Contraceptive Counseling

Shared Medical Decision Making

Shared medical decision making is a process in which the obstetrician–gynecologist or other health care provider shares with the patient all relevant risk and benefit information on all treatment alternatives and the patient shares all relevant personal information that might make one treatment or side effect more or less tolerable than others. It can increase patient engagement and reduce risk resulting in improved outcomes, satisfaction, and treatment adherence.

This section reviews the components of shared medical decision making.

Supporting Patient Autonomy

Coercive provision of contraception and forced sterilization has been used as a means of fertility control in marginalized populations. Any counseling for postpartum contraception, especially sterilization or immediate postpartum LARC, should be sensitive to this history.

Health care provider bias can contribute to coercion and racial and ethnic disparities in health, and health care providers are encouraged to self-reflect on their own biases and how to provide patient-centered care that supports autonomous decision-making.

This section discusses coercion in more detail and the importance of patient autonomy.

Counseling On Immediate Postpartum LARC

Postpartum contraceptive counseling should review the full range of contraceptive options available, including immediate postpartum LARC.

This section outlines the recommended timing and topics for immediate postpartum LARC counseling.