This ratio is elevated in women who take OCPs versus those who do not. Even if the likelihood of this occurring in any one cycle is low, the likelihood that a patient will eventually encounter this mechanism over years of OCP use would be high. For a patient who is of the conviction that human life begins at fertilization, these effects are serious concerns. I am aware of patients with such convictions who were placed on OCPs without any mention of this by the prescriber, and who were later quite upset when informed of the potential for a postfertilization mode of action. I believe it is imperative for all physicians who prescribe OCPs to provide information about the potential for a postfertilization effect.
Patients can then make a more fully informed choice about fertility control options.
Certainly, family physicians, who aim to treat the whole person, should seek to be aware of situations in which prescribed drugs may not be consonant with the value systems of our patients. Update on oral contraceptive pills. Rice-Wray E, et al. Clinical evaluation of norethindrone acetate in fertility control. Physician's Desk Reference.