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Basic steps of client care

Levonorgestrel (LNG) Emergency Contraceptive Pills Session III: Providing LNG Emergency Contraceptive Pills (ECPs). Basic steps of client care. Greet client, introduce yourself, and ask what he/she needs. Show a respectful attitude

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Basic steps of client care

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  1. Levonorgestrel (LNG) Emergency Contraceptive PillsSession III: Providing LNG Emergency Contraceptive Pills (ECPs)

  2. Basic steps of client care • Greet client, introduce yourself, and ask what he/she needs. • Show a respectful attitude • Explain that your discussion with the client will be kept confidential. • Explain the different ECP options. • Screen the client for ECP use. • Tell client about ECPs; give clear information about use, side effects, and needs for referral or follow-up. • Discuss options for regular contraception with client.

  3. Counseling ECP clients When counseling a client about ECP, the provider should: • Actively involve the client in the counseling process • Reassure the client that all information she gives you is kept confidential • Provide a private and supportive environment • Do not make judgmental comments or indicate disapproval through body language (such as such as crossing your arms over your chest) • Be responsive to the client’s needs • Be supportive of the clients choices • Be respectful

  4. Addressing common concerns, rumors and misconceptions about ECPs Correct common concerns, rumors or misconceptions by emphasizing: • The availability of ECPs does not increase risky sexual behavior. • ECPs do not prevent implantation • ECPs do not cause abortions • ECPs do not cause deformed babies • ECPs are not dangerous

  5. When do rumors occur? • Information given is important to people, but it has not been clearly explained. • There is nobody available who can clarify or correct the incorrect information. • The original source is perceived to be credible. • People are motivated to spread them for moral, religious or political reasons.

  6. How to counteract rumors • Listen politely and don’t laugh • Find out where the rumor came from • Explain the facts • Always tell the truth • Clarify information • Use examples • Reassure the client

  7. How to use ECPs ECP information for the client should include: • How and when to take the pills. • What to expect once the pills are taken. Including possible side effects and what the woman should do. • Effectiveness/failure rates. • Importance of using regular contraception.

  8. Possible side effects of ECPs After taking ECPs, some women experience: Changes in bleeding patterns (not serious and will resolve without treatment) • Slight irregular bleeding for 1-2 days or • Monthly bleeding that starts earlier or later than expected Within the week after taking ECPs (these side effects are not serious and usually resolve within 24 hours) • Nausea • Vomiting (rare with LNG-only ECPs or UPA) • Abdominal pain • Fatigue • Headaches or dizziness

  9. Need continuing protection? Ask your client: • Could unprotected intercourse happen again? • Do you need dual protection from pregnancy and STIs/HIV/AIDS? • Can you always choose when you have sex? • Have you been using an regular method of contraception? Are you satisfied with it?

  10. Follow up and referral for clients • If the client reports no menses within 4 weeks of ECP use, she may be pregnant. • Invite client to tell her story, including the number of sex partners. If her story suggests STI exposure, refer for treatment. Discuss use of condoms if appropriate. • If at risk for STIs, discuss dual protection from pregnancy AND from STIs/HIV/AIDS • If story suggests coercion or violence, provide more help if possible. • Can start another method right away. If client chooses no regular method now, offer ECPs and male or female condoms with instructions for use. • Contraceptive use should never be made a condition for ECP use.

  11. When to begin a regular method of contraception following ECPs Method When to begin Immediately The day after taking ECPs or wait until next menstrual bleeding The same day as the ECPs or within the first 7 days after the start of her next menstruation The same day as the ECPs, but needs back-up method for first 7 days Same day as ECPs or after menstruation has returned, but needs condoms or COCs until then Can be used for emergency contraception, or on the same day if taking ECPs or within the first 7 days after the start of her next menstruation Condom COCs Progestin-only injectable Monthly injectable Implants IUD

  12. Resuming contraception after ECP use Contraceptive How to resume the method Use a condom for every sexual encounter Use a condom for the first 7 days. Resume taking COCs as before or continue using condoms until menstruation, then begin a new pack. Use condoms until next menstruation and then begin progestin-only injectable. Need for ECP rare, but If implant or IUD is past expiration and ECP is needed, use a condom until next menstruation. Have a new implant or IUD inserted within first 7 days of menstruation. Condoms COCs Progestin-only injectable Implant and IUD

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