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Public health workers, clinicians, and researchers have tried to increase long- acting reversible contraceptives (LARC) use by changing contraceptive counseling between patients and providers. Several major health organizations now recommend tiered-effectiveness counseling, in which the most effective methods are explained first so that patients can use information about the relative efficacy of contraceptive methods to make an informed choice. Some scholars and practitioners have raised concerns that given histories of inequitable treatment and coercion in reproductive health care, tiered-effectiveness counseling may undermine patient autonomy and choice. This Clinical Opinion examines the development of tiered-effectiveness contraceptive counseling, how its rise mirrored the focus on promoting LARCs to decrease the unintended pregnancy rate, and key considerations and the potential conflicts of a LARC-first model with patient-centered care. Lastly, we discuss how reproductive justice and shared-decision making can guide efforts to provide patient-centered contraceptive care.
This article was published in the following journal.
Name: American journal of obstetrics and gynecology
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A randomized trial comparing LARC uptake and satisfaction after either video or conversational-based contraceptive counseling for pregnant women in labor.
The rate of success or failure of a method of CONTRACEPTION; CONTRACEPTIVE AGENTS; or CONTRACEPTIVE DEVICES.
Counseling during which a professional plays an active role in a client's or patient's decision making by offering advice, guidance, and/or recommendations.
Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)
Assessment of the quality and effectiveness of health care as measured and directly reported by the patient.
Surveys that measure the usage rate of CONTRACEPTIVE DEVICES or CONTRACEPTIVE AGENTS.
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