Background info

  • 1/3 of pregnancies are unplanned
  • The UK government now promotes long acting reversible contraception (LARC) (e.g. IUD, IUS, implant)as the best method of contraception because:
    • Reduced chance of patient error – e.g. forgetting to take the pill, not using condoms
    • It is also cheaper! – it requires fewer primary health care appointments than e.g. the pill, which has to be reviewed every 3-12 months.
  • Prescribing contraception to under 16’s – you should do so under the Fraser Guidelines (aka Gillick competance) – i.e. the doctor should believe that:
    • The patient is able to retain and recall information, and understands advice given
    • The patient should be encouraged to discuss issues with parents; however in the case that this is not possible, the doctor is still able to proceed
    • The patient is likely to have an active sexual life anyway, even if contraceptives are not given
    • The patients mental or physical health may suffer if contraceptives are not given
    • It is in the patients best interests to receive contraceptives and contraceptive advice, with or without parental consent.
  • Without contraception – 80-90% of women will become pregnant within a year if having regular sexual intercourse.
  • All methods of contraception are free to all men and women on the NHS
  • You should always ask if there is any chance the patient is pregnant before commencing contraception! – If there is any doubt, then just do the test.
  • No contraception is 100% effective!

 

It is important that before any method of hormonal (and also IUD) contraception, the patient is counselled by a trained individual, and provided with information leaflets, and allowed to make their own informed decision.

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