On 10-12-28 08:03 PM, Graham Balin wrote:
>> Unlikely to use barrier contraception or abstain.
>
> For how long? Not even till the result of a serum b-HCG in a couple of
> weeks?
Already had at least 2 episodes of unprotected SI despite knowing that depo
is overdue.......so very likely to happen again......and indeed, did.
> I would try to explan that if she is at risk of being pregnant, although
> there is a fair chance she isn't. If she is, her life will be a damn
> sight more complicated than it is already. I would say that I'd be happy
> to insert a Mirena now; otherwise we would have to wait until we can
> prove her non-pregnant. Mirena would be a better option for her anyway,
> esp if her first preg was vaginal.
Now I am a bit confused. I am not clear why inserting a Mirena would be
fine but not depo
>
> I would not stress too much about teratogenic drugs as at this stage they
> would either be abortifacient or nothing.
Probably :-)
I will share my thoughts:
Depo in early pregnancy - no known risk (known to me - but happy to be
corrected if anyone knows differently).
Depo known to be effective for 14 weeks.
Last UPSI few days ago - _could_ have emergency contraception for this
(UPSI before was within 14weeks of last dose of depo - so not a preg risk
and thus emergency contraception not contra-indicated by it).
*Needs birth control for her life* *Needs birth control because of her meds*
So - with no known risk to depo and known risk to her meds (leaving aside
her personal desire for birth control) - doesn't it make sense to give her
her depo *now*?
.....so, the question is posed....'why is that out of fashion?' I see in
the UK guidelines that indeed it _is_ out of fashion there......with the
requirement being to tell her to use barrier methods/abstain for some weeks
before we 'allow' her her birth control.
.......I don't understand that stance - but perhaps there is an issue that
I am not comprehending, that leads to it.
........the Society of Obs and Gynae of Canada guidelines, of similar
vintage to the UK ones say 'check preg test, give the depo asap, repeat
preg test in 3w' (and of course emergency contraception if indicated).
Can anyone help me understand the uk stance on this please?
Cheers :)
--
Jel
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