Help Clients Choose Family Planning Method
1. Help Clients Think About Their Needs	2. Consider These Medical Conditions
These questions help clients think about their needs. Discuss only methods that interest the client. Can you think of more questions?	For the client's preferred method, ask about these conditions and explain that they rule out its use. If needed, help the client choose another method.
Combined Oral Contraceptives (The Pill)
___ Do you want an effective method that you can stop at any time? ___ Do you especially want to postpone or to space births? ___ Do you want a method that needs no action during sex? ___ Do you have heavy, painful menstrual periods or anemia? If so, the Pill may be a good choice for you. ___ Do you dislike taking pills or do you forget them? ___ Would it be hard for you to get more pills? ___ Would you stop the Pill if it made your stomach upset at first? If so, the Pill may be a poor choice for you.	Should not be used by women who: ___ smoke cigarettes and also are over age 35. ___ have blood pressure (bp) over 160/100; report high bp but cannot be checked. ___ are breastfeeding a baby less than 6 months old. ___ have had stroke or problems with heart or blood vessels due to blockages. ___ have or had breast cancer. ___ have active liver disease. ___ get bad headaches with blurred vision. ___ might be pregnant ___ have unusual vaginal bleeding that suggests disease (until diagnosed). ___ have long-term, severe diabetes
Condoms
___ Do you or your sex partner(s) need protection from STDs? ___ Do you have more than one sex partner? Does your partner? ___ Are you a man who wants responsibility for family planning? If so, condoms may be a good choice for you. ___ Would you or your partner find it difficult to use a condom with every sex act? Even so, you should use condoms if you need STD protection or have more than one sex partner. Can use another method, too.	Generally should not be used by someone: ___ as the only method if pregnancy would seriously threatened the woman's health. For most couples condom use is only somewhat effective. Can use condoms for STD protection and another method at the same time for greater protection from pregnancy. ___ who has severe allergic reaction to latex.
Female Sterilization
___ Are you sure you will want no more children? Is your husband? ___ Do you want a very effective, permanent method with no upkeep? If so, female sterilization may be a good choice for you. ___ Are you single or have no children? ___ Are you having marriage problems? ___ Are you worried about surgery? If so, female sterilization may be a poor choice for you.	No medical conditions restrict female sterilization, but some conditions call for delay, special care, or a special facility. These include: ___ gynecologic or obstetric conditions, such as pregnancy, infection, cancer. ___ certain heart or blood vessel problems, such as high blood pressure. ___ long-term diabetes. ___ severe iron deficiency anemia. ___ between 7 days and 6 weeks after giving birth.
Vasectomy
___ Are you sure you will want no more children? Is your wife? ___ Do you want to take responsibility for family planning? ___ Do you want an effective, permanent method with no upkeep? If so, vasectomy may be a good choice for you. ___ Are you single or have no children? ___ Are you having marriage problems? If so, vasectomy may be a poor choice for you.	No medical conditions restrict use of vasectomy, but some conditions call for delay, special care, or a special facility. These include: ___ infection (including STDs), swelling, or lumps in penis or scrotum. ___ undescended testicle. ___ diabetes.
Long-Acting Injectable Contraceptives
___ Do you want to keep your family planning private? ___ Do you want a long-lasting, very effective, reversible method? ___ Do you prefer injections? If so, an injectable may be a good choice for you. ___ Would you mind if menstrual bleeding changes or stops? ___ Would you mind some gradual weight gain? ___ Would you want to become pregnant quickly after stopping? If so, an injectable may be a poor choice for you.	Should not be used by women who: ___ are breastfeeding a baby less than 6 weeks old. ___ have heart or blood vessel problems due to blockages; have had stroke. ___ have or had breast cancer. ___ have active liver disease. ___ might be pregnant. ___ have unusual vaginal bleeding that suggest disease (until diagnosed).
Norplant Implants
___ Do you want a long-lasting, very effective, reversible method with no upkeep? If so, implants may be a good choice for you. ___ Would you mind changes in menstrual bleeding? ___ Are you worried about minor surgery? If so, implants may be a poor choice for you.	Should not be used by women who: ___ are breastfeeding a baby less than 6 weeks old. ___ have active liver disease. ___ have or had breast cancer. ___ might be pregnant. ___ has unusual vaginal bleeding that suggests disease (until diagnosed).
Intrauterine Device (IUD)
___ Do you want a long-lasting, very effective, reversible method with little upkeep? ___ Are you in a mutually faithful sexual relationship? If so, the IUD may be a good choice for you. ___ Do you have more than one sex partner? Does your partner? ___ Do you have painful or long menstrual periods? ___ Would you mind touching your genitals to check the IUD strings? If so, the IUD may be a poor choice for you.	Should not be used by women who: ___ have or might get STDs including HIV/AIDS; had an STD or pelvic inflammatory disease (PID) in last 3 months. ___ might be pregnant. ___ have usual vaginal bleeding that suggests disease (until diagnosed). ___ gave birth more than 48 hours but less than 4 weeks ago ___ have infection following childbirth or abortion. ___ have cancer of a female organ or pelvic tuberculosis.
Fertility Awareness-Based Methods Including Periodic Abstinence
___ Can you and your partner agree to avoid vaginal sex during the fertile time or else to use a barrier method or withdrawal? ___ Do your religious or moral beliefs forbid other methods? ___ Do you worry about side effects with other methods? If so, these methods may be a good choice for you. ___ Would charting cycles or noticing fertility signs be difficult? ___ Would abstinence be difficult for you or your partner? ___ Would you be very upset if you became pregnant? If so, these methods may be a poor choice for you.	Generally should not be used by women: ___ if pregnancy would seriously threatened their health, unless other methods are not acceptable. For most couples, these methods are only somewhat effective. No medical conditions restrict use of these methods, but some conditions can make fertility signs harder to recognize: ___ recent childbirth or abortion, breastfeeding, or other conditions affecting the ovaries, such as stroke, serious liver disease, thyroid conditions, cervical cancer. ___ STDs or pelvic inflammatory disease in last 3 months; vaginal infection. These affect cervical mucus. ___ irregular menstrual periods (may make calendar method difficult or ineffective).
Vaginal Methods (Spermicides, Diaphragm, Cervical Cap)
___ Do you want a method a woman controls and can use when needed? If so, vaginal methods might be a good choice for you. ___ Do you want a very effective method? ___ Do you dislike touching your genitals? ___ Would you sometimes forget the method or choose to ignore it? If so, vaginal methods may be a poor choice for you.	Generally, should not be used by women: ___ if pregnancy would seriously threatened their health. For most couples, vaginal methods are only somewhat effective. Diaphragm or cap should not be used by women who: ___ gave birth less than 6 to 12 weeks ago (proper fitting can be difficult). ___ are allergic to latex. ___ have unusually shaped cervix or vagina that keeps diaphragm or cap from fitting. ___ have had toxic shock syndrome.

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