A guide to your first birth control appointment and questions to ask your doctor

Carla Delgado,Katie SiglerFeb 25, 2021, 20:52 IST

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Your medical provider should walk through the different birth control options you have and discuss their benefits and drawbacks.ljubaphoto/Getty Images

It's important to discuss your birth control options with your doctor to find the right fit for you.
Prior to an appointment, think of what questions and concerns you have about birth control.
Conditions like factor V and chronic migraines may affect what kind of birth control you can take.

Before deciding on a birth control method, it's crucial to have all the information you need to know so you can make the best decision for yourself.

Therefore, you should consider scheduling an appointment with a medical professional to discuss various birth control options and help you narrow down which one meets your needs.

Important: It's important to note that a doctor isn't the only person who can talk to you and prescribe birth control. Nurse practitioners and certified midwives are also an option.

"Patients deserve to have the information they need and the partnership with their clinician to really make these important health decisions," says Nancy Stanwood, MD, FACOG, FSFP, MPH, section chief of family planning at Yale School of Medicine.

"If, in the end, you feel like the person you were talking to isn't hearing your concerns, then you should see if you can find another clinician to talk to," Stanwood says.

Here's how to get birth control, what to expect at a birth control appointment, the questions you can ask, and the different types of birth control available to you.

What should you research before your appointment?

When choosing birth control, consider the ease of use, availability, side effects, and potential risks.

Hormonal contraceptives, which contain estrogen and progestin hormones to thicken the cervical mucus and prevent ovulation, affect the menstrual cycle and cause varied side effects, so some people prefer non-hormonal contraceptives instead.

It's necessary to assess and compare the different types of birth control available, such as: hormonal birth control, IUDs, implants, the patch, and the shot.

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"Some of the options may result in irregular bleeding or no menses. If the person does not expect this, there is a higher risk of them wanting to change their birth control or not be compliant," says Shefali Pathy, MD, MPH, site director of Cornell Scott Hill Health Center, Women's Health.

Some people also tend to switch methods due to concerns about contraceptive effectiveness and potential health risks.

"Birth control is not a one-size-fits-all and sometimes people will start a method and feel like it just doesn't fit ... for whatever reason," says Stanwood. "There are always more options. I wouldn't want patients to feel like they need to give up."

What should you expect at an appointment?

To talk about getting a birth control prescription, usually you'd make an appointment with an OB-GYN, but you can also see a family medicine provider or a certified midwife.

Community health centers, family planning clinics, and Planned Parenthood can also discuss and prescribe various birth control options, says Pathy.

Medical appointments for contraceptive care can vary, but they generally involve the following:

Preparing for your appointment

"A person does not necessarily need to research anything, but should be able to identify their goals for using birth control," says Pathy. "Additionally, they should come to the appointment knowing some of their medical history, as this could impact the type of birth control that would be offered."

If you have a particularly extensive medical history (if you have undergone a transplant or have cardiac history), it might be helpful to bring a summary document, but for most people, there's no need to bring any documents to begin the conversation about birth control, says Stanwood.

For people who have Factor V Leiden, a genetic disorder that makes them more likely to develop abnormal blood clotting, taking oral contraceptives can increase their risk for deep vein thrombosis.

However, clinicians will assess risks and discuss options for further testing at the time of visit, so unless you have a family history of Factor V Leiden, blood tests aren't necessary before your appointment.

Checking your vitals and medical history

After taking your vitals, the clinician will ask about your period, sexual activity, and past pregnancies, as well as your medical, surgical, and family histories.

"Usually a physical exam is not performed, unless there is another patient concern such as vaginal discharge, need for a Pap smear, or other testing," says Pathy.

You don't need to have a pelvic exam before getting a birth control prescription unless you decide to get an intrauterine device (IUD) inserted in your uterus, says Stanwood.

There are medical conditions that can affect what type of birth control are appropriate or safe for you. For example, combined oral contraceptive pills are not recommended for people with:

A history of migraines with aura
High blood pressure
People over the age of 35 who smoke
Those with a previous history of blood clots

You can learn more about the health risks of birth control by consulting Centers for Disease Control and Prevention's (CDC) chart for Medical Eligibility Criteria for Contraceptive Use.

Discussing your birth control options

Your healthcare provider will discuss the different birth control methods and their benefits, disadvantages, and side effects to help you make an informed choice.

It's important for an individual to talk about what they're looking for and what their concerns are, says Stanwood. While some people opt for the methods with the lowest risk of pregnancy possible (like the IUD or arm implant), others may prefer a contraceptive that they can discontinue by themselves for whatever reason (like the pill).

Important: If you can't see a doctor yet and you're interested in knowing your options, experts recommend Bedsider, a website that provides users with the information to compare various birth control methods. It debunks contraception myths and allows you to find the closest location where you can acquire over-the-counter birth control.

Don't hesitate to ask any questions and speak up about your needs. Your healthcare provider should explain the risks, side effects, and alternatives of each birth control option available.

Getting the prescription

Methods that require a prescription (like the birth control pill, hormonal patch, or vaginal ring) are generally prescribed by the clinician during the appointment and you'll be given instructions on when and how to begin taking them. You'll also know when the method will start protecting you from pregnancy.

Resources: Planned Parenthood offers telehealth services for sexual health care, including appointments for contraceptives. If you need prescription birth control, you can pick them up at the nearest health center or have it mailed to you instead. You can also get a birth control prescription online: Nurx and The Pill Club offer online prescriptions that you can get in the mail.

"If the method is the injection, it is generally given that day. In some practices, such as my own, if the person wants the arm implant or one of the IUDs, we usually offer insertion that day. The only method that would need a follow up appointment would be the injection for the next dose in 12 to 15 weeks," says Stanwood.

While this is true of Stanwood's practice, it may not be true of your OB-GYN's, so make sure to inquire about how and when they administer IUDs and injections.

Questions to ask during a birth control appointment:

How well does it work at preventing pregnancy?
What are its risks and side effects?
How will it affect my current health condition or the medications that I'm taking?
How will it affect my period? Should I expect regular, irregular, or no bleeding?
What will my health insurance cover?
Do I need to continue using a backup contraceptive (like condoms) for a period of time after initiating this method?

Insider's takeaway

Scheduling a birth control appointment will help you assess your options and figure out which works best for you. There's no need to bring any documents or undergo blood screening before going to your appointment.

There are plenty of benefits to birth control that go beyond preventing pregnancy, like period regulation that helps manage painful menses (or dysmenorrhea), heavy vaginal bleeding (or menorrhagia), and endometriosis, says Pathy. Other benefits include polycystic ovarian syndrome (PCOS) therapy and a reduced risk of ovarian cancer.

It's crucial to ask questions about the efficacy, side effects, potential risks, and ease of use of different birth control methods so you'll know what to expect. Make sure to inform the clinician of any medical conditions that you have as it can affect the type of birth control they'll prescribe.

"If you feel the particular birth control options are not working for you, it is best to reach out to your doctor sooner than later," says Pathy. "The doctor-patient relationship needs to work in both directions to be effective. I encourage people to reach out for alternate advice if they feel they are not receiving the information or care they need."

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