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NURG 603 CONTRACEPTIVES EXAM
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NURG 603 CONTRACEPTIVES EXAM2024-2025
Should you describe the risks, benefits, alternatives, and potential side effects of
contraception to your patient before prescribing a specific method of birth
control? Should you document that you did so?
yes
a. Healthcare providers are obligated to provide all patients with the benefits, risks,
and SE of BC so patients can make an informed decision on their BC
b. Counseling is likely to increase the likelihood that compliance will be high
c. This should legally be documented, as well as their understanding
What factors affect the choice of contraceptive method?
1. ACOG book: safety, availability, cost, acceptability, and patient physical ability
to appropriately use the method
2. Personal reasons for preventing pregnancy,
3. Contraindications for estrogen
4. Preference of the patient
Coitus interruptus
a. How effective is the “withdrawal” method of birth control?
i. shown to have a 22% pregnancy rate with typical use and a 4% pregnancy rate
with perfect use
b. Disadvantage: lots of self-control required by the male
,c. Risks: risk of pregnancy and STI contraction
d. No contraindications
Lactational amenorrhea
a. How effective is lactation amenorrhea against preventing pregnancy?
i. Reliability:
1. Birth to 6 months: pregnancy rates 0.9-1.2%
2. 6-12 months: 7.4%
b. How soon after a female delivers and breastfeeds might she ovulate?
i. 6 months (the woman is anovulatory if exclusively breastfeeding but may have
menses still)
1. Supplemental feedings might alter both the pattern of lactation and the intensity
of infant suckling which may effect suppression of ovulation
c. Suckling of the infant results in a reduction of GRH, LH, and FSH and prolactin
is suppressed resulting in amenorrhea and anovulation
d. Education: if the woman is not hoping for another pregnancy you should
recommend contraceptives after 3 months after delivery even with exclusive
breastfeeding
Male condom
a. Advantages
i. Provides highly effective & inexpensive contraception
ii. Protects against STDs
iii. Some contain spermicide which may offer further protection against failure
b. Failure Rates:
i. 10-30% in 1st year of use
ii. Imperfections of manufacture (3/1000)
, iii. Errors of technique (doesn’t put the condom on in time)
iv. Escape of semen from the condom
c. Education: can recommend a second contraceptive method for greater protection
Vaginal diaphragm
a. Mechanical barrier b/w the vaginal & the cervical canal
b. Must be used with a spermicide or it is ineffective
c. Additional spermicide should be inserted after the diaphragm in in place
d. Circular rings ranging from 50-105 mm in diameter
e. Designed to fit in the cul-de- sac & cover the cervix
f. Must be fitted by a MD or trained professional
g. Timing
i. Can be inserted 6 hours prior to sex
ii. Must be left in place 6-24 hours after sex
h. Failure Rate:
i. 6 pregnancies per 100 women per year of exposure
ii. Typical use: 15-20 pregnancies per 100 woman years
iii. May result from improper fitting
iv. May result for dislodging during intercourse
i. Aggravating Factors:
i. Women with significant pelvic relaxation can’t use it
ii. May cause vaginal wall irritation (fit too tightly)
iii. Increased risk of UTI (due to pressure against rim of the urethra)
Female Condom
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