Contraception--a woman's dilemma
Wigington, S.
Nursing Times 77(41): 1765-1768
1981
ISSN/ISBN: 0954-7762 PMID: 6913920 Document Number: 181550
The case history of a 36-year-old West German woman--Elsa--who had an abortion is recounted along with information obtained from other members of staff involved with her care--a medical social worker, a family planning nurse, and a doctor. Conversation with Elsa revealed that she had ambivalent feelings about birth control. When Elsa learned she was pregnant, she seriously considered her subsequent decision to have an abortion. Actually, she would have preferred to have the baby if she could have depended on her boyfriend's encouragement and his commitment to being a father. At the clinic, Elsa was found to be in good physical condition. She informed the doctor that she had already had 2 terminations of pregnancy, 15 and 11 years ago. Following the birth of her son she had taken an oral contraceptive (OC) for 4 years, but had stopped taking it in 1976 because she thought she was too old for the pill and had been taking it too long. She had then used an IUD, but this had supposedly been removed 10 weeks before the abortion, after she had suffered from recurrent menorrhagia and heavy vaginal discharge. Elsa was then fitted with a diaphragm which she had been using when she became pregnant. After the abortion, Elsa continued to be undecided about what form of contraception to use in the future. She did not want to become pregnant again before she was in a position to have the baby. Elsa had good reason for concern about using OC, i.e. OCs containing estrogen and progestogen, at the age of 36. Along with discussion about the use of OC, Elsa sought more information about the diaphragm. Elsa finally decided to use OCs, but it is doubtful if she will ever be content with either this method or the diaphragm. Family planning nurses have an important role to play in educating people about contraceptives and their use, but they should never tell people that they should or should not be controlling their fertility.