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Module 8: Concepts in contraception
As well as factual knowledge, good communication and awareness of personal beliefs and preferences will also play a large part in contraceptive counseling. Giving correct information in a sensitive manner can also be difficult in circumstances where the woman may have heard the "urban myths" about some methods of contraception which we know are not evidence based.
There is no ideal contraceptive method. Helping women and their partners choose an appropriate contraceptive will depend on their particular circumstances, what failure rate is acceptable and whether contraindications exist. After taking a history to rule out whether any contraindications exist to any method, it is often best to ask the woman which method she has been thinking of using and start from there.
As with all consultations confidentiality is an important issue in contraceptive counseling and all women, particularly young women, need to be reassured that this is the case.
We will start with the legal aspects of contraceptive provision and then move onto looking at a woman's cycle and fertility awareness both before and after pregnancy. Understanding of this will help us when we come to looking at how various methods of contraception work. We will also discuss the methods available in New Zealand and compare how they work and the failure rates.
Resources: Useful book and website
You will be able to directly access the majority of the readings. However there is a really good book on contraception - Contraception Your Questions Answered by John Guillebaud and Anne MacGregor -7th edition, 2017 and this is available at all hospital sites as one of your reference books. Try not to take it away so that it can be available for everyone. The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists has a really excellent website with many useful publications. You will be directed to these as we go on but you should have a look at it as there is lots of other useful info particularly under Standards and guidance. Most of these are free to download-access at www.fsrh.org
Objectives
- discuss the laws pertaining to family planning matters in New Zealand
- explain the changes during a woman's menstrual cycle
- describe fertility during the cycle and in the puerperium
- list the different forms of contraception currently available in New Zealand
- define the failure rate for each form of contraception in terms of Pearl Index, and contrast the user failure rate with the theoretical failure rate.
Readings
Recommended text
Guillebaud J, MacGregor A. Contraception: your questions answered. 7th ed. Amsterdam : Elsevier.; 2017.
Catalogue
Recommended website
Faculty of Sexual and Reproductive Healthcare, Royal College of Obstetricians and Gynaecologists. https://www.fsrh.org
Readings
Kubba A, Guillebaud J, Anderson RA, MacGregor EA. Contraception. Lancet. 2000;356(9245):1913-9.
Full text
Family Planning. Fertility awareness. 2008. Available from: http://www.familyplanning.org.nz/advice/contraception/fertility-awareness
Royal College of Obstetricians and Gynaecologists, Faculty of Sexual and Reproductive Healthcare, Clinical Effectiveness Unit. Fertility awareness methods. 2015. Available from: https://www.fsrh.org/documents/ceuguidancefertilityawarenessmethods/
Royal College of Obstetricians and Gynaecologists, Faculty of Sexual and Reproductive Healthcare. UK medical eligibility criteria for contraceptive use. 2016. Available from: https://www.fsrh.org/ukmec/
