Contraception for Beginners - Module 1 Guide PDF

**Contraception for beginners -- Quiz Input Text** **Module 1:** **Why do we need to learn about this? \** Designing and implementing effective, safe contraception is a serious and complex task. To ensure women\'s safety, strict regulations must be followed, and various preliminary tests must be...

**Contraception for beginners -- Quiz Input Text** **Module 1:** **Why do we need to learn about this? \** Designing and implementing effective, safe contraception is a serious and complex task. To ensure women\'s safety, strict regulations must be followed, and various preliminary tests must be conducted before determining the appropriate method. **\** Across England and Wales, there were over eight hundred thousand conceptions in 2021 and Data from Public Health England shows that 45% of pregnancies and one third of births are unplanned or associated with feelings of ambivalence. For some, these unplanned pregnancies can have adverse health impacts for the mother, the baby or children in later life. A recent report from NHS Digital shows an increase in the uptake of long-acting reversible contraceptives, like implants, or injectable contraceptives. In contrast, although still the most popular type of contraceptive method, the uptake of the contraceptive pill is down from recent years. Good education in contraception works, and in the UK, over the last ten years, there's been a steady decline in the number of emergency contraception provided by Sexual and Reproductive Health services and at other services in the community. Contraception is much more than prevention, it's about empowering people and giving them choice and control in their future. As a healthcare professional, it's important to understand how to support patients with their contraception choices as well as sexual health. It's our job to provide comprehensive sexual health education and make contraception accessible, effective and most of all safe. Because everyone has the right to choose if and when they want to become parents. **Conception & Pregnancy** Understanding the intricate process of conception and early pregnancy, including the hormonal changes, is essential when considering contraception methods. **\** Conception begins with ovulation, which occurs around day 14 of a typical 28-day menstrual cycle. During ovulation, an egg is released from the ovary and travels down the fallopian tube. When unprotected sex occurs, millions of sperm are released into the vagina. These sperm swim through the cervix and uterus, aiming to reach the fallopian tube where the egg awaits. Out of millions, only one sperm successfully penetrates the egg's outer layer. This moment is called fertilisation, and it results in the formation of a single-celled zygote. The zygote begins to divide rapidly, forming a cluster of cells known as a blastocyst. This journey down the fallopian tube takes about 5-7 days. Once the blastocyst reaches the uterus, it implants itself into the uterine lining. This crucial step is called implantation, and it marks the beginning of pregnancy. From here, the cells continue to divide and develop, eventually forming the embryo and placenta. Hormones are released to support the pregnancy, and the woman's body begins to adapt to nurture the growing baby. Understanding conception helps us appreciate the complexity of human reproduction and communicate this with our patients. **The UK Medical Eligibility Criteria:** **The UK MEC** - Gives guidance to providers of contraception about who can use each contraceptive methods safely - It is based on best evidence and where robust evidence is not available, the advice of clinical experts - The recommendations identify health conditions (e.g. hypertension) or characteristics (e.g. smoking) which may affect the safety of the method - Does not give recommendations about efficacy or advice about drug interactions - It is intended to be used as guidance and does not replace clinical judgement - Guidance is available online both as full guidance and in a shortened summary document **The UKMEC four categories** All forms of medication carry some level of risk. To assess the level of risk, a series of key health conditions and characteristics are considered in relation to contraceptive choices and are graded into four categories. Drag each slider to show the balance of advantages and risk for each category. Category 1: A condition for which there is no restriction for the use of the method Category 2: A condition where the advantages of using the method generally outweigh the theoretical or proven risks Category 3: A condition where the theoretical or proven risks usually outweigh the advantages of using the method. The provision of a method require expert clinical judgement and/or referral to a specialist contraceptive provider, since use of the method is not usually recommended unless other more appropriate methods are not available or not acceptable Category 4 : A condition which represents an unacceptable health risk if the method is used **UKMEC Key areas to look out for** Let's look at some key areas covered by the UK MEC. **\** The UK Medical Eligibility Criteria (UKMEC) from the Faculty of Sexual and Reproductive Healthcare is the go-to decision making tool to assess the best contraceptive method and approach for patients. The UKMEC is an extensive resource, however we'll focus on a few key areas. For example, the UKMEC provides guidance on the use of contraception for breastfeeding women. For those less than 6 weeks postpartum, combined hormonal contraception is not recommended. However, after 6 weeks, options become more flexible, depending on the breastfeeding status and the woman's health. Smoking is also covered, Smoking significantly impacts the eligibility for certain contraceptives. For women over 35 who smoke, especially those smoking 15 or more cigarettes a day, combined hormonal contraception is generally not recommended due to increased health risks. Obesity can influence the safety and effectiveness of contraceptive methods. Women with a BMI of 30 or higher may face additional risks when using combined hormonal contraception. The UKMEC provides specific guidelines to ensure safe and effective contraceptive use for women with higher BMIs. Let's consider Samantha, a 20-year-old student, she smokes and has had a boyfriend for 3 years. He is a student in another city, and they meet every 2 weeks. They have decided to get married and plan to have a child within the next 5 years. There is a history of breast cancer in the immediate family and her mother has BRCA1/BRCA2 gene. Following the UKMEC, we can see that the Copper-bearing intrauterine device would be a good choice for Samantha.  We can also see that the Combined hormonal contraception carries an increased risk, due to the family history of breast cancer. Understanding the key areas and others covered by the UKMEC helps healthcare providers offer personalised and safe contraceptive advice. **The UK MEC: Initiation, continuation and safety risks** The UK Medical Eligibility Criteria (UKMEC) provides comprehensive guidelines on the safety of initiating and continuing contraceptive methods based on various health conditions and personal characteristics. Select the icons below to explore the differences between the terms. **Initiation**- The UKMEC outlines safety relating to health conditions and characteristics present at the point of starting or initiating the method **Continuation**- Guidance is also given on the safety of continuing a method if a health condition or characteristic develops while the patient is using the method **Safety risks** - Safety risks need to be balanced against the individual health risks that may develop if the patient were to become pregnant