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Practitioner. 1991 Nov;235(1508):868-70, 873.

Contrasting contraceptive needs.

Abstract

PIP:

When prescribing a contraceptive method, physicians must consider factors such as cultural background, age, phase of the family life cycle, and the presence of any specific illnesses. Most diversified are the contraceptive needs of newly married couples, some of whom will want to delay childbearing. In cases of 2nd marriages where no additional children are desired, high efficacy contraception or sexual sterilization may be indicated. For those who wish to space births, condoms and the IUD are popular choices. Given a trend toward postponed childbearing, women in their 30s need counseling on the effects of age and parity on fertility. Healthy nonsmokers can continue to use low-dose combined oral contraceptives (OCs) into their 40s, while smokers should use the progestogen-only OC. Contraceptive services also need to be attuned to religious views on issues such as marriage and abortion. Requests for female physicians should be respected, and women from cultures that grant them low status may require participation from their husbands in the consultation. Finally, combined OCs can be tolerated by women with well-controlled diabetes mellitus, epilepsy, and sickle-cell disease, but should not be prescribed to women with liver disease.

PMID:
1843611
[Indexed for MEDLINE]

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