EXERCISES: CONTRACEPTION & AFTERCARE

EXERCISE 6.1

Purpose: To role-play contraceptive counseling and understand recent evidence based contraceptive developments, precautions, and use.

  1. A 17-year old G0P0 patient comes to the clinic that is sexually active and currently using withdrawal and condoms.  Can you role play how you might initiate the conversation, learn about their priorities, and simplify the choice process for them?  Consider using either Your Birth Control Choices or How Well Does Birth Control Work chart as a visual aid.
  2. A patient presents to the clinic seeking to switch to a new method of contraception. They are currently on DMPA, which has been causing weight gain, and want something non-hormonal. A friend mentioned having pain with an IUD, so your patient is hesitant to consider that option. Role-play a healthcare encounter using a patient-centered model. (Adapted from Dehlendorf).
    • What did you like about it or find challenging?
    • How was it different or similar to patient encounters you’ve had previously?
  3. What would you discuss with the following patients regarding to their desire for contraception?
    1. A 36-year-old smoker with moderate obesity who wants the patch.
    2. A 19-year-old who intends to use abstinence.
    3. A 29-year-old with migraine headaches with aura who wants the pill.
    4. A 20-year-old nulliparous patient with a history of Chlamydia at age 15 and who wants an IUD.
    5. A 28-year-old patient who is overweight, has vaginitis, and wants emergency contraception (for unprotected intercourse 3 and 5 days ago), as well as ongoing contraception.
    6. A 25-year-old with SLE who is interested in the ring.
    7. A 31-year-old who takes anti-seizure medications and wants the pill.
    8. A 27-year-old who wants a combined hormonal method but doesn’t want a monthly period.

Teaching Points

EXERCISE 6.2

 

Purpose: To review routine follow-up after uterine aspiration, please answer the following questions.

  1. A patient has had nausea and vomiting throughout pregnancy. How long will it take for them to feel better after the abortion?
  2. Providers typically advise patients to call the office if they have certain “warning signs” following uterine aspiration. What “warning signs” would you include and why?
  3. After an aspiration, how long would you advise your patient to wait before resuming exercise, heavy lifting, and vaginal intercourse? What is the rationale for your recommendations?

Teaching Points

*