Step 4. Conduct physical assessment

Conduct a physical assessment related to contraceptive use, if indicated.

Physical assessments are rarely needed for contraceptive use and can pose unnecessary barriers for patients. Patients initiating a combined hormonal contraceptive (pill, patch, ring) should have a blood pressure check. Patient self-report of blood pressure (that is, normal versus elevated) is acceptable, especially to facilitate telehealth provision of birth control.94 A cervical inspection and bimanual examination are needed for IUD placement. However, no examinations or tests are needed before initiating any other nonhormonal or progestin-only methods.94