Insertion and documentation

Women having Menstrual Cycles

• An implant can be inserted up to and including day 5 of cycle without additional contraceptive precautions.
• An implant can be inserted after day 5 if reasonably certain the woman is not pregnant. See Criteria for Reasonably Excluding Pregnancy

A careful history should be taken to ensure that the women has not had unprotected intercourse since last menses and has been correctly and consistently using a reliable method of contraception. Additional contraceptive precautions should be used for 7 days.

Women who are amenorrhoeic

An implant can be inserted at any time if reasonably certain the woman is not pregnant. Additional contraceptive precautions should be used for 7 days.

Following abortion or miscarriage

• If inserted within 5 days of surgical or second part of a medical abortion - no additional precautions required.
• If started beyond 5 days after event then 7 days of additional contraceptive precautions is required.

Postpartum

• If inserted up to day 21, no additional contraceptive cover is required.
• If started on or after day 21, 7 days of additional contraceptive precautions is required.

Switching from another method

Ensure adequate contraceptive cover from previous method continues for 7 days post insertion of implant.

After emergency contraception

• Following ellaOne, an implant should not be inserted for 5 days, thereafter it can be inserted with additional contraceptive cover required for a further 7 days.
• Following Levonelle, an implant can be inserted immediately with additional contraceptive cover required for 7 days.

Procedures should only be undertaken by staff with appropriate training

• Complete and update the full visit history as required.
• Give written method information including contact number to client.
• Record prescription.
• Record site of implant, batch number and expiry date of medication.
• Record implant site and date due for removal given to client
• Record that the implant is palpated in situ post insertion
• Nurse supplying where appropriate under patient group direction.
• Notify GP of prescription, if permission is given for correspondence.