Many of the strategies and resources recommended in Component 2.2: Counseling and Education are relevant to this Component. The strategies below are also recommended to support patients and their use of contraception.
- Provide education for contraceptive methods that are based on the patient’s stated needs and priorities.
- Include medical contraindications as appropriate, prior to initiation and throughout reproductive health care, as patient lifestyle, reproductive goals, medications/ contraindications and side effects will change.1,2,3,6
- Use decision aids and a tiered counseling approach for nonjudgmental, accessible patient problem-solving. This will increase effective adoption, change, and maintenance of contraception of choice.1,2,3,4,6
- Co-create a patient-centered plan for contraceptive choice using the highest degree of consistent correct use of method.1,2,3
- Confirm the patient’s understanding of their method of choice.
- Address safety concerns and how to contact the clinic when they have questions or concerns.
- Ensure that all clinics have a 24-hour call-back policy for patient telephone calls about contraceptive concerns. Communicate this to the patient.1,2,3,5
- Create a follow-up plan to sustain the method (follow-up visit in three months, IUD check appointment in six weeks, etc.).
- Encourage immediate contact with the clinic about concerns, uncertainty about maintaining methods as planned, adjustments, and emergency contraception as needed.1,2,3,4,7
- Use effective reminders such as text messages or reminder cards for Depo shots or refills.1,7
- Train staff as to how they will route triage calls from patients with contraceptive questions, or who need emergent care or to make a follow-up appointment.1,6
- For example, will staff send calls to one person or is everyone trained?
- Maintain staff supports for providing quality contraceptive care: updated evidence-based training on methods, standing orders for RNs to dispense methods, updated clinic reference resources (e.g. QFP, Contraceptive Technology, etc.).1,2,3,6
- Providing Quality Family Planning Services (QFP), Recommendations of CDC and U.S. Office of Population Affairs, 2014, pages 7-13: http://www.cdc.gov/mmwr/pdf/rr/rr6304.pdf
- Association of Reproductive Health Professionals – contraceptive decision-making tool: http://www.arhp.org/methodmatch
- World Health Organization – evidence-based contraceptive decision-making tool: http://www.who.int/reproductivehealth/publications/family_planning/9241593229index/en
- National Campaign to Prevent Teen Pregnancy – clinician tool with tips to improve contraceptive use: http://thenationalcampaign.org/resource/careful-current-and-consistent
- Center for Evidence Based Practice-Case Western Reserve University – introduction to motivational interviewing: https://www.centerforebp.case.edu/practices/mi
- References for understanding and problem-solving issues (e.g. irregular bleeding) related to specific methods:
- U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. MMWR Recomm Rep 2013;62:1–60. [PubMed] [Full Text]
- Hatcher, R.A., et al., (20th ed.) (2011). Contraceptive Technology. Ardent Media, Inc.
- Dickey, Richard, P., (15th ed.) 2014. Managing Contraceptive Pill Patients. Fort Collins, CO: Emis Medical Publishers
- U S. Medical Eligibility Criteria for Contraceptive Use, 2010. Centers for Disease Control and Prevention (CDC). MMWR Recomm Rep 2010;59(RR-4):1–86. [PubMed] [Full Text]
- Understanding and using the U.S. Medical Eligibility Criteria For Contraceptive Use, 2010. Committee Opinion No. 505. American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;118:754–60. [PubMed] [Obstetrics & Gynecology]
- Bedsider – method finder tool and appointment reminder services: www.bedsider.org