The prescription of contraception: Negotiations between doctors and patients

Maria, an Anglo woman, age 26, married, with medium length brown hair, slightly plump, has a tired air about her which can quickly turn to animated interest if her lively sense of humor is aroused. She has four children ranging in age from 11 years to 6 months, and a varied contraceptive history. This history includes successful use of the birth control pill for several years, followed by a period of 1 year when she would forget to take the pill regularly regardless of how hard she tried. This problem arose at a time when her two oldest (and at that time only) children were starting school and she wanted another child. Her husband was against the idea. She changed contraceptive method to an IUD (intrauterine device) which was inserted painlessly but caused her intense pain with menstruation. After several months she had it removed. She and her husband are presently using condoms which Maria feels interfere with their sexual life as well as creating anxiety for her. She is presently anxious to avoid impreg...