SEMINAR TRAINING FOR CONTRACEPTIVE CARE – WHAT SORT OF DOCTOR? (MISSING PILLS)
A young mother came to a family planning clinic asking to go back on the Pill. She admitted that before the pregnancy she had often forgotten to take the Pills for two or three days at a time. The doctor, who normally listens well, found herself giving a lecture about the importance of regular Pill taking, especially now she had a young baby to care for. When the doctor and nurse discussed the patient later it was discovered that the nurse, too, had lectured the patient in a more didactic way than was normal for her.
Something in this patient had provoked her two carers to treat her as a child, telling her what to do rather than exploring her feelings and the reasons behind her actions. No attempt had been made to discover why she used to miss Pills, or whether the situation was likely to be the same now. If there was a degree of immaturity in the patient that made it difficult for her to appreciate the possible outcome of her actions, that missing Pills could lead to pregnancy, how helpful was it to continue to treat her as a child? Is that the way to encourage maturity and self-care? If she was missing Pills because of an unconscious need to get pregnant, a recognition of that need might have helped her to better use contraception in the future.
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