Introduction to Contraceptives (Nursing)

00:01 So we've spend a good amount of time talking about being pregnant. Let's talk about what to do if you don't want to be pregnant. Our topic for today is contraception. As we begin our discussion, we need to talk about a few definitions. The first one is family planning.

00:21 So family planning is deciding when we want to conceive a pregnancy. Contraception, on the other hand, is what we do when we want to prevent pregnancy. You're going to see some descriptions of failure rates throughout our presentation today. There are 2 different types of failure rates. The first one is perfect use and that means when the contraceptive device is used exactly as it's supposed to be and perfect every time. But we're human, so a more accurate way to think about failure rate would be typical use and that's what's based on realistic use of the contraceptive methods. Before we go any further, I want to talk to you about some statistics and I want to show you why it's so important that we really have good conversations with our clients around contraceptive use. So, this pie graph shows the percentage of unintended pregnancies. So, 41% of unintended pregnancies occur with clients who are using their contraceptive device incorrectly, 41%. If they use their contraceptive devices correctly, generally speaking it's only a 5% rate of pregnancy. Now let's look at what happens if we don't use contraceptives at all. It's 54%. Now I know that 54 is greater than 41, but it's really not that different. So if you think about that for a second, what that means is we have a whole lot of people going around using contraceptives ineffectively and they're getting pregnant. We want to change those statistics. So let's do that. So the first thing when we're talking to patients about contraceptive devices, we want to know what kinds of things would affect their choices.

02:11 So, how often they have intercourse? Thinking about how motivated they are not to get pregnant in the first place. You may make some different decisions if pregnancy really isn't that big of a deal. How much time they need the contraception? So if I only need the contraception for the next 6 months or for the next year, that's different than when I'm looking for long-term protection. I also want to make sure that our clients understand the use. So if I don't really understand how to use the device or when to use the device, it definitely can affect which one I choose. My risk of pregnancy. So if I'm a young person versus being someone that's close to menopause, that may make a difference in my risk factors. My constancy of use. So again, using it correctly and appropriately every time.

03:00 And finally, all the other health conditions that occur. So when we think about heart disease or diabetes, or autoimmune disorders or headaches or anything else, that may really affect which contraceptive devices are safe for me and ones that I might not want to use. We have a mnemonic to help us remember all the things that we should counsel patients about when they come in for contraception and that's called BRAIDED. So kind of like your hair, braided. The B stands for benefit. What's the benefit of this particular contraceptive device? What are the risks? Are there other methods? So we don't just want to tell the client about one particular method, we want to let them know all the options that are available for them. We want to know that they have all their questions answered when it comes to really understanding the devices. And then we need to let them know that they can change their minds at any point. So this is really important. Sometimes our clients feel like they need to please us and they don't want to tell you that they've gone to try a device and they're not really using it, we want to create a relationship where they feel like they can talk to us about it and say "You know what, I tried X and it just didn't work for me." We also want to make sure that we are giving really quality instructions. So if we're not explaining things very well and our clients don't really understand what we're talking about, then again that contributes to that inconsistent use. And finally, we want to document. You know this is healthcare, so if we don't write it down, it didn't happen. We want to make sure that we document all the elements that are embedded so that everyone knows and so that we know that we've covered the full spectrum of contraceptive counseling.