that gathered information on the woman's pre- and post-counselling contraceptive choice, her perceptions, and the reasons behind her post-counselling decision. Results The gynaecologists (N = 121) enrolled 1801 eligible women. Nearly all women (94%) were able to choose a method after counselling (53%, 5%, and 27% chose the COC, the patch, and the ring, respectively). Counselling made many women (39%) select a different method: patch use increased from 3% to 5% (p < 0.0001); ring use tripled (from 9% to 27%, p < 0.0001). Women who were undecided before counselling most often opted for the method their gynaecologist recommended, irrespective of counselling. Conclusion Counselling allows most women to select a contraceptive method; a sizeable proportion of them decide on a method different from the one they initially had in mind. Gynaecologists' preferences influenced the contraceptive choices of women who were initially undecided regarding the method to use.