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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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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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