Contraception counseling or management
During a contraceptive counseling visit, your provider will ask about your reproductive goals and go over your medical history, including any heart or blood‑pressure problems, migraines, smoking habits and medicines you take, to see which methods are safe for you. Most women do not need a pelvic exam or Pap smear to start birth control; a pelvic exam is only needed if an intrauterine device (IUD) is being inserted. Your provider will check your blood pressure and weight and may perform a urine pregnancy test if there is any chance you could be pregnant. They will then explain all of the available options—long‑acting devices like IUDs or implants, hormone pills, patches and rings, injections, barrier methods and emergency contraception—and help you choose based on how effective the method is, how easy it is to use and what side effects you might have.
Birth control methods fall into several categories: (1) Long‑acting reversible options such as hormone‑releasing or copper IUDs and the small arm implant that last from 3 to 10 years; (2) an injection (depot medroxyprogesterone) every three months; (3) combined estrogen‑progestin pills, skin patches and vaginal rings taken daily, weekly or monthly; (4) progestin‑only pills for those who should avoid estrogen; (5) barrier methods like male or female condoms and diaphragms; and (6) emergency contraception pills or a copper IUD after unprotected sex. No medicine is given during counseling; the type of birth control prescribed depends on your choice and health history.
Most healthy women do not need special blood tests before starting birth control. Your blood pressure will be measured because high blood pressure and certain medical conditions make some estrogen‑containing methods unsafe. If pregnancy is possible, a urine pregnancy test may be done. For women with health issues like high cholesterol, diabetes or a history of blood clots, your doctor may order a lipid panel, blood sugar test or clotting studies. Screening for sexually transmitted infections may be done before placing an IUD.
No imaging is required for most birth control. An ultrasound may be used after IUD placement if there is concern about its position or if the strings cannot be found.
Call your doctor right away if you develop any of the ACHES warning signs—severe abdominal pain, chest pain or trouble breathing, sudden severe headaches, vision changes, or swelling or pain in one leg—as these may signal serious side effects like blood clots. Also seek care for heavy or prolonged bleeding, severe pelvic pain, fever or chills after an IUD insertion, if you think you may be pregnant, or if an IUD or implant seems to have moved or fallen out.
Follow‑up depends on the method. After starting a new hormonal method, your provider may check your blood pressure and discuss side effects in about 3 months. An IUD or implant insertion is usually followed by a visit 4–6 weeks later, then yearly. Depot injections are repeated every 3 months. Otherwise, an annual checkup is sufficient unless problems occur
Use your chosen birth control consistently and correctly. Always use condoms, even with other methods, to prevent sexually transmitted infections. Do not smoke if you use estrogen‑containing birth control because smoking raises the risk of blood clots and strokes. Stay at a healthy weight, be physically active, control chronic diseases like high blood pressure or diabetes, and check with your provider before taking new medicines or herbal supplements.
Your primary care doctor can prescribe most forms of birth control. They may refer you to a gynecologist or family planning specialist for placement or removal of an IUD or implant, or if you have complex medical issues. Pharmacists help with refills and can sometimes prescribe birth control directly. You may also be offered counseling on healthy relationships and safer‑sex practices, or assistance from social workers if you need help obtaining contraception.