Contraceptive Pearl: Implicit Bias and Counseling

Patient-centered contraceptive counseling encourages patients to make the best choice for themselves among all birth control options. Implicit bias can lead clinicians to encourage certain contraceptive methods over others for particular groups of patients. 

How do we know that implicit bias affects contraceptive counseling? Third- and fourth- year medical students were asked to complete an online survey. They reviewed the same scenarios, with the exception of the patient’s name– which was randomly assigned to indicate one of five racial/ethnic groups (White, Chinese, Filipina, Native Hawaiian, and Micronesian). Students suggestions varied with patients’ age and race. For example, students recommended sterilization for 60% of older Micronesian women and 27% of older White women. 

Research has shown that implicit bias affects seasoned clinicians, too. A review of 42 studies indicated that clinicians exhibit the same levels of implicit bias as the general population. 

We should provide patients with information about all indicated contraceptive options, regardless of patients’ race, gender, socio-economic status, age, mental illness, weight, HIV/AIDS status, drug usage, disability, and social circumstances. In the absence of medical contraindications, the best birth control method for each patient is the one the patient wants. 

Featured Resources

Contraceptive Counseling: Best Practices

Medical Eligilibility Criteria for Initiating Contraception



FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Medical Ethics. 2017;18:19. doi:10.1186/s12910-017-0179-8.

Williams A, Kajiwara K, Soon R, et al. Recommendations for Contraception: Examining the Role of Patients’ Age and Race. Hawai’i Journal of Medicine and Public Health. 2018;77(1):7-13.



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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