This World Contraception Day (26th September) we’re celebrating doctors who work in family planning.
Family planning in New Zealand
Dr Christine Roke is one of New Zealand’s foremost experts in sexual and reproductive health. She’s been working with Family Planning since 1977 and in 2019, became an officer of the New Zealand Order of Merit for her work.
While studying to become a doctor, she chose to do a project on the Lawson quintuplets. This sparked an interest in family planning for Dr Christine, which has turned into a forty-year career.
“I’ve found it very interesting. I think I have been particularly lucky in that I have had a broad range of things, not just being a clinician and working in a clinic. Quite early on I found I really enjoyed teaching (my father was a teacher),” says Dr Christine.
She’s also worked overseas and been involved in professional development for senior doctors.
“It certainly does take something to balance them all. I think, with the teaching and when you’ve got a professional development role, you have to be working in the clinic too. […] I think that it is the basis from which you do your training. I find that when I’m teaching I’ll say things like ‘Last week, I saw this person with this sort of problem,’ and so on.”
How family planning has changed
Dr Christine joined Family Planning when the Contraception, Sterilisation, and Abortion Act 1977 was passed. In March 2020, this was updated with the Abortion Legislation Act 2020 which decriminalised abortion. Dr Christine has been involved in setting up an early medical abortion clinic in Tauranga and access to this will be extended throughout their clinics.
She adds that family planning in New Zealand “has certainly changed a bit” over the past 40 years.
“One of the major ways is that it was purely contraception at the stage when I came into it. Over the years it has moved out beyond that – and beyond women. While most of our clientele are women, we do see men. Also, we do cervical smears, STI testing and a lot of what’s called medical gynaecology, that’s sorting out people with abdominal or pelvic pain, or vaginal bleeding problems who don’t require a surgical solution. People who we can manage with medication of some sort or another.”
Attitudes towards family planning and the scope of what the work entails has changed too.
“It was very much thought that we were encroaching on other doctors’ work but now it is recognised that we do have specific expertise in this and we’re not trying to do anyone else out of a job – we’re just trying to make sure that we can provide a more specific expertise like sorting out those problems of bleeding and pain; or putting in IUDs and removing difficult implants.”
Vocational registration has helped ensure there are now more doctors specifically trained in family planning (rather than only an extension of GP work). Dr Christine was part of the group who organised the Diploma in Sexual and Reproductive Health, which enables doctors to become vocationally registered in Family Planning and Reproductive Health. It’s an option Dr Christine encourages others to consider; “I do think it is a great life for people.”
“In spite of the fact that it sounds like a narrow field, it is broad. And you’re mainly seeing well people and talking to them about their contraception and other sexual health needs. […] It is mostly a 9–5 type of roster (thought it may go into the evening) – there’s no emergency work as a rule so that can suit a lot of people.”
On matters of choice and access to contraceptives, Dr Christine says that even if a patient requests a specific contraceptive method it’s important to let them know there are alternatives in case they’re not aware of them.
“Lots of people don’t know about the different methods. They might say they want the pill but when they hear about the other methods they might prefer one of those. So rather than just state it, ask them if they know and if would they like to hear more about them.”
Maintaining a healthy work-life balance
After 40 years in her career, Dr Christine says finding a healthy balance in life “depends so much on your individual circumstances.”
“We haven’t had children so that’s something that I haven’t had to balance. But it is important that you nurture relationships and you make sure you have time to do that. And of course, delegation, which is something I find difficult to do… no one of us is perfect and no one of us can do everything, so we need to learn how to be part of a team.
“I’m enjoying my life in family planning and I’m still doing the clinical and teaching work. (I’m no longer doing the management part of it.) I’d encourage anyone who has a leaning this way to take it up because I see around me a lot of good doctors who enjoy what they do.”
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