Family Planning, Reproductive Health, and Sexually Transmitted Infections
Core concepts
Know the WHO eligibility criteria for contraceptive methods (categories 1–4, where 4 means unacceptable risk) and the effectiveness hierarchy: implants and intrauterine devices are long-acting reversible methods with failure rates under 1%, while typical-use failure of pills and condoms is higher. Understand mechanisms, side effects, and non-contraceptive benefits: combined hormonal methods suppress ovulation; progestin-only methods thicken cervical mucus; copper IUDs are spermicidal; condoms are the only method that also prevents STIs.
Counseling
Use a client-centered approach: explain all options, discuss effectiveness and side effects, respect autonomy, and address misconceptions (weight gain, infertility after stopping, return to fertility). Emergency contraception works best the sooner it is taken.
STIs
Know syndromes and management: vaginal discharge, genital ulcers, pelvic inflammatory disease, and the link between untreated STIs and infertility, ectopic pregnancy, and adverse pregnancy outcomes. Recognize syphilis (painless chancre, then rash), gonorrhea and chlamydia (often asymptomatic), herpes (painful vesicles), and HIV (test and treat; prevention of mother-to-child transmission).
Traps
Do not withhold contraception from nulliparous or young women. Distinguish perfect-use from typical-use failure. Remember that hormonal contraception does not protect against STIs.
Rule of thumb
For any client seeking contraception, offer the full method mix and highlight long-acting reversible options, then let the client choose.