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Effective and safe contraception protects women against physical, psychological and socioeconomic consequences of an unwanted pregnancy and against the major decision of induced abortion. In the Netherlands, more than 95 % of contraceptive advice and contraception itself is provided by general practitioners. In addition, in sexual health centres (GGD-Sense) young people under the age of 25 years can get contraceptive advice free of charge. Midwives are involved in discussing or providing contraception after the delivery and in the period between consecutive pregnancies. Gynaecologists are specialized in contraception for women with specific medical conditions or needs, and instrumental or surgical methods. All health workers should have sufficient knowledge about the advantages and disadvantages of the available contraceptive methods. The health worker should provide information on the different contraceptive methods to the individual woman. Above all else, the health worker should take care that this information is objective, understandable and also includes non-contraceptive benefits such as cycle regulation and prevention of sexually transmitted diseases. Choices will be made in accordance with the person’s wishes, possibilities, life course and medical prerequisites. Effective and safe contraception will be different for each individual.
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Involves the use of contraceptive methods which enables men and women to choose if and when to have their children as well as to choose the time-interval between births
Total fertility rate (TFR)
Represents the average number of children that would be born per woman if all women were to live to the end of their childbearing years and would bear children in accordance with current age-specific fertility rates. Without immigration, population growth stops at a TFR of 2.1
Refers to use of the method as intended and covering all acts of exposure to pregnancy
A measure of how effective methods are when used by a group of people under study actually using them
The number of unintended pregnancies divided by the number of women years of exposure to the risk of pregnancy while using the method. A Pearl Index of 2 means that of 100 women who use the method during 1 year, 2 women get pregnant (or 2 % of the users per year)
Defined as the receptivity of a person to sexual stimuli
In monophasic COCs all tablets have the same fixed dose of oestrogen and progestin
Second generation COCs
In second generation COCs all tablets contain an oestrogen and a progestin synthesized later than the original progestins in the pill (first generation)
A long-acting contraceptive method with immediate return of fertility after stopping, such as Implanon, hormone-IUD and copper-IUD. LARCs do not require frequent office or pharmacy visits and do not depend on user compliance for effectiveness
Bone mineral density (BMD)
Usually measured by low-dose x-rays and reflects the strength of bones as represented by calcium content
The practice of maintaining an interval between pregnancies of at least 18 months
EMA. Benefits of combined hormonal contraceptives (CHCs) continue to outweigh risks. 2013. http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2013/11/WC500155455.pdf.
Farmacotherapeutisch Kompas. Accessed at https://www.farmacotherapeutischkompas.nl/.
FSRH Clinical Guidance. Emergency contraception 2012. Accessed at https://www.fsrh.org/standards-and-guidance/documents/ceu-emergency-contraception-jan-2012/.
NHG-Standaard Anticonceptie. 2011. Accessed at https://www.nhg.org/standaarden/volledig/nhg-standaard-anticonceptie.
NVOG Richtlijn Sterilisatietechnieken bij een vrouw. http://nvog-documenten.nl/index.php?pagina=/richtlijn/pagina.php&fSelectTG_62=75&fSelectedSub=62&fSelectedParent=75.
WHO. Health topics. Reproductive health. Accessed at http://www.who.int/topics/reproductive_health/en/.
WHO. Family planning: a global handbook for providers. 2011 Update. https://www.fphandbook.org/sites/default/files/wallchart_english_2012.pdf.
WHO. Ensuring human rights in the provision of contraceptive information and services: guidance and recommendations. 2014. Accessed at http://who.int/reproductivehealth/publications/family_planning/human-rights-contraception/en/.
WHO. Medical eligibility criteria for contraceptive use. 5th ed. 2015. Full text. http://apps.who.int/iris/bitstream/10665/181468/1/9789241549158_eng.pdf?ua=1.
WHO. Selected practice recommendations for contraceptive use. 3rd ed. 2016. http://apps.who.int/iris/bitstream/10665/252267/1/9789241565400-eng.pdf?ua=1.
Dr Frans J. M. E. Roumen
Dr Rik H. W. van Lunsen
Suzy M. de Swart
- Bohn Stafleu van Loghum