Strategy
Ensure clinicians have the technical skills for initiating, stopping, changing, and removing various contraceptive methods.
Action Step(s)
- If a contraceptive knowledge champion exists at the CHC, create protected time for them to train other clinicians on IUD insertion and removal.
- Contact Merck to schedule subdermal contraceptive implant (Nexplanon) insertion and removal training.
- Ensure all clinicians with prior training in inserting subdermal contraceptive implants have reviewed the updated insertion protocol.
- Identify a local Center of Experience for referral of deep contraceptive implant removals.
- If a contraceptive knowledge champion does not exist at the CHC, arrange for off-site IUD insertion and removal training for clinicians with structured follow-up proctoring upon return.
- Provide training on guidelines for stopping, starting, and changing methods, including use of the US Selected Practice Recommendations for Contraceptive Use.
Tools & Resources
- US Medical Eligibility Criteria for Contraceptive Use, 2016 (Website): From the Centers for Disease Control and Prevention, this publication includes recommendations for using specific contraceptive methods by people who have certain medical conditions.
- Summary Chart of US Medical Eligibility Criteria (PDF): Summary chart of the CDC MEC
- US Selected Practice Recommendations for Contraceptive Use (PDF): From the Centers of Disease Control and Prevention and adapted from the World Health Organization, this document provides evidence-based guidance on how to use certain contraceptive methods safely and effectively once medical eligibility has been established.
- When to Start Using Specific Contraceptive Methods (PDF): A job aide from the CDC on when it’s appropriate to initiate a new contraceptive method and what additional contraception might be needed at initiation
- Management of Bleeding Irregularities While Using Contraception (PDF): A job aide from the CDC on management of bleeding irregularities with different contraception and management of an IUD when PID has been diagnosed.
- Recommended Actions after Late or Missed Combined Oral Contraceptives (PDF): A job aide from the CDC on managing missed or delayed contraceptive pills, patches, or ring.
- Quick Start Algorithm for Hormonal Contraception (PDF): Algorithms from the Reproductive Health Access Project on quick starting various contraceptive methods.
- This is How I Teach: No Touch Technique for Copper IUD (Video): A short video from Innovating Education in Reproductive Health that teaches No-Touch Copper IUD insertion
- This is How I Teach: Self-Injection DMPA-SQ (Website with video lecture): A short video from Innovating Education in Reproductive Health that teaches self-injection of DMPA-SQ
- Request Nexplanon Training from Merck (Website with form): Link to Merck form where clinicians can request free in-person training on the insertion of Nexplanon, a subdermal contraceptive implant
- View Updated Nexplanon Training Module (Website with login required): Any clinicians who trained in Nexplanon insertion prior to 2018 must watch an updated Nexplanon Training Module on the new insertion technique
- Localization and Removal of Deeply Placed Contraceptive Implants (Video): Although most clinicians will not be removing deeply placed contraceptive implants, this important video from Jhpiego teaches localization and removal of deeply placed implants. Understanding the localization and removal can help all clinicians placing implants to avoid deep placement and recognize deep placement for appropriate referrals