Importance of Selected Procedures for Providing Family Planning Methods

Class A = Essential and required or otherwise important for safe use of the family planning method Class B = Makes medical sense in some cases for safest use of the family planning method but may not be appropriate for all clients in all settings Class C = May be appropriate for good preventive health care but not materially related to safe use of the family planning method Class D = Not materially related to either good routine preventive health care or to the safe and effective use of the family planning method
— = Not addressed
NA = Not applicable

Please refer to the following to identify each method:
Low-Dose Combined Oral ContraceptivesCOCs VasectomyVas
Progestin-Only Pills During BreastfeedingPOPs Barrier Methods**BM
DMPA/NET EN InjectablesDMPA Copper IUDsIUDs
Norplant ImplantsNP Lactational Amenorrhea MethodLAM
Female Sterilization*FS Fertility Awareness-Based MethodsFABM

Procedure COCs POPs DMPA NP FS* Vas BM** IUDs LAM FABM
Plevic exam (speculum and bimanual) for women; gental exam for men C C C C A A C1 A C C
Blood pressure reading B C C C A C C C C C
Breast exam B C C C C NA C C C C
STD screening by lab tests (for persons without symptoms) C C C C C C C B2 C C
Cervical cancer screening C C C C C NA C C C C
Routine, mandatory lab tests (for example, cholesterol, glucose, liver function tests) D D D D C3 D D D -- --
Proper infection-prevention procedures C C A A A A C4 A C C
Specific counseling points for family planning method** A5 A5 A A A6 A6 B7 A8 A9 A10
Counseling about change in menses, including irregular or absent menstrual bleeding A A A A -- NA -- A -- --

    * Classification is for both general and local anesthesia.
  ** Classification is for condoms, spermicides, and diaphragm.
*** Specific counseling points: efficacy, common side effects, correct use of method, signs and symptoms for which to see a health care provider, STD protection (when/as appropriate).

  1. Class A for diaphragm.
  2. STD screening by history is Class A, however.
  3. Hemoglobin level testing and urine sugar testing are Class B, however.
  4. Class A for diaphragm fitting.
  5. Including instructions for missed pills.
  6. Points to include: permanent method, preoperation and recovery/postoperation instructions.
  7. Counseling is a good idea but cannot always be done with over-the-counter sales of condoms and spermicides. Class A for diaphragm, however.
  8. Points to include: high-risk behavior; condom use for women who, under certain circumstances, might become at high risk for STDs. NOTE: Women who are currently at high risk for STDs in general should not receive IUDs.
  9. Points to include: LAM criteria, best breastfeeding behavior, and when and where to get follow-up method.
  10. Point to include: importance of partner's cooperation.

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