Although women do not need pelvic exams before obtaining prescriptions for birth control pills, one-third of health care providers always require such exams and 44% usually do, according to a new study in the journal Obstetrics & Gynecology, Reuters reports. Researchers from the University of California-San Francisco surveyed 1,196 ob-gyns, family doctors and advanced-practice nurses who specialized in women’s health or family medicine.
The World Health Organization and the American College of Obstetricians and Gynecologists advise that oral contraceptives can be safely prescribed without a pelvic exam. There is no medical need for the exams in that context, study researcher George Sawaya said.
The study found that 29% of ob-gyns said they always required an exam and that 50% said they usually do. Among family doctors, 33% said they always required an exam and 45% said they usually do. Rates were lowest among advance-practice nurses specializing in women’s health, with 16% saying they always required a pelvic exam, while 45% of nurses specializing in family medicine always required such exams.
Requiring the exams adds an unnecessary hurdle to the process of obtaining birth control, the study said. “In my view, we should have as few barriers as possible to women trying to get effective birth control,” Sawaya said. Some women might opt for less-effective methods, such as condoms.
The study did not assess why providers paired the exams with prescriptions, but experts said it could be habit or tradition, as providers are used to writing prescriptions and performing exams in the same visit (Norton, Reuters, 11/22).
2010 National Partnership for Women & Families