Workshop 1

1. A condition for which there is no restriction for the use of the contraceptive method.

2. A condition where the advantages of using the method generally outweigh the theoretical or proven risks.
3. A condition where the theoretical or proven risks usually outweigh the advantages of using the method. 4. A condition which represents an unacceptable health risk if the contraceptive method is used.

CATEGORY

WITH CLINICAL JUDGEMENT

WITH LIMITED CLINICAL JUDGEMENT Yes (Use the method)

Use method in any circumstances

Generally use the method

Use of method not usually recommended unless other more appropriate methods are not available or not acceptable

No (Do not use the method)

Method not to be used

Counselling

Mrs. JK aged 30 yrs, BMI 28, P3 all SVD, LCB 3 months ago. 3 yrs, 15 months Fully breastfeeding Non smoker, always too late for contraception Now very keen to space her pregnancies Homemaker, very busy with children
Options for Contraception

Natural Methods Barrier / Condom Combined OCP Progestin POP Copper Intrauterine Device Implanon Injectables Ring Intrauterine System

POP Copper Intrauterine Device Implanon Intrauterine System Injectables

1 1 1 1 1

Mrs. LM aged 38 yrs, BMI 35, P1 LSCS 1 year ago for pre ecalmpsia. BP now borderline, not on any medication Does not want any more children Non smoker, Business woman

Options for Contraception

Natural Methods Barrier / Condom Combined OCP Progestin POP Copper Intrauterine Device Implanon Injectables Ring Intrauterine System

POP Intrauterine Device Implanon Injectables Intrauterine System

1 1 1 1 1

WHO Medical Eligibility Criteria for Contraceptive Use

Progestins & BP Blood Pressure Controlled BP Uncontrolled Bp Injectables BP with with vascular disease when BP >160 / 100 1 1 2

Mrs. AB aged 32 yrs, BMI 30, P2 LCB 3 years ago. Not sure if she wants any more children Irregular, heavy painful periods which have become worse after child birth Non smoker

Options for Contraception

Natural Methods Barrier / Condom Combined OCP Progestin POP Copper Intrauterine Device Implanon Injectables Ring Intrauterine System

POP COC Vaginal ring Injectables Intrauterine System Implanon

Ms YU aged 24yrs, BMI 23, P0. Sexually active. Worried about STDs Regular periods Smoker 2 packs per day

Options for Contraception

Natural Methods Barrier / Condom Combined OCP Progestin POP Intrauterine Device Implanon Ring Intrauterine System

COC POP Implanon Ring + C0ndom

Mrs MN aged 33yrs, BMI 36, P3, LCB 1 year ago, all LSCS (elective). Pregnancy induced HT Diabetic on insulin during pregnancy, presently on glucophage 500 mgs bd . Diabetic retinopathy Regular periods, not breastfeeding. Non smoker, varicose veins present Fatty liver
Options for Contraception

Natural Methods Barrier / Condom Combined OCP Progestin POP Intrauterine Device Implanon Ring Intrauterine System

POP IUS / IUD Permanent methods

WHO Medical Eligibility Criteria for Contraceptive Use

Progestins & Diabetes Diabetes Non vascular insulin / non insulin dependant 2 Vascular disease (retinopathy) Injectables diabetes with vascular disease long standing diabetes 2 1

Mrs PQ aged 36yrs, BMI 34, P2, LCB 1 year ago, Both LSCS (elective). DVT after last pregnancy Hypothyroid on medication Regular heavy periods, not breastfeeding. Smokes about 10 cig / day, has varicose veins,

Options for Contraception

Natural Methods Barrier / Condom Combined OCP Progestin POP Intrauterine Device Implanon Ring Intrauterine System

WHO Medical Eligibility Criteria for Contraceptive Use

Progestins & Diabetes DVT
History of DVT 2

Acute DVT
On anticoagulants Known thrombogenic events

3
2 2

Smoking Varicose Veins

1 2

POP IUS Implants Injectables

Thank you for listening