For clients who have completed child bearing or do not plan to have children, permanent sterilization (female or male) is an option that may be discussed. both female of male) is an option that may be discussed. Both female and male sterilization are safe are highly effective, and can be performed in an office or outpatient surgery setting (40,41) women and men should be counseled that these procedures are not intended to be reversible and that other highly effective , reversible method of contraception (e.g, implants or IUDs) might be an alternative if they unsure about future child bearing client interested in sterilization, should be refereed to an appropriate source of care if the provider does not perform the procedure.
Women educating client about concentraceptive method that the clients can use safely, provider should ensure that clients understanding the following.
METHOD EFFECTIVENESS. A contraceptive methods rate of typical effectiveness, or the percentage of women experiencing an unintended pregnancy during the first year of typical use, is an important consideration (Trusell J. 2011, CDC.U S. 2013 MMW)
• CORRECT USE OF THE METHOD. The mode of administration and understanding how to use the method correctly might important consideration for the client when choosing a method. For example, receiving a concentrative injection every 3 months might not be acceptable to a women who fears injections.
Similarly, oral contraceptive might not be acceptable to a woman who is concerned that she might not be to remember to take a pills every day.
• NON CONTRACEPTIVE BENEFITS: Many contraceptive, benefits. In addition to preventing pregnancy, such as reducing heavy menstrual bleeding. Although the non concentraceptive benefits are not generally the major determinant for selecting a method, awareness, of these benefit can help client decide between two or more suitable method and might enhance the client’s motivation to use the method correctly and consistently.
• Side effects: provider should inform the client about risk and side effects of the method(s) under consideration, help the client understand that certain side effects of contraceptive, methods might disappear over time, and encourage the client to weight the experience of coping with side effects against the experience and consequences of an unintended pregnancy. The provider should be prepared to discuss and correct misperceptions about side effects. Clients also should be informed about warning sign for rare, but serious adverse events with specific contraceptive methods, such as stroke and venous thromboembolism with use of combined hormonal methods
• PROTECTION FROM SIDES INCLUDING HIV:- clients should be informed that contraceptive methods other than condoms offer no protection against STDs including HIV condom, when used correctly and consistently, help reduce the risk of STDs, including HIV, and provide protection against pregnancy. Dual protection (i.e, protection from both pregnancy and DTDs) is important for clients at risk contracting and STD, such at those with multiple or potentially infected partner(s).dual protection can be achieved through correct and consistent use of condoms with every act of sexual intercourse or correct and consistent use of a condom to prevent infection plus another form of contraception to prevent pregnancy. (for more information about preventing and treating STDs, see STD services).
When educating clients about the r contraceptive methods, provider should ensure that clients have information that is medically accurate, balanced, and provided in a non judgmental manner. To assist clients in making informed decisions, providers should educate clients in a manner that can be readily understood and retained. The content, formal, method, and medium for delivering educations should be evidence based.
When working with male client, when appropriate, providers should discuss information about female-controlled method (including emergency contraception) encourage discussion of contraception with partners, and provide information about how partners can access contraceptive services. Male client should also be reminded that condoms should be used correctly and consistently to reduce risk of STDS, including HIV.
When working with any client, encourage partner communication about contraception as well as understanding partner barriers (e.g misperception, about side effects) and facilities (e.g, general support) of contraceptive use (Kerns J. Westhoft C, morroni Severy L. Silver S. 1994).
The provider should help the client method(s) under consideration. This include consideration of the following factors
SOCIAL –BEHAVIOURAL FACTORS: Social behavioural factor might influence the livelihood, of correct and consistent use of consider the advantages and disadvantages of the method(s) being considered, the client’s feelings about using the method(s), how her or his partner is likely to respond, the client peer’s perceptions of the method(s), and the client’s confidence in being able to use the method correctly and consistently (e.g using a condom during every act of intercourse or remembering to take a pill every day (Grady W, klepinger D. Billy J, Cubbins L Sci 2010)…
