from the July 25, 2011 issue of Connect

Dr. Sheila Dunn

In her own words, Dr. Sheila Dunn “has always wanted to work in areas that no one else wants to work in.” Areas like contraception and abortion.

“These are really big areas of unmet need,” particularly amongst immigrant and refugee populations, explains Dr. Dunn, who directs research and practises medicine in the Family Practice Health Centre at Women’s College Hospital. Dr. Dunn is also a scientist at Women’s College Research Institute.

“There’s so much stigma around sexuality and contraception. It’s societal, but it’s also personal. Women themselves often hold beliefs that need to be factored into discussions about contraception.”

Dr. Dunn’s study examining contraception – part of a larger study co-ordinated by Canadian Collaboration of Immigrant and Refugee Health – was published online in the prestigious Canadian Medical Association Journal (www.cmaj.ca) on July 25, 2011. The study recommends that health-care providers explore the influence of people’s different preferences and beliefs when counselling about contraception – with the ultimate goal being to provide women with effective contraception that they’re comfortable using.

“Women from different cultures, need a different approach to contraception,” says Dr. Dunn.

The study notes that unintended pregnancy is common and immigrant populations may be particularly vulnerable.  When a pregnancy isn’t planned, the mother is less likely to follow recommendations for healthy pregnancies. She’s also less likely to achieve her educational and career goals. So the implications of unintended pregnancy are serious, and education and counselling about contraception should not be taken lightly.

“Our study’s recommendations highlight the need for health-care providers to identify when a woman or a couple’s contraceptive needs aren’t being met and then work with them in a culturally sensitive way to meet those needs.”

The study also stresses the need for health-care teams to approach contraceptive counselling in a “patient-centred” way. That means that nurses and doctors should be aware of – and sensitive to – sociocultural, religious and regional differences that may impact which contraceptive a woman or couple prefers.

For example, “patients from certain areas, like eastern Europe, the Middle East and Asia, may prefer IUDs,” explains Dr. Dunn. “So we need to make sure they can easily access them if we hope to prevent unwanted pregnancies.”

“The health-care system works for many people, much of the time. But for a lot of people, it doesn’t work as well. As a doctor, you just want to make it work for all your patients.”