13
Helping to debunk myths around contraception
There is an ongoing role for GPNs in dispelling myths around contraception , and those who spoke to Nursing in Practice say they ‘ regularly ’ hear concerns from patients about the impact on their fertility , as well as worries about the health implications of specific types of contraception .
Women ’ s health nurse in North Norfolk Donna Loose stresses the importance of ‘ breaking that down , giving good education , enabling provision of services and opening up those conversations about how everything works ’.
‘ Everything for me boils down to education : empowering the person to understand what is going on in their body and what they are taking and what it is doing ,’ she says .
Jodie Crossman , a sexual health specialist nurse and co-chair of the STI Foundation , says she is regularly asked ‘ if contraception affects long-term fertility , so there must still be a lot of rumours around about this ’. And she has seen ‘ a lot of discussion on social media ’ around wanting to be ‘ natural ’.
‘ I think it ’ s important to listen to these discussions while at the same time helping patients to avoid pregnancy if they are not planning one ,’ she says .
‘ Our “ natural ” evolutionary bodies want us to reproduce , so although it is good to be aware of your own hormones and how these can affect you , it ’ s also important to protect yourself from STIs and unintended pregnancy .
‘ Synthetic hormones can also be very helpful in managing the symptoms of chronic conditions , but it ’ s important to listen to the individual patients concerns and needs .’
Nurses must help to debunk myths by ensuring that ‘ any advice they give is evidence-based , but also listening and taking seriously people ’ s concerns ’, adds Ms Crossman . ‘ If contraception choice is more of a discussion rather than just “ take these pills ”, people are more likely to find a method they are happy to stick with .’
The GPNs we spoke to suggest the contraceptive pill is still popular among patients , although many also want what they describe as a period – which is a withdrawal bleed from the pill .
Ms Crossman says she has seen ‘ a lot of people ’ moving to LARC methods such as the implant and the coil , and that this could be in part because of difficulties faced during the pandemic ‘ where it was harder to get a repeat prescription of pills ’.
But there is also ‘ a move away from hormonal methods , or people wanting to use the lowest amount of hormones possible ’, she adds . ‘ A lot of this is due to negative experiences of contraception , but it may also be the popularity of apps like Natural Cycles and discussion on social media – particularly TikTok – about awareness of your body ’ s natural cycle .’
ALAMY in North Norfolk , says she knows of some clinicians who felt they lost LARC competencies during the pandemic when they stopped fitting them . ‘ So , we ’ ve lost a few fitters from that point of view , because they didn ’ t pick the competencies up again ,’ she tells Nursing in Practice .
More widely , Ms Loose feels more needs to be done to educate the workforce in general practice around contraception services and their value . She believes ‘ women ’ s health has always been on the back burner in general practice ’ because it ‘ doesn ’ t have the financial incentive ’ of services like diabetes and asthma checks .
‘ But it can be seen that we need more education out there to make it an equal health condition to long-term disease management ,’ she says . ‘ Because I always think women ’ s health will be a long-term health condition .’
Ms Loose also highlights the use of contraception services by transgender patients , noting that specific training around supporting these patients is ‘ not that well provided generally ’. Training around caring for patients within the LGBTQ + communities in primary care is included within modules , but it is only done ‘ lightly ’, she adds .
‘ I tend to lean on what the patient is telling me about how [ these issues ] affect their emotional and psychological wellbeing ,’ she says .
Ms Loose also spends time working in schools to educate young people about the issue of contraception . She says that , when doing so , she discusses ‘ contraception as hormones to prevent menstruation ’ in order to counter ‘ the association it can only be taken as a contraception ’.
Young people in particular face barriers to accessing contraception because they ‘ do not know where to access it or whether they should access it ’, adds Ms Loose . She therefore sees her role in educating school pupils as essential to improving knowledge and accessibility .
Staying up to date Meanwhile , Helen Lewis , an advanced nurse practitioner in a general practice in Cardiff , highlights the importance of nurses using the UK Medical Eligibility Criteria ( UKMEC )³, created by the FSRH to support clinicians to check eligibility and suitability when delivering contraceptive care .
‘ It is so important for new practice nurses coming in , or existing practice nurses who have never dealt with contraception , to treat it like your Bible ,’ she tells Nursing in Practice . She stresses how vital it is that all nurses stay ‘ up to date ’ with the tools available to support patients .
Ms Lewis also emphasises that nurses should be aware of availability issues with contraception . She cites ‘ supply problems ’ with some oral contraceptives and says practice teams should work collaboratively , with pharmacy colleagues for example , to help ensure access .
She underlines the value of GPNs for contraception support and family planning services . ‘ General practice nurses can provide their patients with a plethora of information and safe and effective contraception from both oral and long-acting reversible contraception .
‘ Patients can be assessed within familiar surroundings by the practice nurse they are familiar with and trust ,’ she concludes .
References 1 FSRH Statement on latest UKHSA and OHID Sexual and Reproductive Health profile statistics , 2023 . tinyurl . com / FSRH-LARC 2 NHS Digital . General Practice Workforce , 31 July 2023 . tinyurl . com / NHSD-723 3 The Health Foundation , 2022 . A quarter of GP and general practice nursing posts could be vacant in 10 years . tinyurl . com / HF-vacancies 4 FSRH . UK Medical eligibility criteria 2016 . Amended 2019 . tinyurl . com / UK-MEC