The reality TV phenomenon Love Island returned to viewer's screens on 20 January 2020, opening to an audience of 4.8 million. One contestant's open display of contraceptive choice has caught the attention of viewers and, hopefully, some GPs.
Former Miss Newcastle, Rebecca Gormley, can be seen for most of the programme with a small "mystery" patch on her upper thigh. Speculators suggested a nicotine patch, but viewers have concluded that it is most likely to be a contraceptive patch.
Rebecca's decision to openly display her contraceptive patch has received a lot of online commentary. Unfortunately (albeit expectedly) much of this has had a misogynistic tinge, shaming her for her choice. However, a positive conversation has followed, with many commentators praising the contestant for de-stigmatising the use of the contraceptive patch.
The contraceptive patch contains the same hormones as the combined pill – oestrogen and progestogen – and works in the same way by preventing the release of an egg each month. When used correctly, the patch is more than 99% effective at preventing pregnancy (but will not protect against sexually transmitted infections – Love Island has confirmed to Huffington Post that the villa is supplied with condoms).
Each patch lasts for one week, and is changed every week for three weeks, before a week's break. It is therefore a useful alternative option for women who might find it difficult to ensure they take the pill every day at the same time (which can impact the effectiveness of progestin-only pills). In addition, because the hormones from the patch aren't absorbed by the stomach, it is still effective if the woman suffers vomiting or diarrhoea (unlike the pill). The patch may therefore be a good contraceptive option for many women.
But, the commentary that has followed Rebecca's reality TV show debut has indicated that many women have never been offered this option and were unaware it even existed.
NICE guidelines state that women asking for contraception should be given information about, and offered a choice of, all methods, and go on to list fourteen different options (including the contraceptive patch). A 2018 survey revealed that the majority of women (59.1%) are supplied contraception by their GP. It is therefore imperative that GPs are aware of all the available options and discuss them fully with patients, to ensure they are acting in accordance with NICE guidelines.
Nevertheless, a 2016 survey by the Family Planning Association found that just 2% of GPs offered the full range of contraceptive methods (13% did not offer the contraceptive patch). The GPs surveyed highlighted that there is not enough time to discuss contraceptive options with patients during a standard appointment and suggested that a lack of training qualifications and funding prevented their practice from offering Long-Acting Reversible Contraceptives (such as the implant).
Failure to give appropriate contraceptive advice can lead to litigation, including (fortunately uncommon) wrongful birth cases (where a claim arises out of the birth of a child who, absent any negligent treatment, would not have been born). Insurers will be aware that a successful wrongful birth case can result in significant damages. It is therefore crucial that GPs (and other medical practitioners offering contraceptive advice) are able to offer and discuss the full complement of contraceptive options, so that every woman finds a method that works effectively for her. Hopefully, Rebecca's openness will spark more wide-ranging discussions between women and their medical practitioners.