📚 Reading: ch. 6 · ATI ch. 1 — confirmed by the M1 reading guide
💡 The one idea
Contraception questions are almost always about the contraindication, not the method.
Learn who cannot have estrogen and a large block of the exam answers itself.
🚨 Who must not have combined estrogen contraception
Smoker over 35 — the classic exam stem
History of DVT, PE or clotting disorder
Migraine with aura — stroke risk
Uncontrolled hypertension, known or suspected pregnancy
Breast cancer, active liver disease
Estrogen increases clotting. Every contraindication above is a clot or a hormone-sensitive cancer.
⭐ ACHES — report these immediately
Abdominal pain · Chest pain · Headache (severe) ·
Eye problems · Severe leg pain
Each one is a possible clot. This mnemonic is worth more marks than the method list.
Method
Typical use
Key teaching
Implant / IUD
>99%
Most effective; nothing to remember daily
Injection (Depo)
~96%
Every 12 weeks; bone density loss, take calcium
Combined pill
~93%
Same time daily; estrogen rules above
Condom
~87%
The only method that prevents STIs
Withdrawal / rhythm
~77–80%
Least reliable
✅ The teaching point students miss
An IUD or implant is more effective than sterilization on paper, but only condoms protect
against infection. A patient using an IUD with a new partner still needs condoms —
that is dual protection.
⭐ High-yield — what the exam actually asks
Show 5 moreHide these 5
Diaphragm stays in place at least 6 hours after intercourse. Refit after a weight change or a birth.
Combined OCs are contraindicated in smokers (thromboembolism) and in migraine with aura.
ACHES — report now: Abdominal pain, Chest pain or shortness of breath, Headache (severe), Eye or vision change, Severe leg pain.
Suspected toxic shock with a barrier device: remove the device FIRST, then antibiotics.
A cystocele or other pelvic support problem makes a diaphragm a poor fit — an IUD is the better option.
Show 4 moreHide these 4
Breastfeeding → progestin-only pill. Avoid anything estrogen-containing, and that includes the vaginal ring — it delivers estrogen plus progestin.
The true IUD contraindication is a structural uterine anomaly — congenital malformation, or fibroids distorting the cavity → malposition, expulsion, perforation. Smoking, chronic hypertension and VTE history restrict estrogen methods, not IUDs.
A first-degree relative with a pulmonary embolism means combined OCs need evaluation first — inherited thrombophilia: factor V Leiden, protein C or S deficiency.
Fertility awareness: basal body temperature rises 0.4–0.8°F after ovulation; cervical mucus turns thin, clear and stretchy (spinnbarkeit).
Scale is the thing the words never tell you. The cap is under half the width of the diaphragm, which is why each needs its own fitting. The implant really is the size of a matchstick. The ring is soft and is not felt once it is in — but it carries estrogen and progestin, so it is out while breastfeeding.
Calendar method math: shortest cycle −18 = first fertile day; longest cycle −11 = last fertile day. Ovulation is ~14 daysbefore the next period starts, not 14 days after the last one.
Barrier timing, all three: diaphragm in up to 6 h before, stays 6 h after, out by 24 h. Cervical cap same 6/6 but a 48 h ceiling. Sponge in up to 24 h before, 6 h after, 30 h absolute max.
Refit a diaphragm after a 10 lb weight change, pelvic surgery, or a birth.
Spermicide goes in 15 min before and lasts about an hour; no douching for 6 h. Nonoxynol-9 more than twice daily causes mucosal lesions and raises HIV risk.
Progestin-only pill has a 3-hour window — later than that needs backup. It is the lactation-safe oral option and can start immediately after birth.
Show 5 moreHide these 5
Depot medroxyprogesterone: do NOT massage the site — massage speeds absorption and shortens coverage. Every 11–13 weeks. Return of fertility can take up to 18 months.
Emergency contraception works up to 5 days out, sooner is better; a copper IUD within 5 days is the most effective form. No period within 21 days → pregnancy test. It does not terminate an established pregnancy.
Vaginal ring may be out up to 3 h with no loss of protection; beyond that, new ring plus 7 days of backup.
Vasectomy is not immediate — sterility takes roughly 20 ejaculations or 2–4 months, confirmed by two consecutive zero sperm counts.
Pregnancy with an IUD in place is high-risk for ectopic — report immediately.
📚 From your Maternal & Child textbook
Pillitteri, Maternal and Child Health Nursing — ch. 6 (reproductive life planning) · ch. 7 (genetics) · ch. 8 (difficulty conceiving).
Effectiveness divides on one question: does the method depend on the user doing something correctly every single time? An IUD or implant does not, and fails under 1%. A pill, patch, ring, diaphragm or condom does, which is why typical use and perfect use diverge so far.
Only condoms protect against infection. Everything else is contraception alone, so if the scenario mentions infection risk, a condom is in the answer whatever else is.
⚠️ Exam traps
Read for why a method is a bad fit — anatomy, smoking, migraine, breastfeeding — not which method sounds most effective.
Estrogen restrictions and IUD restrictions are different lists. Do not apply one to the other.
🧠 Mind maps 1
One per disorder, built from the structure of your ATI chapter.
Fertility
🧪 What confirms it
Pelvic exam checks for uterine or vaginal structural anomalies.
Hormone panel: prolactin, FSH, LH, estradiol, progesterone, and thyroid levels assess the hypothalamic-pituitary-ovarian axis.
Postcoital test evaluates coital technique and how sperm interact with cervical mucus.
Ultrasound (transvaginal or abdominal) visualizes the reproductive organs.
🩺 What you do
Recognize infertility as a major life stressor; encourage clients to voice their feelings.
Explain the roles of the genetic counselor, reproductive specialist, geneticist, and pharmacist.
Monitor for adverse effects of fertility medications.
Warn that ART significantly raises the odds of a high-risk multiple gestation pregnancy.
⚠️ What goes wrong
Ectopic pregnancy: ovum implants outside the uterus, often from endometrial tissue or adhesions in the tube.
As an ectopic pregnancy grows, tube rupture can cause severe bleeding requiring surgical removal.
Unruptured ectopic pregnancy is treated with surgical removal or methotrexate to dissolve it.
Losing the tube from ectopic pregnancy raises risk of recurrence and future infertility.
Read left to right: who gets it → what you see → what confirms it → what you do → what goes wrong. Cover a column and rebuild it out loud.
🎥 Lecture recordings 7
Tap a card to open that recording in Google Drive. The same list lives in the lecture library.
ATI Active Learning Template — System DisorderContraception
Filled from ATI chapter 1, row by row from that chapter’s own sections — 12 of 12 rows have content.
10 rows came from outside your ATI chapter — 4 cite a source, 6 are built from this page’s own notes. Each one is labeled.
🧭 What it isAlterations in Health (Diagnosis) · Health Promotion & Disease Prevention
Alterations in Health (Diagnosis)
This chapter compares natural, barrier, hormonal, and permanent contraceptive options, covering effectiveness, correct use, timing windows, and STI protection. It equips nurses to counsel clients on choosing a method matching their lifestyle, health history, and pregnancy-prevention goals.
Health Promotion & Disease Prevention
From this module — built from the notes above on this page, not a section of the ATI chapter.
Preconception counseling at every contraception visit — ask what she wants and when, not just what she wants to avoid.
Only condoms reduce STI transmission. Any other method still needs a condom if STI risk is present.
Folic acid 400 mcg daily for anyone who could become pregnant, started before conception.
Review immunization status — rubella and varicella are live vaccines and must be given before, not during, pregnancy.
Screen for intimate partner violence privately; coercion about contraception is a form of it.
👀 How it shows upAssessment — Risk Factors · Assessment — Expected Findings
Assessment — Risk Factors
Not in your ATI chapter — filled from CDC, 2024.
Combined hormonal contraceptives are Category 4 (avoid) for women with migraine with aura or current ischemic heart disease.
Smokers age 35 or older who use 15 or more cigarettes daily fall into Category 4 for combined hormonal methods.
A personal history of DVT or pulmonary embolism on anticoagulant therapy also rates Category 4 for combined hormonal contraceptives.
Centers for Disease Control and Prevention · Appendix A: Summary of Classifications for U.S. Medical Eligibility Criteria for Contraceptive Use, 2024 · open the source →
Assessment — Expected Findings
From this module — built from the notes above on this page, not a section of the ATI chapter.
Expected on hormonal methods: breakthrough spotting in the first 3 months, breast tenderness, nausea — usually settling.
Depo-medroxyprogesterone: irregular bleeding early, then commonly no periods at all. Expected, not a problem.
Levonorgestrel IUD: lighter periods or none. Copper IUD: heavier, crampier periods.
Implant: unpredictable bleeding is the commonest reason people stop — warn about it up front and it is tolerated better.
Unexpected: severe headache, chest or leg pain, vision change — those are ACHES, and they are never expected.
🧪 How it is confirmedLaboratory Tests · Diagnostic Procedures
Laboratory Tests
From this module — built from the notes above on this page, not a section of the ATI chapter.
No routine bloodwork is required to start most methods — blood pressure and a health history are what matter.
Blood pressure is the one measurement that must be taken before starting a combined method.
Pregnancy test if there is any doubt, before an IUD, implant or injection.
STI testing (gonorrhea, chlamydia) as indicated — it does not delay IUD insertion in someone without symptoms.
Hemoglobin if periods are heavy, particularly with a copper IUD.
Diagnostic Procedures
From this module — built from the notes above on this page, not a section of the ATI chapter.
Pelvic examination before fitting a diaphragm or cervical cap — both are sized to the individual.
Bimanual exam and uterine sounding before IUD insertion, to confirm position and depth.
Ultrasound if IUD strings cannot be felt — to locate it before assuming expulsion.
A cervical smear is not required to start contraception and should not be used as a barrier to it.
🩺 What you doNursing Care · Medications · Therapeutic Procedures
Nursing Care
From this module — built from the notes above on this page, not a section of the ATI chapter.
Match the method to the life, not the effectiveness table — the most effective method is the one she will actually use.
Teach the backup rule: 7 days of backup for most methods unless started within 5 days of the period beginning.
Teach what to do about a missed dose before it happens, not after.
Check she can state ACHES before she leaves.
Document the method, the start date, and the teaching given.
Never assume a partner is not present in the decision. Ask whether the method needs to be undetectable.
Medications
Not in your ATI chapter — filled from CDC.
With typical use, combined oral contraceptive pills fail for about 9 of 100 users in the first year.
Hormonal IUDs have a typical-use failure rate near 0.2%, compared with about 0.8% for the copper IUD.
The subdermal etonogestrel implant is among the most effective reversible methods, with a very low typical-use failure rate.
Centers for Disease Control and Prevention · Effectiveness of Family Planning Methods · open the source →
Therapeutic Procedures
Not in your ATI chapter — filled from CDC, 2024; MedlinePlus.
IUD placement can occur immediately postpartum, but expulsion rates run higher than with interval, non-postpartum insertion.
Female and male sterilization are intended as permanent methods, though reversal is occasionally attempted with variable success.
CDC / MedlinePlus · Intrauterine Contraception (U.S. SPR, 2024); Sterilization Surgery - Making a Decision · open the source →
💬 Around the patientClient Education · Interprofessional Care
Client Education
Calendar rhythm fertile window: start = shortest cycle length minus 18 days; end = longest cycle length minus 11 days.
BBT method: fertility confirmed by 3 consecutive days of temp rise; take temp before getting out of bed.
Cervical mucus method: fertile period begins with thin, slippery mucus (spinnbarkeit) and lasts 3-4 days after.
LAM only reliable if infant is under 6 months, exclusive breastfeeding on a strict schedule, and no menses return.
Diaphragm: insert up to 6 hr before sex, remove within 24 hr; refit after a 4.5 kg weight change.
Cervical cap: max 48 hr in place; replace every 2 years.
Contraceptive sponge: max 30 hr total wear; TSS risk rises if left in over 24 hr.
Interprofessional Care
From this module — built from the notes above on this page, not a section of the ATI chapter.
Provider or advanced practice nurse for insertion of an IUD or implant and for sterilization referral.
Pharmacist — interactions matter: rifampin and some anticonvulsants reduce hormonal contraceptive effectiveness.
Social work for cost and access; method choice collapses to whatever is affordable if this is skipped.
Genetic counseling when a heritable condition affects family planning.
⚠️ What goes wrongComplications
Complications
Not in your ATI chapter — filled from CDC.
Because typical use includes missed doses, the male condom's first-year failure rate reaches about 18%, risking unintended pregnancy.
Postpartum IUD placement raises expulsion risk, so clinicians weigh this against the benefit of immediate contraceptive protection.
CDC · Effectiveness of Family Planning Methods; Intrauterine Contraception (U.S. SPR, 2024) · open the source →
📋 Fertility6 parts
ATI Active Learning Template — System DisorderFertility
Filled from ATI chapter 2, row by row from that chapter’s own sections — 12 of 12 rows have content.
7 rows came from outside your ATI chapter — 5 cite a source, 2 are built from this page’s own notes. Each one is labeled.
🧭 What it isAlterations in Health (Diagnosis) · Health Promotion & Disease Prevention
Alterations in Health (Diagnosis)
Covers infertility evaluation and care for people unable to conceive after 6 to 12 months, including causes, diagnostic workup, assisted reproductive technologies, genetic counseling, and psychosocial support for fertility-related grief and treatment decisions.
Health Promotion & Disease Prevention
Not in your ATI chapter — filled from NICHD.
Losing just 5% of body weight can meaningfully raise the odds of ovulation in women who have PCOS.
Avoiding tobacco, heavy alcohol use, and illegal drugs protects fertility in both female and male partners.
Limiting exposure to known reproductive toxins, such as certain pesticides and industrial chemicals, is advised to protect fertility.
Eunice Kennedy Shriver National Institute of Child Health and Human Development · What lifestyle and environmental factors may be involved with infertility in females and males? · open the source →
👀 How it shows upAssessment — Risk Factors · Assessment — Expected Findings
Assessment — Risk Factors
Not in your ATI chapter — filled from NICHD.
Both obesity and being underweight impair ovulation and reduce the chance of conception in women.
In men, obesity is linked to lower sperm count, and high blood pressure can alter sperm shape.
Radiation therapy and chemotherapy can cause infertility in either partner, depending on dose and treatment site.
NICHD · What lifestyle and environmental factors may be involved with infertility in females and males? · open the source →
Assessment — Expected Findings
From this module — built from the notes above on this page, not a section of the ATI chapter.
Infertility is a diagnosis of time: no conception after 12 months of unprotected sex, or 6 months if she is over 35.
Expected on examination: often entirely normal findings in both partners — which is itself distressing and needs naming.
Irregular or absent periods point toward an ovulation problem; PCOS commonly adds acne, hirsutism and weight gain.
Painful periods and pain with intercourse suggest endometriosis.
Expect grief, guilt, and strain on the relationship. Ask about mood at every visit — it is part of the assessment, not an aside.
🧪 How it is confirmedLaboratory Tests · Diagnostic Procedures
Laboratory Tests
Not in your ATI chapter — filled from NICHD.
A progesterone blood level drawn around day 23 of the cycle helps confirm that ovulation occurred.
FSH and AMH blood tests estimate how many eggs remain in a woman's ovarian reserve.
Semen analysis requires the male partner to avoid ejaculation for about 48 hours before the sample.
Clomiphene citrate and letrozole stimulate ovarian follicle production.
Metformin supports ovulation; exogenous progesterone primes the endometrium for implantation.
IUI: prepared sperm is placed directly into the uterus at ovulation.
IVF-ET: eggs are retrieved, fertilized in the lab, and the embryo is transferred to the uterus.
Gamete intrafallopian transfer: retrieved oocytes and motile sperm are injected together into the fallopian tube via laparoscopy.
Donor oocyte: donor eggs are fertilized via IVF after the recipient's uterus is hormonally prepared.
💬 Around the patientClient Education · Interprofessional Care
Client Education
Not in your ATI chapter — filled from NICHD.
Instruct male partners to abstain from ejaculation for about 48 hours before providing a semen sample.
Explain that more than one semen sample may be needed because sperm production varies over time.
Gonadotropin injections typically run 7 to 12 days and require ultrasound monitoring of egg growth.
NICHD · How is infertility diagnosed?; Fertility Treatments for Females · open the source →
Interprofessional Care
From this module — built from the notes above on this page, not a section of the ATI chapter.
Reproductive endocrinologist leads the workup and any assisted reproduction.
Genetic counselor for recurrent loss, known carrier status, or maternal age over 35.
Mental health — infertility care has a high dropout rate, and distress is the usual reason.
Pharmacist for injection teaching and the ovulation-induction schedule.
Financial counselor — treatment cost drives more decisions than clinicians tend to realize.
⚠️ What goes wrongComplications
Complications
Ectopic pregnancy: ovum implants outside the uterus, often from endometrial tissue or adhesions in the tube.
As an ectopic pregnancy grows, tube rupture can cause severe bleeding requiring surgical removal.
Unruptured ectopic pregnancy is treated with surgical removal or methotrexate to dissolve it.
Losing the tube from ectopic pregnancy raises risk of recurrence and future infertility.
ART raises the incidence of multiple gestation, adding risk for the client and each fetus.
📋 Client Education and Discharge Teaching6 parts
ATI Active Learning Template — System DisorderClient Education and Discharge Teaching
Filled from ATI chapter 19, row by row from that chapter’s own sections — 12 of 12 rows have content.
10 rows came from outside your ATI chapter — 5 cite a source, 5 are built from this page’s own notes. Each one is labeled.
🧭 What it isAlterations in Health (Diagnosis) · Health Promotion & Disease Prevention
Alterations in Health (Diagnosis)
This chapter covers postpartum discharge teaching: perineal and breast care, activity and nutrition guidance, resuming sex and contraception, and warning signs of complications that require prompt reporting to the provider.
Health Promotion & Disease Prevention
Not in your ATI chapter — filled from CDC, 2024.
Teach caregivers to place the newborn on the back for every sleep, on a firm flat surface, with no soft bedding
Advise keeping the baby's sleep space in the same room as the parent, ideally until around 6 months, rather than bed-sharing
Centers for Disease Control and Prevention · Providing Care for Babies to Sleep Safely · open the source →
👀 How it shows upAssessment — Risk Factors · Assessment — Expected Findings
Assessment — Risk Factors
From this module — built from the notes above on this page, not a section of the ATI chapter.
Risk of postpartum hemorrhage: prolonged or very fast labor, over-distended uterus, grand multiparity, retained fragments.
Risk of infection: cesarean, prolonged rupture of membranes, repeated vaginal exams, retained products.
Risk of VTE: cesarean, obesity, immobility, previous clot — pregnancy is already a clotting state for about 6 weeks after birth.
Risk of postpartum depression: previous depression, poor support, unplanned pregnancy, difficult birth, infant in special care.
Assessment — Expected Findings
From this module — built from the notes above on this page, not a section of the ATI chapter.
Fundus firm, midline, descending about 1 cm per day — no longer palpable by around day 10.
Lochia in order: rubra (days 1–3) → serosa (days 4–10) → alba (up to 6 weeks). It should get lighter, never redder.
Afterpains, stronger with breastfeeding and with each subsequent baby.
Baby blues in the first two weeks — tearful, labile, but able to care for herself and the baby.
Lochia returning to red, a boggy fundus, or one-sided calf pain are not expected findings.
🧪 How it is confirmedLaboratory Tests · Diagnostic Procedures
Laboratory Tests
From this module — built from the notes above on this page, not a section of the ATI chapter.
Hemoglobin and hematocrit before discharge if blood loss was significant.
Rh status and Coombs — Rh-negative mother with an Rh-positive baby needs Rho(D) within 72 hours.
Rubella titre — if non-immune, MMR before discharge, and no pregnancy for 28 days afterwards.
Blood glucose if she had gestational diabetes; insulin needs fall sharply once the placenta is out.
Diagnostic Procedures
From this module — built from the notes above on this page, not a section of the ATI chapter.
Usually none — postpartum discharge is a clinical assessment, not an imaging one.
Ultrasound if retained placental fragments are suspected because bleeding persists.
Venous Doppler for a swollen, painful calf.
Depression screening with a validated tool before discharge and again at the follow-up visit.
🩺 What you doNursing Care · Medications · Therapeutic Procedures
Nursing Care
Not in your ATI chapter — filled from StatPearls, 2024.
Teach the client to self-monitor lochia and report red-colored discharge that persists past the first week rather than fading toward serosa/alba
Confirm the client can verbalize expected involution changes (fundal descent, lochia progression) before considering discharge teaching complete
StatPearls (NCBI Bookshelf) · Physiology, Postpartum Changes · open the source →
Medications
Not in your ATI chapter — filled from StatPearls, 2023.
An Rh-negative mother of an Rh-positive infant should receive Rho(D) immune globulin within 72 hours of birth before or shortly after discharge
A rubella-nonimmune mother should get the MMR vaccine as soon as possible postpartum and before leaving the facility
After MMR vaccination, counsel the client to avoid becoming pregnant for 28 days because the vaccine contains live attenuated virus
From this module — built from the notes above on this page, not a section of the ATI chapter.
Perineal care: peri-bottle front to back after every void, pat dry, change pads every 2–4 hours.
Ice for the first 24 hours to the perineum, then warm sitz baths.
Stool softener and fluids — the first bowel movement is feared more than it needs to be, and constipation makes it worse.
Pelvic floor exercises once comfortable.
Teach when to resume activity, driving and intercourse per the provider — and that contraception is needed before the first period returns.
💬 Around the patientClient Education · Interprofessional Care
Client Education
Perform hand hygiene before/after toileting and before breastfeeding; clean perineum front to back, no tampons while bleeding.
Breastfeed on demand 8 to 12 times/24hr; alternate starting breast each feeding.
For engorgement: warm compress before feeding, cold compress between feeds; empty breast fully.
Sore nipples: dab with breast milk and let air-dry after feeding.
Not breastfeeding: wear a supportive bra continuously for 72 hr; avoid nipple stimulation and warm water on breasts.
Nonlactating clients need about 1,600 to 2,400 kcal/day; lactating clients need roughly 2,000 to 2,800 kcal/day.
Continue prenatal vitamins until 6 weeks postpartum.
Interprofessional Care
Not in your ATI chapter — filled from AAP.
Arrange pediatric follow-up that includes screening the mother for depression, since this is now a recommended part of well-child visits
Refer families showing signs of strained adjustment to counseling or dyadic therapy rather than waiting for the comprehensive postpartum visit
American Academy of Pediatrics · Perinatal Mental Health and Social Support · open the source →
⚠️ What goes wrongComplications
Complications
Not in your ATI chapter — filled from CDC, 2024.
Teach the client to seek immediate care for severe headache, vision changes, dizziness, or fainting after discharge
Chest pain, irregular heartbeat, trouble breathing, or severe abdominal pain are also urgent warning signs to report right away
Thoughts of harming herself or the baby require immediate medical attention, not a wait-and-see approach
These warning signs apply for a full year after delivery, not just the first days home
Centers for Disease Control and Prevention · Urgent Maternal Warning Signs Educational Materials, HEAR HER Campaign · open the source →
📝 Notes & key concepts
The lines from this module that carry a number, a dose or an absolute rule — the ones that decide questions. Everything else is on the cards above.
Diaphragm stays in place at least 6 hours after intercourse. Refit after a weight change or a birth.
Combined OCs are contraindicated in smokers (thromboembolism) and in migraine with aura.
Suspected toxic shock with a barrier device: remove the device FIRST, then antibiotics.
The true IUD contraindication is a structural uterine anomaly — congenital malformation, or fibroids distorting the cavity → malposition, expulsion, perforation. Smoking, chronic hypertension and VTE history restrict estrogen methods, not IUDs.
A first-degree relative with a pulmonary embolism means combined OCs need evaluation first — inherited thrombophilia: factor V Leiden, protein C or S deficiency.
Fertility awareness: basal body temperature rises 0.4–0.8°F after ovulation; cervical mucus turns thin, clear and stretchy (spinnbarkeit).
Calendar method math: shortest cycle −18 = first fertile day; longest cycle −11 = last fertile day. Ovulation is ~14 daysbefore the next period starts, not 14 days after the last one.
Barrier timing, all three: diaphragm in up to 6 h before, stays 6 h after, out by 24 h. Cervical cap same 6/6 but a 48 h ceiling. Sponge in up to 24 h before, 6 h after, 30 h absolute max.
Refit a diaphragm after a 10 lb weight change, pelvic surgery, or a birth.
Spermicide goes in 15 min before and lasts about an hour; no douching for 6 h. Nonoxynol-9 more than twice daily causes mucosal lesions and raises HIV risk.
Progestin-only pill has a 3-hour window — later than that needs backup. It is the lactation-safe oral option and can start immediately after birth.
Depot medroxyprogesterone: do NOT massage the site — massage speeds absorption and shortens coverage. Every 11–13 weeks. Return of fertility can take up to 18 months.
Emergency contraception works up to 5 days out, sooner is better; a copper IUD within 5 days is the most effective form. No period within 21 days → pregnancy test. It does not terminate an established pregnancy.
Vaginal ring may be out up to 3 h with no loss of protection; beyond that, new ring plus 7 days of backup.
🎯 Module quiz
Questions for this module. They also feed the Mega Quiz.