2017 — Job Aid: How and When to Use the Pregnancy Checklist and Pregnancy Tests contains guidance to help providers rule out pregnancy in their clients before initiating a hormonal contraceptive or inserting an intrauterine device (IUD). To rule out pregnancy, family planning providers in low-resource settings have typically relied on a client’s medical history (often collected using the Pregnancy Checklist) or required that the client return during her next period to initiate the method. With an increase in the availability of pregnancy tests, and knowing that both the pregnancy checklist and a pregnancy test can be highly accurate for ruling out pregnancy, providers want to know when to use the checklist or the test.
The decision to use the checklist or a test is based on the client’s chosen method and on whether she has been having monthly bleeding/menses or she is not having menses at all (amenorrhea). The checklist also addresses the situation for a woman who has been having menses each month but now has missed her expected monthly bleeding. In addition to ruling out pregnancy, the job aid makes it clear that all hormonal methods, except the LNG IUD, can be provided without delay even when uncertainty about pregnancy exists, although follow-up is required in some cases. The job aid is included in the 2017 update of the Family Planning Global Handbook for Providers.
