THE METHOD AND ITS MEANING – INTRODUCTION
The choice of which, if any, form of contraception to use is one of the most intimate decisions a man and woman can make. The title of this book, Contraceptive Care: Meeting Individual Needs, draws attention to the contrast between the needs and perceptions of individual health professionals and the individual needs of those they are trying to help. It could be argued that the word ‘care’ is hardly relevant here, certainly if used in its literal sense of watching over or tending (Hawkins, 1989). Might we be tempted to use this knowledge, this care, to intrude into, even try to control, other people’s private sexuality? And yet, modern contraception is complicated, often highly technical and scientific, and our patients do feel the need to seek our advice. Clearly, doctor and patient share the same difficulty when it comes to balancing emotional and physical needs in this field. Patients bring to even the most apparently uncomplicated consultation their own hidden agenda, which doctors and nurses, intent on the rational and scientific aspects of birth control, frequently miss.
To doctors, methods of birth control fall into five main categories: barrier, hormonal, intrauterine devices, sterilization and termination of pregnancy. To patients there are two main divisions: those you can get on with yourself, and those for which you have to involve others, usually doctors or nurses, and therefore lose some privacy and control. The extent to which this external interference is tolerated depends on many factors, some obvious to medical minds, like the absolute desire not to get pregnant now, and others less clear – a fear of using something perceived as unnatural or artificial, for example. Every method has a different meaning for each individual patient.
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