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A uniquely qualified team at The Ohio State University Wexner Medical Center now offers a weekly clinic for patients with complex contraceptive needs, providing resources for patients with medical co-morbidities—particularly those that increase the risk of blood clots, such as stroke or high blood pressure, as well as patients who face challenging contraceptive device insertion or removal.
“Even for physicians who routinely place them, arm implants and IUDs can prove difficult to insert or remove,” says Katherine Rivlin, MD, an Ohio State Wexner Medical Center obstetrician/gynecologist. “Our team specializes in these challenging procedures, and we welcome referrals from across central Ohio.”
The Ohio State Wexner Medical Center has been named a Center of Excellence for Nexplanon® (the contraceptive implant) but also manages the full array of implants and IUDs. The complex contraception clinic team also regularly collaborates with physicians in other specialties who want to find the safest contraceptive choice for their patients with chronic conditions or specific risk factors that can be exacerbated by the hormones used in birth control.
In addition to her clinical practice, Dr. Rivlin has presented and authored or co-authored several articles supporting the development and availability of more contraceptive options for patients. This includes “Patient-centered Contraceptive Counseling and Prescribing,” written with Ohio State Wexner Medical Center obstetrician/gynecologist Michelle Isley, MD, and “Long Acting Reversible Contraceptives,” an educational presentation for primary care physicians.
“Most current contraception is safe, so that typically isn’t a concern unless patients have certain health issues,” Dr. Rivlin says. “But we need to continue the development of options that can be tailored to each patient’s diverse needs. As an ob/gyn, I see it every day—each patient makes a contraceptive choice based on some very specific, personal preference or maybe her plans for the future. We shouldn’t settle for limited solutions, but continue the development of a full range of effective therapies.”
Dr. Rivlin routinely counsels patients on contraception, always with consideration of their current medical situation.
“While it’s true that patients who have medical comorbidities or risk factors have to carefully consider the safety of certain contraceptives, the discussion never ends there, she says. "We can always find an appropriate contraception that’s safe, so the conversation needs to expand. Sometimes it ends up being less about pregnancy prevention and more about side effects or non-contraceptive benefits like ease of use, elimination of acne, reduction of pelvic pain or managing heavy or irregular periods. Ultimately, it’s about helping each patient find the best contraception for this point in time and then readjusting and finding something new as specific life and health circumstances evolve.”
