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Appendix D: Routine Follow-Up After Contraceptive Initiation

These recommendations address when routine follow-up is recommended for safe and effective continued use of contraception for healthy women. The recommendations refer to general situations and might vary for different users and different situations. Specific populations that might benefit from more frequent follow-up visits include adolescents, those with certain medical conditions or characteristics, and those with multiple medical conditions.

TABLE. Routine follow-up after contraceptive initiation

Action

Contraceptive method

Cu-IUD or LNG-IUD

Implant

Injectable

CHC

POP

General follow-up

Advise women to return at any time to discuss side effects or other problems or if they want to change the method. Advise women using IUDs, implants, or injectables when the IUD or implant needs to be removed or when a reinjection is needed. No routine follow-up visit is required.

X

X

X

X

X

Other routine visits

Assess the woman's satisfaction with her current method and whether she has any concerns about method use.

X

X

X

X

X

Assess any changes in health status, including medications, that would change the method's appropriateness for safe and effective continued use based on U.S. MEC (i.e., category 3 and 4 conditions and characteristics) (Box 2).

X

X

X

X

X

Consider performing an examination to check for the presence of IUD strings.

X

Consider assessing weight changes and counseling women who are concerned about weight change perceived to be associated with their contraceptive method.

X

X

X

X

X

Measure blood pressure.

X

Abbreviations: CHC = combined hormonal contraceptive; Cu-IUD = copper-containing intrauterine device; HIV = human immunodeficiency virus; IUD = intrauterine device; LNG-IUD = levonorgestrel-releasing intrauterine device; POP = progestin-only pill; U.S. MEC = U.S. Medical Eligibility Criteria for Contraceptive Use, 2010.


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