CONTRACEPTION

1. CONTRACEPTION
Dr Raishem Ali
Associate professor
OBGYN PUMHS

2. CASE 1
• 32 year old women delivered vaginally healthy
baby girl at 38 week of gestation at a local
hospital 24 hour ago.She is breastfeeding and
would like to space her pregnancy for 3 year.
• She is interested in implants.
1. Is she eligible for implant prior to discharge
from hospital ?
2. What other method she can use?

3. Answer
1. yes she is eligible for implant
IMPLANTS are category 2 for women who are
breastfeeding
2 . Ocp
Pop
Cu iucd
These can also be used

4. Case 2
• 24 year old women delivered a healthy baby
at 39 week at a local hospital 6 week ago and
she is breastfeeding. she would like to space
her next pregnancy 3 year.she has history of
hypertension during pregnancy.
1. can we offer oral contraceptive pills for this
patient?
2. what other method she can use?

5. Answer
1.Yes, she is eligeble for progesterone oral
contraceptive pills
History of hypertension is classified as category
2 for the use of combine and progesterone only
pills.
2.Breastfeeding is category 2 for pop from
delivery but use of combine is category 4 at less
than 6 week and category 3 through less than 6
month

6. Case 3
• 26 year old pt who is known case of epilepsy
just delivered her third baby.Her seizers are
well controlled with phenytoin.
Which contracetion she should start in
postpartum period?

7. Answer
• Her contraception offer include
1 Iuds
2 Implants
3 DMPA
4 NET-EN Injectibles

8. Case 4
• 36 year old women delivered vaginally 30
hour back.she is not using ARTs.she is
breastfeeding .she has fever and foul smelling
lochia .she does not want any more childern
.she would like to have iud inserted or BTL
done immediately
1.Is she eligible for these methods?
2.What are the other method she can use?
3.What other advices will you give to her?

9. Answer
1.Not eligible for iud or BTL due to sepsis
2 DMPA
POP
3 Avoid breastfeeding
Can have BTL or Cu iucd once the infection is
treated.
Use barrier methods in addition to above

10. CASE 5
• 17 year old girl is getting married next month
came to you for contraception advices.
• What method would be appropiate for her?

11. Answer
• She can use all method of contracetion
including Cu-IUD and LNG-IUD