There are certain circumstances under which special consideration needs to be given to the means of contraception.

Disability

Disabled women have special contraceptive needs. Most disabilities don’t impair fertility. However, some methods of contraception may be unsuitable depending on the nature of the disability and other medications or treatments used. If you are disabled, discuss contraception with your doctor. The Family Planning Association provides special services in all states for physically and intellectually handicapped people. Contact the head office of the Association in your State for information about these services.

Adolescence

Once periods have become regular, most young women are very fertile. Though some young women don’t ovulate for a year or more after the first period, this can’t be relied on for contraception.

Many adults believe that it’s wrong to teach teenagers about contraception, thinking that it will encourage them to start sex earlier. Many studies in the UK and Scandinavia have shown just opposite: young women who’ve learned about sex and contraception generally have their first intercourse later than those who haven’t, and are better able to say ‘No’ if asked to have sex when they’re not ready for it. Condoms and the Pill are usually the most suitable methods, though the latter needs medical prescription.

Breast-feeding

Many women have used breast-feeding a natural form of birth spacing, as it’s well known that breast-feeding delays the turn of fertility after childbirth. The duration of this delay seems to depend on infant feeding practices such as the frequency and length of each feed, the time between feeds, and when other milk and liquid or solid feeds are introduced.

If you’re nursing five or more times per day, are not giving any supplements or solids and if you haven’t started menstruating, you have less than two chances in a hundred of conceiving within first six months after birth. However, if you don’t want to risk pregnancy until after the baby has been weaned, discuss contraception with your doctor or midwife. Barriers and the mini-Pill are chosen, and for some women an IUD may be suitable.

Around the menopause

Though fertility declines rapidly after mid-forties, this is a time of life when most women won’t want to take any chance on an unplanned pregnancy. Contraception is recommended for 12 months after the last menstruation. Choice of a method is the same as for younger women, according to your health, circumstances and preferences.

Until the mid-1980s it was thought that taking the Pill after the age of 35 was a health risk. This has now been proved wrong and healthy women up to the age of 50 who wish to and who don’t smoke may now take the Pill.

Rape

Any woman who is raped when she is at risk of pregnancy should be offered ‘morning-after’ contraception. This is the usual practice in rape referral centres.

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