24 Jul Contraceptive Management Discussion

Please respond to discussion below using APA 7th edition. Use 3 references dated less than 4 years.

Discussing contraceptive management with patients essentially needs to start by asking the patient about their preferences to steer the conversation in the direction of patient-centered care. As a healthcare provider establishing a good rapport with patients by starting with their wishes and concerns fosters shared decision-making between the patient and provider (Dehlendorf, 2022). During this clinical rotation, I have experienced that the patient has often taken the initiative to explore the different options for birth control methods by searching the internet and talking with friends before coming into the office to discuss the possibilities. It is vital to ensure the patient is well informed of the risk factors and current guidelines on the different methods of contraception to assist in choosing the best method for the individual.

While working with my clinical preceptor this week, a patient was being seen for her 6-week postpartum visit and wanted to discuss her contraception management. After reviewing the patient’s medical history, she did not have any medical conditions that would hinder the decision on the method of contraception. Still, the patient is currently breastfeeding her baby. Before providing clinical guidance, we took the time to listen to the patient about her concerns and the methods she had researched prior to the visit. This patient was aware that continuous lactation could be a method of not getting pregnant but was very concerned about the slight possibility and stressed the importance of wanting to be placed on contraception to reduce the chance further. We further discussed if the patient had returned menses or would be returning to work soon. The patient expressed her menses have not returned, but she will be returning to work earlier than expected, and her baby will be staying with a family member. We provided education on how lactational amenorrhea (LAM) can be effective for birth control. Still, efficacy can decrease if separated from the baby for long periods, supporting her decision to choose another method (Przybylski & Pederson, 2019). The contraceptive counseling continued by discussing progestin-only contraception methods that would be the best option for her due to breastfeeding. We provided the options available were implants, Depo-Provera by injection, or a progestin-only pill. Quickly the patient expressed she was not interested in the possibilities that had long-lasting effects and wished to be started on the progestin-only pill. Since the patient was interested in contraception in pill form, we counseled her on the appropriate way to take the mini-pill, stressed the importance of ensuring the dose was taken each day simultaneously, and discussed the proper way to manage if pills were missed. We also discussed some disadvantages, including possible irregular bleeding, some drugs can interfere, and the possibility of this affecting lipid in the blood, but this was not a big concern relative to her history (Przybylski & Pederson, 2019). The patient expressed how appreciative she was about us taking the time to discuss the risks and benefits of the options available to her.

References

Dehlendorf, C. (2022). Contraception: Counseling and selection (C. A. Schreiber & K. Eckler, Eds.). UpToDate. https://www.uptodate.com/contents/contraception-counseling-and-selection?search=contraception%20counseling%20and%20selection%26source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Przybylski, E., & Pederson, C. (2019). Managing contraception and family planning. In D. M. Schadewald, U. A. Pritham, E. Q. Youngkin, M. S. Davis, & C. Juve (Eds.), Women’s health: A primary care clinical guide (5th ed., pp. 224–267). Pearson.