Provision of contraceptives by Brazilian general gynaecologists: a nationwide online survey

Abstract

Objective

To assess the provision of contraceptives by Brazilian obstetricians and gynaecologists (Obst/Gyns) during medical consultation and associated factors.

Methods

An anonymous online survey was conducted with Obst/Gyns regarding age, gender, training, method counselling about and provision of long-acting reversible contraception (LARC).

Results

Of 16,000 Obst/Gyns, 610 (3.8%) answered the survey. After multiple regression analysis, female Obst/Gyns (reference) (OR male was 0.53 [95%CI 0.28–0.98], p = 0.044) and Obst/Gyns aged between 20 and 39 were more likely to provide an IUD. For hormonal-IUDs, Obst/Gyns who had had theoretical training in hormonal-IUD insertion (reference no training) (OR = 2.13 [95%CI 1.14–3.99], p = 0.018), those who work in a private facility or public hospital, and those that allowed more time during consultations (reference) (OR short time = 0.33 [95%CI 0.17–0.63], p < 0.001) were more likely to provide them. Obst/Gyns who were hands-on trained were more likely to provide subdermal implant (OR = 2.04 [95%CI 1.45–2.87], p < 0.001).

Conclusions

There is a gap between theoretical and practical training received by this cohort of Obst/Gyns regarding LARCs, mainly contraceptive implants and hormonal-IUDs. The identification of barriers to offering contraceptives is essential to providing client-centred contraceptive care.

SHORT CONDENSATION

There is a gap between the theoretical and practical training received by Brazil-based Obst/Gyns regarding LARC methods, mainly subdermal implants and hormonal-IUDs. The identification of barriers is essential to providing client-centred contraceptive care.

摘要

目的：评估巴西妇产科医生在医疗咨询期间提供避孕药具的情况及其相关因素。

方法：与妇产科进行了一项关于年龄、性别、培训、方法咨询和长效可逆避孕（LARC）提供的匿名在线调查。

结果：在16000名产科医生中, 610人（3.8%）回答了调查。经过多元回归分析, 年龄在20至39岁之间的女性产科医生（参考）（OR男性为0.53[95%CI 0.28–0.98], p=0.044）和产科医生更有可能提供宫内节育器。对于激素类宫内节育器, 接受过激素类宫内避孕器插入理论培训（参考无培训）的产科医生（OR=2.13[95%CI 1.14–3.99], p=0.018）、在私人机构或公立医院工作的产科医生以及在会诊期间允许更多时间的产科医生更有可能提供这些药物（参考）（OR短时间=0.33[95%CI 0.17–0.63], p<0.001）。经过实践培训的妇产科医生更有可能提供皮下植入物（OR=2.04[95%CI 1.45-2.87], p<0.001）。

结论：这一组妇产科医生在LARC方面接受的理论和实践培训之间存在差距, 主要是避孕植入物和激素宫内节育器。查明提供避孕药具的障碍对于提供以客户为中心的避孕护理至关重要。

简短总结

巴西妇产科在LARC方法（主要是皮下植入物和激素宫内节育器）方面接受的理论和实践培训之间存在差距。查明障碍对于提供以客户为中心的避孕护理至关重要。

Keywords:

• Practice
• prescription
• contraception
• survey

Disclosure statement

No potential conflict of interest was reported by the author(s).