Contraception & Reproductive Choices
Support informed contraceptive decisions using medical eligibility and reproductive goals.
Quick revision ↓ Medical Dictionary
01Start with preferences
Ask whether pregnancy is desired now or later, what methods have been used and what matters most to the patient. Discuss effectiveness in typical use, bleeding patterns, reversibility and ease of use. Provide confidential care and assess reproductive coercion when relevant. The decision belongs to the patient; counselling should support choice without pressure towards a particular method.
02Medical eligibility
Assess conditions and medicines that change safety or effectiveness, including thrombotic risk, migraine features, blood pressure, smoking and postpartum timing where relevant. Combined hormonal methods are unsuitable in some circumstances, while alternatives may remain appropriate. Use current medical eligibility guidance rather than assuming all hormonal methods share identical risks or that one contraindication excludes every contraceptive option.
03Long-acting methods
Implants and intrauterine methods provide effective reversible contraception without daily action. Explain insertion, removal, likely bleeding changes and the differences between hormonal and copper intrauterine methods. Assess pregnancy and infection considerations through the appropriate pathway. Access to removal is part of informed choice, and a request to stop a method should be taken seriously.
04Emergency contraception
Assess timing of unprotected intercourse, cycle information, current contraception, medicines and pregnancy possibility promptly. Oral emergency methods and a copper intrauterine device have different suitability and timing rules. Follow current guidance, including advice on starting or resuming hormonal contraception after the selected method. Arrange pregnancy testing and safety advice where indicated; emergency contraception does not replace ongoing planning.
05Ongoing reproductive care
Explain missed-dose or device concerns using method-specific instructions and reliable contact information. Condoms can add infection protection, while most other contraceptives do not protect against STIs. If pregnancy is unintended, offer non-judgemental discussion and referral to appropriate local services. Review changing health circumstances and preferences rather than treating the first choice as permanent.
High-Yield Revision
- Contraceptive choice should be informed and voluntary.
- Medical eligibility is method-specific.
- Emergency contraception needs prompt, individual assessment.
Common Pitfalls
- Assuming every hormonal method has the same contraindications.
- Forgetting infection protection when discussing pregnancy prevention.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.