A midwife is caring for a 40-year-old patient who has obesity and a history of deep vein thrombosis (DVT). The patient is interested in starting a highly effective method of contraception but reports heavy menstrual bleeding and states she prefers to avoid any invasive procedures. Which of the following types of contraception is the midwife most likely to recommend?
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✓ Correct answer: C. Progesterone-only pillsAnswer: Progesterone-only pills The progesterone-only pill (POP) contains no estrogen and is a good choice for a woman with a history of DVT and obesity. It can also help reduce menstrual bleeding which addresses the patient's concern about heavy menstrual bleeding. Combined oral contraceptives (COCs) and vaginal contraceptive rings both contain estrogen and are contraindicated in someone with a history of DVT due to an increased risk of blood clots. A copper IUD would be medically appropriate for DVT history but is invasive and tends to increase menstrual bleeding, making it unsuitable given the patient's specific preferences and existing heavy menstrual bleeding.
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