Description
Peer Responses:
Relate to another journal reading
Length: A minimum of 180 words per post, not including references
Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
36-year-old mother of 3 that states she does not want to have any more children.
Three Birth Control Options
Progestin Implant
Pros – according to Thaxton and Lavelanet (2019) advantages to a progestin-only implant include high efficacy (less than 1 pregnancy per 100 women in a year of use), fertility typically returns in about 1 month after removal, and the progestin-only hormone may reduce menstrual cramps and bleeding for some women. Cons include difficulty access to trained clinicians to implant and remove, high costs, and usual infection risks with implanting the device under the skin (Thaxton & Lavelanet, 2019). Indications include a long-term, maintenance free option and for a patient that may require hormonal treatment to help with menstrual cramping/bleeding. Contraindications include pregnancy, liver disease, known or suspected breast cancer, unexplained vaginal bleeding, or thrombolytic disorders (Arthur, 2023).
Copper IUD
Pros for this method are its nearly 100% efficacy and its effectiveness for up to 10 years and can be implanted up to 5 days post fertilization to prevent pregnancy; it is also reversible (Arthur, 2023). The copper IUD is hormone-free using copper ions to disrupt sperm function and prevent implantation (Arthur, 2023). Cons – because it is hormone-free, it may result in higher frequency and intensity of menstrual bleeding and cramps/pain (Arthur, 2023). The typical risks – pain, irritation, infection – also exist as it is implanted via a small surgical procedure. Indications – this method could be indicated for someone looking for long-term contraception that is maintenance and hormone-free.
Tubal Ligation
Pros for this method include a guaranteed, permanent solution. In this case, the pro can also be considered a con as the procedure is considered irreversible. Therefore, the decision must be made carefully, and the patient must be considered eligible for surgery (Howard & Soumya, 2023). Indications include a permanent, one-time solution that takes away any uncertainty. The primary contraindication is if there is any uncertainty about permanent nature of procedure (Howard & Soumya, 2023). There is also a risk of ectopic pregnancy, and a chance insurance will not cover all aspect of the procedure, leaving significant cost to the patient (Arthur, 2023).
Recommendations would depend on how sure the patient is about future pregnancy. After careful discussions, if there was any hesitation, I would recommend the copper IUD; if absolutely certain, I would recommend the tubal ligation.
References
Arthur, R. (2023). Gynecologic guidelines. In J. Cash (Ed.), Family practice guidelines. (6th ed). Springer Publishing.
Howard, S. A., & Soumya, R. B. (2023). Non-Hormonal Contraception. Journal of Clinical Medicine, 12(14), 4791. https://doi.org/10.3390/jcm12144791
Thaxton, L., & Lavelanet, A. (2019). Systematic review of efficacy with extending contraceptive implant duration. International Journal of Gynecology & Obstetrics, 144(1), 2-8. https://doi.org/10.1002/ijgo.12696
