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Pelvic exam necessary for contraception Rx?
"Clinicians at my family planning facility often refuse to give a birth control method if the patient is late for her annual exam," says a respondent to the 2010 Contraceptive Technology Update Contraception Survey. Is this practice prevalent in the United States?
While some providers might continue to require a pelvic exam prior to providing hormonal contraception, results of a national survey indicate many providers are dropping such restrictions. 1 In a poll of obstetrician-gynecologists (OB/GYNs), family medicine physicians, and advanced practice nurses specializing in obstetrics and gynecology and women's health or family medicine, less than one third of OB/GYNs (29%) and exactly one-third of family medicine physicians (33%) said they always require a pelvic examination when prescribing oral contraception. Almost half of advanced practice nurses in primary care (45%) and some advanced practice nurses in reproductive health (17%) reported always requiring an exam.
Is a pelvic examination necessary? No, according to national and international guidance. Hormonal oral contraception can be prescribed safely without a pelvic examination, according to guidelines from the World Health Organization and the American College of Obstetricians and Gynecologists. 2,3 While weight, blood pressure, and health history are required before prescription of hormonal contraception, screening for...