The premise is technically elegant. Hormonal contraceptives carry a measurable environmental impact, largely because synthetic hormones such as ethinyl estradiol are excreted and pass through wastewater systems largely unfiltered, ending up in surface waters where they can affect aquatic organisms. At the same time, physicians and midwives share responsibility for contraceptive counselling, making this one of the few clinical domains where two professions jointly shape the same decision. That dual character—real environmental stakes combined with genuinely shared professional territory—made environmentally sustainable contraception an ideal clinical entry point for the Amsterdam team’s ongoing interprofessional education programme.

Between May 2024 and March 2025, the researchers ran five two-hour interprofessional sessions at Amsterdam UMC as part of the regular curriculum. Seventy-three final-year medical students and midwifery students took part. The evaluation was cross-sectional and mixed-methods, combining post-session questionnaires with independent non-participant observations, in which a researcher attended the sessions to document how students engaged in real time. Quantitative responses were analysed descriptively, while qualitative answers were examined using reflexive thematic analysis—a method in which the researchers explicitly acknowledged their own perspectives as part of the interpretive process rather than pretending to pure objectivity.

The numbers tell a striking story about awareness. The sessions scored highly for relevance, averaging 4.4 on a five-point scale, and overall satisfaction averaged 4.1. Most remarkably, although 79 percent of participants had already received some form of sustainability education during their training, 59 percent had never previously connected sustainability to contraception. After the sessions, 82 percent said they were willing to consider environmental sustainability in their future consultations. In other words, prior planetary health teaching had left most students with abstract knowledge but no clinical bridge; a single well-designed session on one concrete topic supplied that bridge almost immediately.

Independent observation added texture that questionnaires alone could not capture. Students did not passively absorb the material—they debated it. The qualitative analysis surfaced three themes. The first was increased awareness and intended clinical integration: students described a genuine shift in how they would approach contraceptive counselling, moving from a purely patient-centred frame toward one that acknowledged broader environmental consequences. The second theme was a demand for practical information and professional role reflection. Students wanted concrete environmental data on specific contraceptive methods, validated communication tools they could use in consultations, and clarity about whether raising environmental considerations fell within their professional remit at all.

The third theme is the one most likely to spark debate beyond the classroom: ethical ambivalence and critical engagement with the session’s framing. Students did not simply endorse the environmental message—they pushed back on it, questioning how clinicians should weigh individual patient interests against broader environmental responsibility. This tension is inherent to sustainable clinical decision-making. A contraceptive method that is environmentally preferable may not be the best choice for a particular patient’s health, lifestyle, or values. The students’ discomfort was not a failure of the teaching; the researchers argue it was evidence of critical engagement, exactly the kind of ethical reasoning sustainable clinical practice demands.

That ambivalence points to the study’s central conclusion about what planetary health education actually needs. Awareness and intention, the authors found, are necessary but insufficient. Translating environmental consciousness into confident clinical action requires three things: concrete environmental data on contraceptive methods, validated communication tools for raising sustainability in consultations, and explicit ethical frameworks for navigating the individual-versus-planetary tension. Without these, students risk knowing that environmental impact matters but feeling unable to act on that knowledge in a real consultation—reproducing the very gap the teaching was designed to close.

The interprofessional dimension deserves particular attention. Medical students and midwifery students learned side by side, reflecting the reality that both professions counsel patients about contraception. This shared learning environment allowed students to reflect on their own professional roles and on where responsibility for environmental considerations sits across the care team. The authors argue that this interprofessional setting is not incidental but essential: planetary health is inherently a shared enterprise, and teaching it through a clinical topic that two professions jointly own models the collaborative decision-making that sustainable healthcare delivery will require.

What makes this study resonate beyond medical education is its reframing of how sustainability enters clinical consciousness. Rather than treating planetary health as a standalone lecture topic, the Amsterdam team embedded it inside a routine clinical decision that students will face thousands of times in their careers. Every contraceptive consultation becomes a potential moment where environmental considerations can surface naturally, framed by the clinician’s judgement and the patient’s values. The study received no external funding and was delivered as part of the regular educational programme, suggesting the approach is practically implementable without special resources—a detail that matters for institutions considering adoption.

The findings arrive at a moment when healthcare systems worldwide are confronting an uncomfortable paradox: healthcare professionals increasingly face the health consequences of environmental change while healthcare delivery itself contributes to environmental harm. Education that equips future clinicians to recognize and act on that paradox within everyday clinical practice may prove more durable than abstract curricula. The Amsterdam results indicate that environmentally sustainable contraception is a clinically relevant, practically implementable entry point for planetary health education in an interprofessional setting—one that left students more aware, more willing to act, and more ethically alert. Whether that willingness matures into routine clinical practice will depend on the environmental data, communication tools, and ethical frameworks the students themselves said they still need.

Subject of Research: Environmentally sustainable contraception as a clinical entry point for planetary health education: a mixed-methods evaluation of student experiences in interprofessional teaching sessions

Article Title: Environmentally sustainable contraception as a clinical entry point for planetary health education: a mixed-methods evaluation of student experiences in interprofessional teaching sessions

Article References: Tersteeg, Y. C. H., Cohen, E. S., Algera, E., van der Heide, E. E. R., Ashruf, Y., van Roekel, M., Müller, F., & Timmermans, A. (2026). Environmentally sustainable contraception as a clinical entry point for planetary health education: a mixed-methods evaluation of student experiences in interprofessional teaching sessions. BMC Medical Education. https://doi.org/10.1186/s12909-026-10449-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10449-7

Keywords: Environmentally, sustainable, contraception, clinical, entry, point, planetary, health, education, mixed-methods, evaluation, student