There may be a discrepancy between the strength of the patient’s demand for contraception and her reliability in using it. Some women and couples do not use contraception at all, although they could benefit from doing so. They fail to attend either the general practitioner or family planning clinic for advice, but are nevertheless frequent attenders at the surgery for various physical ailments of themselves or their children. Such women or their children are often involved with the social services, and may have children on the non-accidental injury or sexual abuse register. They tend to be labelled as feckless and inadequate, or as ‘poorly motivated’. They form the bulk of the work of a domiciliary family planning service, and some of the insights gained in working with them will be discussed later in this chapter.


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