[Mallika]

Hello!

Thank you for sharing this with us. While I have not used contraceptives before, I'll try to help.

Recently I listened to a podcast whereby a gynaecologist was almost forcing an expecting couple to do a procedure they clearly did not want to do. They managed to stand their ground confidently after meeting a genetic counsellor who rooted for them instead of the gynaecologist, and subsequently had their way. Unfortunately, the physician-patient relationship can sometimes get pretty paternalistic - the doctor/gynae can be quite insistent on you doing something even if you might not be fully comfortable with it. I suggest you might be able to do two things:

1) Openly share your viewpoint and the reading you've done about it.

Since this form of birth control has previously worked for you, you can honestly tell the doctor that you and your husband are comfortable using a previously tried-and-tested contraceptive and would rather not go for something new. You had described that you and your husband are willing to take the risk even if it's not as effective - you can tell that to the doctor as well, just so they know how firmly you feel about this. You've done some research on how there is currently no convincing evidence that this form of contraceptive does not work for larger sized individuals. You might want to share that you've done your reading of scientific literature regarding this matter too.

It can be quite difficult to challenge a professional who is an expert in that field, however, you have your autonomy and understand your needs best. If you prefer using one form of treatment that has helped you in the past, you have the right to express that openly. As patients, I guess the best we can do is assert ourselves as politely yet firmly so our point gets across.

2) Get a second opinion/go to another gynae

If you've been seeing this doctor for a long time, then it might be a little challenging to go elsewhere and get familiarised with a new doctor. But if you feel your voice might be heard more well elsewhere, or that you might meet another gynaecologist/doctor who would be more open to administering this BC, then perhaps that might be a good option. After all, this doctor did not administer the BC the previous time you visited - you can of course try to get your point across this time, but if they are still not up for it, then perhaps switching to another doctor might be worth thinking about.

When I was younger, I had to get a knee surgery. Though the surgeon I first visited was really good and well-known for his capabilities, my parents insisted on getting a second opinion, and I'm glad they did. While the first surgeon presented the surgery as "optional", the second doctor was very firm that getting a surgery was necessary or else my knee would worsen. Medical experts do differ in their viewpoints, so if you feel that another gynaecologist might be able to understand you better, then go for it.

At the end of the day, the physician-patient relationship is dependent on human interaction - how well we can get along with the doctor and how well they understand our needs plays a key role our treatment journey.

I wish you the very best with this!!