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Contraception counselling

First ask a few questions

β€˜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

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!

Test yourself with some questions!

Which contraceptive methods are suitable for breastfeeding mothers?

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You have seen a patient with menorrhagia who would like contraception. Which methods would you discuss with her?

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A patient who travels frequently and who does not like taking pills asks for some contraceptive options. What would you suggest?

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A woman who’s partner has HIV with an undetectable viral load asks about contraception. She is HIV-negative. What would you discuss?

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Now try a full OSCE station

  1. Initiating the COCP
  2. Find loads of stations here

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