Contraception counselling

First ask a few questions

‘First, I need to ask a few questions about your health and relationships to decide which methods are most appropriate for you…’

• Age
• Relationship (regular partner/multiple partners)
• Menstrual history
• Previous contraception and chance of pregnancy
• Are they post-partum or breast feeding?
• PMHx: current conditions, past history, STIs, past obstetric history/previous ectopic pregnancies
• DHx
• Contraindications to COCP
  • Smoking (+ age >35)
  • Hx/FHx of
    • Venous thromboembolism
    • Breast/cervical cancer
    • Migraine with aura

What they like and what they know

• Ask them what they are hoping to get out of the consultation and what they know so far (let the patient lead the consultation)
• Try to determine which type of method will be most appropriate
  • Any preferences 
  • Preferred administration method
  • Ability to remember to take pills
  • Tolerance of injections

Describe a method in more detail

• How it works
• Treatment course
• Side effects/risks (and effects on menstrual cycles)
• Positives vs. negatives

Want to find out how 99% of people passed their exams?

Briefly discuss other options

• Mention alternatives

Ending

• Let the patient think about it and advise them they can return again if they wish to discuss other options
• Summarise
• Give leaflets and recommend websites

Learn about contraception here!

Please note OSCEstop content is for educational purposes only and not intended to inform clinical practice. OSCEstop and authors take no responsibility for errors or the use of any information displayed. 

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A patient presents to ED with chest pain and this trace. What would you do?

Interpretation management

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