Resources

Contraceptive Pearl: Contraception During COVID-19: E-Visit Contraceptive Template

COVID-19 is putting a strain on the entire health system, requiring clinicians to step into difficult roles and take on risks they may not have been expecting. To all health care workers out there, we stand with you and are grateful for the tireless work you are putting in to help end this pandemic.

We also know that during this time, non-COVID-19 related health care is still needed by many, including reproductive health care. Our upcoming Contraceptive Pearls will be focusing on issues related to providing contraceptive care during this period. Please email us any specific questions or issues of concern you have.

For patients who would like a new birth control method, we have drafted this new E-Visit Template that you can adapt and use in your clinics. It can be used in conjunction with the “Your Birth Control Choices” fact sheet to help patients choose the method that is best for them. This is intended as a template for electronic visits: that is, visits occurring through email or a web-based portal, without any in-person contact.

The IUD/implant chart helps us guide patients regarding the duration for these methods. Patients who are happy with a current LARC method may continue using it up to its maximum evidence-based duration. For patients over 35, the copper IUD will likely continue to work past its removal date, through menopause.

E-VISIT TEMPLATE: Patient desires a new birth control method

Question 1: Have you had unprotected sex in the past 5 days?

  Answer: no, go to Question 4

  Answer: yes, go to Question 2

Question 2: Is your body mass index (BMI calculator link) over 25?

  Answer: no, link to levonorgestrel EC 

  Answer: yes, link to ulipristal EC 

Question 3: Was your unprotected sex more than 3 days ago?

  Answer: no, link to levonorgestrel EC

  Answer: yes, link to ulipristal EC

Question 4: Have you had any of these?

  • Migraine headaches with aura
  • Stroke
  • Ischemic heart disease
  • High blood pressure
  • Liver disease
  • Recent surgery
  • Recent childbirth
  • Blood clot
  • Lupus
  • Cigarette Smoking

  Answer: no, to Question 5

  Answer: yes, please describe and give date

Question 5: After reviewing Your Contraceptive Choices, have you chosen a method?

  Answer: no, please describe your questions and concerns.

  Answer: yes, link to buttons for pill, patch, ring, minipill, self-injection

Patients who need ulipristal should wait 5 days before starting their new method, and should use condoms in the interim.

Question 6: Which pharmacy would you like to use?

IUD/Implant Duration

Brand name Type Duration: FDA Duration:

evidence

Mirena Progestin IUD 5 years 7 years
Liletta Progestin IUD 6 years 7 years
Skyla Progestin IUD 3 years 3 years
Kyleena Progestin IUD 5 years 5 years
Nexplanon Progestin implant 3 years 5 years
Paragard Copper IUD 10 years  12 years

  

We would love to hear from you about the resources you need and the questions you have during this time. Please feel free to reach out to pearls@reproductiveaccess.org.

 

Resources

RHAP Birth Control Choices Fact Sheet

RHAP Birth Control Methods User Guides

Contraception in the Time of COVID-19

Contraceptive Pearl: Progestin IUDs

AAFP Virtual Visit Algorithm

 

Sources

CDC. US Selected Practice Recommendations (US SPR) for Contraceptive Use, 2016. Updated November 2018. https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html.

Wu JP, Pickle S. Extended use of the intrauterine device: a literature review and recommendations for clinical practice. Contraception. 2014 Jun;89(6): 495-503. doi: 10.1016/j.contraception.2014.02.011.

 

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.