Doctors in India profiteering from patients, report finds

Women, who underwent sterilization surgery at a government mass sterilisation camp, pose for pictures inside a hospital at Bilaspur district in the eastern Indian state of Chhattisgarh November 14, 2014. The doctor whose sterilisation of 83 women in less than three hours ended in at least a dozen deaths said the express operations were his moral responsibility and blamed adulterated medicines for the tragedy. REUTERS/Anindito Mukherjee

When women who are family planning experts need to pick a birth control method for themselves, what do they generally choose? Not the same thing the average woman chooses, a new study found.

About 42 percent of the family planning experts in the study used long-acting reversible contraceptives (LARCs) – a choice made by only about 12 percent of women in the general population.

This doesn't mean there's a single correct choice for birth control, said Lisa Stern, the study’s lead author from the Planned Parenthood Federation of America in New York City.

Women should "feel empowered to access information and the resources they need to obtain birth control that’s right for them,” Stern said.

LARCs, which include intrauterine devices (IUDs) and other implanted contraceptives, are highly effective at preventing pregnancy over several years, according to the American Congress of Obstetricians and Gynecologists (ACOG).

IUDs are inserted into the uterus, where they release small amounts of either copper or the hormone progestin. The contraceptive skin implant, about the size of a matchstick, is inserted under the skin of the arm. IUDs and implants are about 20 times more effective than other options, including the Pill, says ACOG.

Stern and her colleagues write in the journal Contraception that female doctors are reportedly more likely than other women to choose LARCs, but birth control options have changed since most of those reports were first published.

Use of LARCs for birth control is encouraged by the American College of Obstetricians and Gynecologists, which is a companion organization to ACOG.

For the new study, the researchers analyzed data from an anonymous 2013 online survey of 488 female family planning providers, ages 25 to 44, including doctors and nurses.

Overall, 331 were using a contraceptive. Of those, about 40 percent were using IUDs and about 2 percent were using implants.

In contrast, in 2011-2013, about 12 percent of U.S. women in the general population used intrauterine contraceptives and about 1 percent used implants.

The family planning providers were also more likely to use the vaginal ring and less likely to use sterilization and condoms, the researchers found. Only a handful were using patches, injections or other methods to prevent pregnancy.

“I will totally tell this to patients in the exam room,” said Dr. Katherine Greenberg, an adolescent medicine specialist at the University of Rochester Medical Center in New York.

Greenberg, who wasn’t involved in the new study, said she’s known anecdotally that providers are more likely to choose LARCs. “This gives me some numbers to tell them,” she said.

Greenberg said the results will help reassure women who are concerned about the safety of IUDs and implants.

“These are so safe that we choose them as doctors,” she said.

Stern said another reason providers may be more likely to use IUDs and implants is that they have historically had better insurance and access, but that may be changing in the U.S. thanks to the 2010 Affordable Care Act (ACA), better known as Obamacare.

For the most part, the ACA requires new insurance plans to cover birth control methods approved by the Food and Drug Administration. Those include IUDs, implants, pills and emergency contraception, according to the Centers for Medicare and Medicaid Services.

“There’s already been research showing there have been changes in contraceptive use patterns,” Stern said.