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Treatment Goals
A primary treatment goal for Claudia today is the choice of a reliable contraceptive method. The patient does not have any serious health problems or chronic diseases; she has a normal weight and does not have allergies to components of contraceptive medicine. Consequently, the choice of possible contraceptive methods will be based on their reliability, availability, and comfort for the patient. It should also be considered that Claudia is not sure about her pregnancy plans. Thus, no radical methods such as sterilization are possible.
Possible Contraceptive Methods
According to the information provided by the Centers for Disease Control and Prevention (CDC) (2016), long-acting reversible methods of contraception (LARC) are considered to be the most effective with more than 99%. They include the intrauterine device (IUD) and the implant. In case Claudia does not plan another pregnancy within the following three or five years, the implant can be recommended. IUD is not approved for the patient because its action lasts from five to ten years, which is too long for Claudia if she plans another pregnancy.
Another contraceptive method suitable for Claudia is hormonal, which includes injections, pills, patch, ring, and diaphragm, with injection being the most reliable method with only 6% of pregnancies (Centers for Disease Control and Prevention, 2016). However, the use of pills for contraception is the most popular method among American women aged 25-34, with 16.9% of young females using it (Daniels, Daugherty, & Jones, 2014). For Claudia, the injection can be a suitable type of hormonal contraception because, as a mother of two, she can forget to take pills on time while the injection has to be done once in three months. Moreover, it can be used in case the patient is breastfeeding. In case the patient is against injections, a blood test for hormones is necessary to select an oral contraceptive between combined and progesterone-only contraceptive pills. Disregarding the choice of contraceptive methods, condoms are still recommended to prevent STDs.
Patient-Centered Teaching
In case LARC is selected as a contraceptive method, the following patient-centered teaching points should be considered.
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LARC is a reliable method with 99% effectiveness, so the patient should not worry about getting pregnant.
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The implant can be used for three to five years, and its action starts immediately after implantation.
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In case the patient plans pregnancy earlier than three or five years, the implant can be safely removed, and the patients fertility returns to normal.
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There is a risk of getting acne with the use of an implant, but it depends on every patient.
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Despite 99% effectiveness of implant, it does not protect against STDs. Consequently, it is advisable to use condoms simultaneously.
Alternative Contraceptive Choice
The choice of contraceptive methods for patients who smoke will be different. The research proves that combined hormonal contraceptives, such as drospirenone-containing pills increase the risk of thrombolytic events (Sidney et al., 2013). Considering the fact that smoking itself causes undesirable cardiovascular problems such as plod pressure increase and increased heart rate and hypertension in the patients history, it is advisable to avoid combined oral hormonal contraceptives. Still, it is possible to use patch or ring as the contraception method because they do not have adverse effects similar to those of combined oral contraceptives. Also, IUD can be used for women who smoke without risk of negative health outcomes.
References
Centers for Disease Control and Prevention. (2016). U.S. medical eligibility criteria for contraceptive use, 2016.
Daniels, K., Daugherty, J., & Jones, J. (2014). Current contraceptive status among women aged 15-44 in the United States, 2011-2013. NCHS Data Brief, 173, 1-8.
Sidney, S., Cheetham, T., Connell, F., Ouellet-Hellstrom, R., Graham, D., Davis, D. & Cooper, W. O. (2013). Recent combined hormonal contraceptives (CHCs) and the risk of thromboembolism and other cardiovascular events in new users. Contraception, 87(1), 93-100.
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