Doctors Not Telling Women About Plan B

Emergency Contraception: If Women Don't Ask, Doctors Don't Tell

(WebMD)  Despite widespread misinformation about emergency contraception — the so-called morning-after pill — only 3% of women's doctors discuss Plan B with them.

The finding comes from data collected during face-to-face interviews with 7,643 women aged 15 to 44. The interviews were conducted in 2002, when emergency contraception was available only by prescription. Yet only 3% of women said their doctors discussed the issue with them.

Even when women saw a gynecologist for a Pap test or pelvic exam, only 4% received emergency-contraception counseling, find University of Pittsburgh researchers Megan L. Kavanaugh, DrPH, and Eleanor Bimla Schwarz, MD.

"A lot of women, and the American public in general, are very misinformed about what emergency contraception is, how to use it, and how to access it," Kavanaugh tells WebMD. "Yet counseling about emergency contraception really is missing from the clinical encounter, especially for young women, low-income women, and minority women."

There was also good news from the survey. The researchers found that 73% of women who had used emergency contraception had used it only once. The finding shows that women are truly using the "morning-after pill" for emergencies, and not — as some had feared — for routine birth control.

Women were more likely to have used emergency contraception if their doctors had told them about it. But the small number of doctors who have such conversations with their patients rankles David M. Plourd, MD, assistant professor of obstetrics and gynecology at San Diego's Naval Medical Center and clinical instructor at the University of California San Diego. Plourd was not involved in the Kavanaugh study.

"This is abysmal. It is embarrassing [that] the numbers are so low on women getting this crucial information from their gynecologists," Plourd tells WebMD. "I just don't know the downside of emergency contraception. The upside is preventing terminations and unintended pregnancies."

Plan B 'Special' on Birth Control Menu

Nearly all of the FDA's outside advisors, including a 2003 expert advisory panel, urged the agency to make the emergency contraceptive Plan B available over the counter. But the agency delayed making a decision until 2006 — and then it ruled that Plan B could be sold without a prescription only to women aged 18 and older. Prescriptions are still needed by women aged 17 and younger.

On the menu of contraceptive options doctors offer to women, Plourd says Plan B is like an off-the-menu special.

"A woman has a menu of contraception options," Plourd says. "It is my job, as the 'waiter,' to help her understand what is on that menu — and to tell her that emergency contraception is one of the best things we have, but it is not on the menu. It is my job not to tell her what to order, but to tell her about what we have to offer."

Plourd says he tells his patients about emergency contraception during their annual checkups. He wants all his sexually active patients who do not want to get pregnant to keep Plan B on hand, just in case.

"Emergency contraception is like a fire extinguisher. If your house catches fire, this is not the time to go out and buy one," he says. "And if you have a contraceptive failure or, God forbid, you are involved in a nonconsensual sexual act, there is Plan B."

Many women, Kavanaugh says, confuse Plan B with the abortion pill RU-486 (Mifeprex). Plan B does not cause abortions. When it does not work, a woman has a normal pregnancy. When it does work — which, according to Plourd, is 75% of the time — it either prevents sperm from fertilizing an egg or prevents the fertilized egg from implanting into the womb and becoming a fetus.

Although Plan B is a brand name, it really is plan B. It's less effective than other forms of contraception used before intercourse.

Plan B is more likely to work the sooner it is taken after intercourse. That's why Plourd wants every woman who isn't ready to be pregnant to have it on hand. Kavanaugh says this is particularly important for sexually active women under age 18.

"For those under 18 who still need a prescription, it is very much in their interest to get it in advance so they don't waste time going through the prescription process when they need emergency contraception," she says.

Plan B isn't the only form of emergency contraception. Women may also opt for the Copper T IUD, an intrauterine device that can prevent pregnancy even when implanted five days after intercourse.

Kavanaugh and Bimla Schwarz report their findings in the June issue of Perspectives on Sexual and Reproductive Health.

[kesac4650]

What we have here is an infomercial for a product.

[cyberus-2009]

I think that some doctors might be a bit leary about discussing it for fear of being branded as a baby killer since the fundy groups consider it abortion.

[keithle1]

Why don''t single American women know more about birth control?

[mercyme884]

What a crock... I think the best contraceptive today is the one my Mother taught me when I started to get serious about a boy. She gave me an aspirin tablet and when I asked how it prevented pregnancy and how to use it. She said when the kissing started to feel really nice, I should clasp the aspirin between my knees and hold it there tightly until I got home.

[denn034]

Doctors shouldn''t discuss it with kids without a parent present though under any circumstances.

[denn034]

The morning after pill could prevent unnecessary abortions and give rape victims peace of mind in that regard. Shame on those doctors!

Isn''t there anything that is natural for the body that women can take? It seems all that is offered is problem drugs laced with side effects.

[lfitts1]

I assume that implicit in this issue is the question of whether the doctor should be compelled to mention "Plan B." In that respect, I think it is a matter of personal conscience, just as it is a matter of a woman''''s conscience as to whether she wishes to ask about the option.

Posted by family2007

That is BS--as a physician it is your job to do your JOB--that includes NOT making moral judgements for others--whether you believe in plan B or not--your job is to properly inform your patients--this study I don''t think examined patients presenting with--oops the condom broke or I forgot to take my pills--if that were true it would almost be criminal

[family2007-2009]

I assume that implicit in this issue is the question of whether the doctor should be compelled to mention "Plan B." In that respect, I think it is a matter of personal conscience, just as it is a matter of a woman''s conscience as to whether she wishes to ask about the option.

[bobgee_1999]

afmca:

Nicely said. Thank you for saving me some fruitless effort.

[afmca]

von_marko needs to cut down on the caffeine or get a better understanding of medicine. Plan B is not an abortion pill but tries to ensure that the process of the eggs not being fertilized or implanting does not occur. There is a good chance that even without taking the pill any pregnancy would result. If the egg has already implanted, it will not terminate the pregnancy. Plan B means there would be no need for a future difficult decision to either medically or surgically terminate the pregnancy. I guess your compassion is overruled by your anger.

Now if von_marko is one of those extremists that figure the act of sperm swimming around an unfertilized egg equates to a baby, then there is no hope in this conversation anyway. Plan B should be readily available and advertised so all women know there reproductive choices.

[shoppingnut-2009]

Doctors are not in the business of saving lives anymore. They are in the business of pushing top of the line drugs from pharmaseutical companies at you rather than talk to you about alternative options without drugs, for instance they will immediately push Lipitor on you for high colesteral rather than talk to you about changing your diet to bring it down, they are little more than drug pushers these days. Also your office visit is no longer about knowing their patient, it is about how many patients can I see today to get the insurance company payments for those visits.

[ioweign]

Doctors Not Telling Women About Plan B


Medical school isn''t all about medicine.

The doctors probably don''t own any stock in the company that makes it.

[von_marko]

I''m voting Democrat because it''s my body, and if I want to kill my baby, I''ll do it, even if its head is in the birth canal. If I want to cut out my intestines and feed them to the crocodiles, I''ll do that too. That''s the freedom our forefathers enshrined in the Constitution.

[afmca]

Actually, having doctors explain about Plan B WILL improve health. Knowing about Plan B can allow a woman to decide to stop a potential pregnancy prior to having to consider other medical or surgical options that are more dangerous or intrusive. Gynocologist should be required to have brochures and information readiy available and visible in their office. If not the are bordering on malpractice.

[drivelphobe]

Maybe we need some more television ads. They should link this emergency pill into an ED commercial. Better yet, show it to younger people, perhaps during Dora the Explorer or Max and Ruby!

[rosesnpearls]

Good grief. There are lots of things that doctors do not talk to us about in our 5 minutes with them. Most doctors are in the business of saving lives not squelching them. Find something important to complain about, researchers. In fact, earn your research dollars by researching something that will improve health.

[tcoleman12]

I find it hard to believe that out of 7,643 women that no more than 3% ASKED their doctors about this option. Where is the patients'' responsibility here?

When I go to my doctor with an issue, I have questions for that doctor.

[haoli25]

Does ''Plan C'' involve the ''sin of the Greeks''?