CHAPTER 15 1 Describe the mechanism of action of various methods of birth control. 2 Compare the effectiveness ratings of the various methods of birth control. 3 Construct appropriate questions to use while interviewing a woman about her contraceptive history. 4 Describe the risks and benefits of each method of birth control. 5 Rank the various contraceptives in order of their appropriateness for an individual woman. 6 Explain how postpartum status affects choice of contraception. 7 Identify ethnocultural considerations that can affect the choice of contraception for a woman in postpartum status. 8 Identify social and psychologic considerations that help determine the appropriate choice of a contraceptive method after childbirth. 2. Reproductive health history a. Previous complications associated with contraceptive use including satisfaction or dissatisfaction b. Health conditions that affect the choice of contraception c. Factors that affect the timing of resumption of sexual intercourse after childbirth 4. Psychosocial responses regarding contraception a. Attitude toward timing of resumption of sexual activities b. Religious or cultural views about contraception (1) Identify religious or cultural barriers to contraception or to the use of particular contraceptive methods. (2) Identify differences in beliefs or values between the woman and her partner. (3) Identify conflicts between a desire to avoid conception and religious or cultural values that affect choice. c. Attitudes about future pregnancies and their appropriate timing 1. Deficient knowledge about postpartum fertility (1) Explain variations in timing of the return of ovulation and menses during the postpartum period. (2) Explain lack of reliable effectiveness of lactation alone to prevent conception during the postpartum period. (3) Explain the possibility that pregnancy can occur because ovulation occurs before the resumption of menses. (1) Patient states that 4 to 6 weeks after delivery is the usual time for the return of menses in the nonlactating woman. (2) Patient explains that breastfeeding on demand (at least six or seven times daily) without supplementing the infant’s diet with formula or other food delays the resumption of ovulation and menses for some, but not all, women. (3) Patient acknowledges that pregnancy can occur with the first postdelivery ovulation although no menses have occurred. (4) Patient states an understanding of the risk of pregnancy during the postpartum period and the need to use effective contraception if pregnancy is not desired.
Contraception
CLINICAL PRACTICE
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