CONTRACEPTION

Contraceptive methods allow you to choose when and whether you want
to have a baby.

However, they don't protect you from sexually transmitted infections

(STIs.).

Contraceptive choice

 Barrier methods have no medical contraindications

 Metabolically neutral

 Higher failure rate

 IUD requires proper patient selection

 Metabolically neutral

 Highly efficacious

 Hormonal contraception requires careful consideration

 Combined vs. progestin only

 Route of progestin-only contraception

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Contraceptive efficacy

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 Approach to Best Method

 First: Do no harm

 Second: Try to do good

 Third: If you don’t know, ask

 Fourth: Document

How Do You Choose the Best Method?

 Thorough medical history and plans for future pregnancy

 Assess medical eligibility for contraception

 Consider evidence surrounding method/ condition interaction

 Efficacy

 Safety/availability of method

Thorough Medical History

 Very important to perform a thorough medical history when

deciding contraception for a woman with a chronic medical
condition

 Is this medical condition going to affect a pregnancy?

 Will pregnancy affect this medical condition?

WHO Medical Eligibility Criteria

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 Contraception for women with medical condition

 Women with chronic medical illness need effective contraception

 Evidence-based guidelines for medical

 eligibility for contraception are readily available

 The risk of contraceptive method needs to be balanced against the

risk of pregnancy

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