Antepartum Behavioral Methods: Comprehensive Overview and Key Points
ANTEPARTUM
CONTRACEPTION/ BEHAVIORAL METHODS:
- Abstinence: not partaking in sexual intercourse.
- Withdrawal: removal of the penis from the vagina before ejaculation occurs.
- Natural family planning: avoiding intercourse (or using an alternative method of
birth control) during “fertile periods”. Uses calendar method and/or daily
assessment of basal body temperature or cervical mucus consistency.
Key point that you need to know: NO STI PROTECTION WITH WITHDRAWAL AND
NATURAL FAMILY PLANNING METHODS.
CONTRACEPTION/ BARRIER METHODS:
- Diaphragm: a flexible dome placed over the cervix, usually used with spermicide.
Can be inserted up to 6 hours prior to sex
Keep the diaphragm in place for at least 6 hours after sex, but no more than 24
hours total.
Reapply spermicide around the rim prior to each act of intercourse
Get refitted every 2 years, with a weight changed of 20% fluctuation, after
pregnancy, abdominopelvic surgery, weight gain/loss.
- Condoms: male or female, made out of polyurethane or latex. ONLY method that
offers protection against STIs.
Male condoms: pinch tip of the condom during application to create a reservoir for
ejaculation.
CONTRACEPTION/ HORMONAL METHODS:
- Oral contraceptives: hormone based oral medications that suppress ovulation and
prevent implantation. Includes combined oral contraceptives (estrogen and
progestin) or progestin-only “mini-pills”.
Side effects: breast tenderness, breakthrough bleeding, fluid retention, nausea,
HTN, headache.
Contraindication: smoking (increase clot risk), pregnancy, history of blood clots,
stroke, CAD, uncontrolled HTN. Combined oral contraceptives during breastfeeding.
Antepartum Behavioral Methods: Comprehensive Overview and Key Points
, Antepartum Behavioral Methods: Comprehensive Overview and Key Points
Patient teaching: take pills near the same time each day. Monitor for signs and
symptoms of thromboembolic events (DVT, PE, stroke, or MI). Carefully follow
instructions for missed doses. No STI protection.
- Progestin-only pills: are safe during breastfeeding but are less effective than
combination oral contraceptives.
Way to remember: oral contraceptives cause clotting (CCC)
- Transdermal patch: estrogen and progestin patch applied on lower abdomen,
buttocks, or upper body (excluding the breasts).
Apply new patch to a different site each week for 3 weeks, no patch for 1 week to
allow for menstruation.
- Vaginal ring: small, flexible ring that releases estrogen and progestin.
Left in place for 3 weeks, taken out for the 4th week to allow for menstruation.
- Subdermal implant: progestin-only rod implanted under the skin in the upper arm
(using local anesthetic).
Provides 3 years of contraception.
KEY POINT TO KNOW: these methods do not protect against STIs. Side effects
similar to those with oral contraceptives
- Intrauterine device (IUD): T-shaped device inserted into the uterus via the cervix.
Releases hormones or copper ions that harm sperm and prevent fertilization.
Side effects: increase risk of ectopic pregnancy, pelvic inflammatory disease PID,
and uterine perforation, irregular periods, cramping.
Patient teaching: check string length monthly, report to the provider change in
string length/ abdominal pain/foul smelling discharge, does not protect against STI.
CONTRACEPTION/ PERMANENT STERILIZATION:
- Female sterilization (tubal ligation): surgery that severs the fallopian tubes.
Provides permanent sterilization, cannot be reversed.
- Male sterilization (vasectomy): surgery that severs the vas deferens.
Requires follow up testing of sperm count!
Antepartum Behavioral Methods: Comprehensive Overview and Key Points
ANTEPARTUM
CONTRACEPTION/ BEHAVIORAL METHODS:
- Abstinence: not partaking in sexual intercourse.
- Withdrawal: removal of the penis from the vagina before ejaculation occurs.
- Natural family planning: avoiding intercourse (or using an alternative method of
birth control) during “fertile periods”. Uses calendar method and/or daily
assessment of basal body temperature or cervical mucus consistency.
Key point that you need to know: NO STI PROTECTION WITH WITHDRAWAL AND
NATURAL FAMILY PLANNING METHODS.
CONTRACEPTION/ BARRIER METHODS:
- Diaphragm: a flexible dome placed over the cervix, usually used with spermicide.
Can be inserted up to 6 hours prior to sex
Keep the diaphragm in place for at least 6 hours after sex, but no more than 24
hours total.
Reapply spermicide around the rim prior to each act of intercourse
Get refitted every 2 years, with a weight changed of 20% fluctuation, after
pregnancy, abdominopelvic surgery, weight gain/loss.
- Condoms: male or female, made out of polyurethane or latex. ONLY method that
offers protection against STIs.
Male condoms: pinch tip of the condom during application to create a reservoir for
ejaculation.
CONTRACEPTION/ HORMONAL METHODS:
- Oral contraceptives: hormone based oral medications that suppress ovulation and
prevent implantation. Includes combined oral contraceptives (estrogen and
progestin) or progestin-only “mini-pills”.
Side effects: breast tenderness, breakthrough bleeding, fluid retention, nausea,
HTN, headache.
Contraindication: smoking (increase clot risk), pregnancy, history of blood clots,
stroke, CAD, uncontrolled HTN. Combined oral contraceptives during breastfeeding.
Antepartum Behavioral Methods: Comprehensive Overview and Key Points
, Antepartum Behavioral Methods: Comprehensive Overview and Key Points
Patient teaching: take pills near the same time each day. Monitor for signs and
symptoms of thromboembolic events (DVT, PE, stroke, or MI). Carefully follow
instructions for missed doses. No STI protection.
- Progestin-only pills: are safe during breastfeeding but are less effective than
combination oral contraceptives.
Way to remember: oral contraceptives cause clotting (CCC)
- Transdermal patch: estrogen and progestin patch applied on lower abdomen,
buttocks, or upper body (excluding the breasts).
Apply new patch to a different site each week for 3 weeks, no patch for 1 week to
allow for menstruation.
- Vaginal ring: small, flexible ring that releases estrogen and progestin.
Left in place for 3 weeks, taken out for the 4th week to allow for menstruation.
- Subdermal implant: progestin-only rod implanted under the skin in the upper arm
(using local anesthetic).
Provides 3 years of contraception.
KEY POINT TO KNOW: these methods do not protect against STIs. Side effects
similar to those with oral contraceptives
- Intrauterine device (IUD): T-shaped device inserted into the uterus via the cervix.
Releases hormones or copper ions that harm sperm and prevent fertilization.
Side effects: increase risk of ectopic pregnancy, pelvic inflammatory disease PID,
and uterine perforation, irregular periods, cramping.
Patient teaching: check string length monthly, report to the provider change in
string length/ abdominal pain/foul smelling discharge, does not protect against STI.
CONTRACEPTION/ PERMANENT STERILIZATION:
- Female sterilization (tubal ligation): surgery that severs the fallopian tubes.
Provides permanent sterilization, cannot be reversed.
- Male sterilization (vasectomy): surgery that severs the vas deferens.
Requires follow up testing of sperm count!
Antepartum Behavioral Methods: Comprehensive Overview and Key Points
