Source: Jackie Shepherd / drjessicashepherd.com

Youll be hardpressed to find any area of life that hasnt changed since the onset of COVID-19. And that includes, pregnancy. With the pandemic looming on, with no end in sightparticularly for the United Stateswomen are thinking seriously about family planning, contraception and delaying having children.

Which means birth control.

We spoke to Dr. Jessica Shepherd, practicing OB/GYN and womens health expert at the University of Illinois, about the options available to women these days, specifically the hormone-free IUD called the Paragard, what Black women can do to advocate for a safer, healthier pregnancy and delivery, and what we can do to get the most out of our gynecological visits.

MadameNoire:Have your patients expressed concerns about getting pregnant or giving birth in the midst of this pandemic?

Dr. Jessica Shepherd: I think thats a very valid concern that patients have and should discuss with their doctors. Most pregnancies are unplannedif you want to call it that. But for those who are planning and have those questions, it could require a visit.

MN: In addition to the pandemic, Black women face additional concerns during pregnancy and labor. Do your patients speak to you about these concerns?

Dr. Shepherd: Oh yeah, I think thats the overwhelming topicmore than just this year. But this year has really made it a discussion topic. The increased maternal mortality rate is a public health issue. Its all intertwined but Im glad its being discussed more so we can be very open with our intent on how we plan to fix that.

MN: How is childbirth different because of COVID?

Dr. Shepherd: The process is different in the sense that we cant have more than one person in the delivery room. Many times, if someone is COVID positive, prior to delivery, we have to keep them isolated. And also postpartum if mom is COVID positive, they have to determine the babys status before theyll allow mom to be with baby.

Most hospitals now are testing patients with rapid testing or if they have a c-section or planned induction date, theyll try and test them about a good 48 hours prior to their admission to the hospital. So these protocols are not always easy to implement because deliveries happen any and every time. But its really for the safety of everybody.

Also using PPE wear during delivery, making sure physicians wear eye protection, face shield and the N-95 masks because some people cant get tested before they start the delivery process if theyre already in labor.

The best way to be preventative is to assume that everyones positive.

MN: What do you advice do you offer expectant mothers? Its a public health issue but its not their fault so is there anything you can advise to ensure that theyre able to have a safe pregnancy and delivery?

Dr. Shepherd: There are a few things that Id highlight. If I could name three specific goals that a woman could do it would be:

Not like people dont go prepared but now that we know that this is something to be focused on, its important to go with concise questions. And find a way to document or record the information that you get. If you need to have that information for later, you have access to it. And you can also share that information with someone else so that they know what they heard was exactly as they heard it.

Have a family member, a confidant, a family member, or friend come to visits with them, if thats possible. Because of the pandemic, thats less likely but there are telehealth appointments that can be done. There are consults that can be done with family members around. What we see now because of COVID is bringing people into delivery rooms or appointments via FaceTime so thats a great way that you can have more than one ear open to the information thats being delivered. So you can ensure that more than one person heard it. And that helps to reiterate the messaging.

A lot of times when we give patients information, it can be misconstrued or misunderstood. So one of the ways of navigating through that is having someone there that can reiterate the message and also make sure that it stays prioritized.

Outside of race of the pandemic, I always encourage patients who feel that the relationship they have with their physiciansometimes its not always a physician problem or a patient problem. Sometimes its a communication problem. The communication can be a little off. So thats when you can ask for a second opinion or a different provider or going to another specialist. And you really want to make sure that youre paying attention because one of the things we dont advocate for or dont advise is changing care late in the pregnancy. Thats not helpful to anyone because theres so much time and information that was missed.

And sometimes it can be difficult to determine what needs to be done when you have such a time sensitive process.

Source: Bryan Bedder / Getty

MN: For those people who are trying to avoid getting pregnant during this time, how do you ensure that you dont have a toxic reaction to the birth control that you choose?

Dr. Shepherd: I think one of the things is discussing with your physician prior to having contraceptive counseling is for patients to know whats in what theyre getting.

Now, the great thing about the Paragard is there is no hormone. Its a 100% hormone free. So youre less likely to see what we hear patients referring to when they talk about side effects of contraception. Usually, theyre referring to a hormonal side effect rather than something else. Its usually due to the active ingredient. And the Paragard only has a couple of active ingredients, so if there is an issue we would know what caused it.

MN: Can you tell us more about the Paragard? How is it were able to have birth control with no hormones?

Dr. Shepherd: The Paragard is one of those forms of contraception thats been around for a very long time. Its an IUD. The IUD has been around decades. Its been so longstanding because its reliable. Its hormone free and maintenance is very low. So, once its inserted, its completely reversible. It works for a maximum of two years.

MN: Would you say that women should avoid adding any types of additional hormones to their bodies?

Dr. Shepherd: No, I wouldnt say that. I think when you look at the world of contraception and whats available to womenwhat has been developed over the decades, I think there is absolute need for all forms of contraception, whether they have hormones or not. The availability and the flexibility within our options and choices as women which is the most important.

When you look at how many women are allowed to have that freedom, that should be the take home message.

Yeah, there are going to be a lot of women who dont respond to hormonal birth control but there are millions of women who use contraception, it doesnt matter what kind. And thats the beautiful part about where we are today because prior to contraceptives being developed, women had no options. Like, none. Weve come a long way and I wouldnt label it as something that is not good to have.

MN: What about affordability of birth control?

Dr. Shepherd: When you think about affordability, I usually go to my mainstay of Planned Parenthood. But when you think about contraceptive counseling, people have insurance. They have insurance plans. The most important distinction of whether they go to Planned Parenthood or whether they go to the doctors office is about what am I looking for? What are my expectations? What have I experienced in the past? And using that as a guideline to narrow down your choices of birth control and what looks best for that person. Its a very individual decision.

Most people come in after theyve had an uh oh moment and realize they need to be on birth control. But its really a conversation that should start early in age. Not that they should start at that time but that they have the information. When you have young women who at least know whats available so they can make better decisions for themselves.

MN: When can you do a telehealth appointment and when should you go into your gynecologists office?

Dr. Shepherd:I think thats been something thats changed over the last five months. The telehealth visits can really accomplish more than one would think. I know a lot of people are freaked out like, What?! How are you going to do an exam? Its not so much of the exam but the foundationwith any medical disciplinethe basis of the relationship starts in the information room.

That requires a lot of information that needs to be extracted from the patient, starting the discussion. When you look at it from that perspective, you can start the discussion and determine if its something thats urgent and the patient needs to come in right away or two weeks out or maybe they can get their question resolved right then.

In my practice, the top three things I saw patients for on telehealth were abnormal uterine bleeding, contraceptive counseling, and IUDS. So we would do the initial consultation and then bring them in for the insertion.

I saw an increase in IUD patients over this time because people were thinking about things that were longstanding so the features of the IUDS really made a stand out appearance because it has such low maintenance

MN: How can women make sure they get the most out of their gynecological visits? Too often we go into those appointments anxious or scared and then we end up leaving without giving or receiving the information we wanted.

Dr. Shepherd: One of the best features is to come prepared. We all have it in our heads, right and then you get there and then you have some anxiety and then you leave and youre like, I literally forgot to ask A, B, and C. So writing it down is sometimes the best and easiest advice to take.

Now, I would say the challenge is when patients have the expectation that the questions they bring are all going to be answered. That sometimes can fail.

The relationship between a physician and patient should be one thats ongoing. So the expectation of going and getting twenty questions answered versus we can look at those questions and say lets tackle the most important ones that are impacting you right now and then lets do a follow up visit and get to the rest of those questions. Sometimes its a part B and part C type of visit.

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Dr. Jessica Shepherd Talks Family Planning During COVID And Getting The Most Out Of Your Gyno Visits - MadameNoire

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