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Family Planning: A Global Handbook for Providers

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Family Planning

A GLOBAL HANDBOOK FOR PROVIDERS

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 What's New in This Handbook?

 

This new handbook on family planning methods and related topics is the first of its kind: Through an organized, collaborative process, experts from around the world have come to consensus on practical guidance that reflects the best available scientific evidence. The World Health Organization (WHO) convened this process. Many major technical assistance and professional organizations have endorsed and adopted this guidance.

This book serves as a quick-reference resource for all levels of health care workers. It is the successor to The Essentials of Contraceptive Technology, first published in 1997 by the Center for Communication Programs at Johns Hopkins Bloomberg School of Public Health. In format and organization it resembles the earlier handbook. At the same time, all of the content of Essentials has been re-examined, new evidence has been gathered, guidance has been revised where needed, and gaps have been filled. This handbook reflects the family planning guidance developed by WHO. Also, this book expands on the coverage of Essentials: It addresses briefly other needs of clients that come up in the course of providing family planning.

 

 Updates from 2008 WHO Working Group Meeting

WHO convened an expert Working Group in April 2008 to address questions for the Medical Eligibility Criteria and the Selected Practice Recommendations. This 2008 printing of the Global Handbook reflects new guidance developed in that meeting. Updates include:

 

  • A woman may have an injection of the progestin-only depot-medroxyprogesterone acetate (DMPA) up to 4 weeks late. There is no need for other indications that she is not pregnant. Her next appointment should still be planned for 3 months. (Previous guidance said that she could have her DMPA reinjection up to 2 weeks late.) For the injectable norethisterone enanthate (NET-EN), the guidance continues to say that reinjection can be up to 2 weeks late. (See page 74.)
  • Women with chronic hepatitis or mild cirrhosis of the liver can use any contraceptive method (MEC category1). (See page 331.)
  • Women with deep vein thrombosis who are established on anticoagulant therapy generally can use progestin-only contraceptives (MEC 2) but not combined hormonal methods (MEC 4). (See page 327.)
  • Women with systemic lupus erythematosus generally can use any contraceptive except that:
    (a) A woman with positive (or unknown) antiphospholipid antibodies should not use combined hormonal methods (MEC 4) and generally should not use progestin-only methods (MEC 3). (b) A woman with severe thrombocytopenia generally should not start a progestin-only injectable or have a copper-bearing IUD inserted (MEC 3). (See page 328.)
  • Women taking medicines for seizures or rifampicin or rifabutin for tuberculosis or other conditions generally can use implants. (See page 332.)
  • Women with AIDS who are treated with ritonavir-boosted protease inhibitors, a class of antiretroviral (ARV) drugs, generally should not use combined hormonal methods or progestin-only pills (MEC 3). These ARV drugs may make the contraceptive method less effective. These women can use progestin-only injectables, implants, and other methods. Women taking only other classes of ARVs can use any hormonal method. (See page 330.)

 New Information and Guidance

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