At a glance
This appendix summarizes recommendations for health care providers on routine follow-up after contraceptive initiation. This information comes from the 2024 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). The U.S. SPR provides recommendations for health care providers that address a selected group of common, yet sometimes complex, issues regarding initiation and use of specific contraceptive methods.
Overview
This appendix addresses when routine follow-up is recommended for safe and effective continued use of contraception for healthy patients (Table D1). The recommendations refer to general situations and might vary for different users and different situations. Specific populations who might benefit from more frequent follow-up visits include adolescents, those with certain medical conditions or characteristics, and those with multiple medical conditions.
Table D1. Routine follow-up actions after contraceptive initiation
| Action | Contraceptive method | ||||
|---|---|---|---|---|---|
| Cu-IUD or LNG-IUD | Implant | DMPA | CHC | POP | |
| General follow-up | |||||
| Advise the patient that they may contact their provider at any time to discuss side effects or other problems or if they want to change the method. Advise patients using IUDs, implants, or DMPA 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 patient’s satisfaction with their current method and whether they have 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 on the basis of 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 discussing concerns about any changes in weight and whether changes might be related to use of the contraceptive method. | X* | X* | X* | X* | X* |
| Measure blood pressure. | —† | —† | —† | X* | —† |
Abbreviations: CHC = combined hormonal contraceptive; Cu-IUD = copper intrauterine device; DMPA = depot medroxyprogesterone acetate; IUD = intrauterine device; LNG-IUD = levonorgestrel intrauterine device; POP = progestin-only pill; U.S. MEC = U.S. Medical Eligibility Criteria for Contraceptive Use.
* The action is applicable to the contraceptive method.
† The action is not applicable to the contraceptive method.