Step2: Obtain clinical and social about their medical history to identify methods that are safe. To learn more about factors that might influence a client’s choice of a contraceptive methods providers should confirm the client’s pregnancy intentions or reproductive life plan, ask about the client’s contraceptive experiences and preferences, and conduct a sexual health assessment. When available, standardized tools should be used.
Medical History. A medical history should be taken to ensure that methods of contraception being considered by a client are saft for that particular client. For a female client, the medical history should including should include menstrual history (including last menstrual period, menstrual frequency, length and amount of bleeding and other patterns of uterine venial bleeding), gynecologic and obstetrical history, contraceptive use, allergies, recent intercourse, recent delivery, miscarriage or termination and any relevant infectious or chronic health condition and other characteristics and exposures(e.g, age, post partum, and breastfeeding) that might affect the client’s medical eligibility criteria for contraceptive methods (CDC. 2010).
Clients considering combined hormonal contraception should be asked about smoking tobacco, in accordance with CDC guidelines on contraceptive use (CDC. 2010)
Additional details about the methods of contraception that are safe to use for female clients with specific medical conditions and characteristics (e.g hypertension) are addressed in previously published guidelines (CDC. 2010). For a male client, a medical history should include use of condoms, know allergies to condom, partners use of contraception, recent intercourse, whether his partner is currently pregnant or has had a child, miscarriage, or termination, and the presence of any infectious or chronic health condition, however, the taking of a medical history should not be a barrier to making condom available, in the clinical setting (i.e.., a formal visit should not be a perquisite for a clients to obtain condoms).
Pregnancy intention or reproductive life plan: Each client should be encouraged to clarify decisions about her or his reproductively life plan (i.e.., whether the client wants to have any or more children and, if so, the desired timing and spacing of those children). (CDCMMWR 2006).
- CONTRACEPTIVE EXPERIENCES AND PREFERENCES: Method- specific experiences and preferences should be assessed by asking questions, such as “what method(s) are you currently using if any? What methods have you used in the past?†“have you previously used emergency contraception?â€. Did you use contraception at last sex?†what difficulties did you experience with prior methods if any (e.g, side effects or non compliance)?†“Do you have a specific method in mind?†and :have a specific method options with your partner, and does your partner have any preference for which method you use?†Male clients should be asked if they are interested in vasectomy.
- SEXUAL HEALTH ASSSESSMENT:- A sexual history and risk assessment that considers the client’s sexual practices, partners, past STD history, and steps taken to prevent STDs (CDCMMWR, 2010). is recommended to help the client select the most appropriate method(s) of contraception. Correct and consistent condom use is recommended for those at risk for. CDC recommendation for how to conduct a sexual health assessment have been summarized STEP 3. Work with the client interactively to select the most effective and appropriate contraceptive method. Provides should work with the client interactively to select an effective and appropriate contraceptive method. Specifically, provides should educate the client about conceptive methods that the client can safely use, and help the client consider potential barriers to using the method(s) under consideration use of decision aids (e.g computerized programs that help a client to identify a range of methods that might be appropriate for the client based on her physical characteristic such as health conditions of preferences about side effects) before or while waiting for the appointment can facilitate and maximize the utility of he time spent on this step.
Provides should inform clients about all contraceptive methods that can be used safely. Before the health care visit.
Clients might have only limited information about all or specific methods of contraceptive (Jaccard J.Zolo)
A broad range of methods, including long-acting reversible contraception (i.e intrauterine device (IUDs) and Implants should be discussed with all women and adolescents, if medically appropriate.
Provides are encouraged to present information, potential reversible methods of contraception by using a tiered approach (i.e, presenting information on the most effective method first, before presenting information on less effective methods) (Trussell J. contraception 2011, winner B, Peipert J, Zhao Q, et all. 1998-2007)
This information should include an explanation that long-acting reversible contraceptive methods are safe and effective for most women, including those who have never given birth and adolescents. Information should be tailored and present to ensure a client centered a pproach. It is not appropriate to omit presenting information on a method solely because the method is not available at the service site. If not a methods are available at the service site, it is important to have strong referral inks in place to another providers to maximize opportunities for client to obtain their preferred method that is medically, appropriate. (Severy L, Silver S. 1994).
