Checklist for Postpartum Family Planning Irmnch

Standard Operating Procedure: Postpartum Family Planning (PPFP) Integration

Document Control Block

• Document ID: TR-IRMNCH-PPFP-092
• Effective Date: 2023-10-27
• Version: 1.0.4
• Review Cadence: Biennial (Every 24 months)
• Target Audience: Obstetricians, Midwives, Nursing Staff, Reproductive Health Counselors

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1. Executive Summary & Scope

This SOP defines the clinical architecture for the systematic implementation of Postpartum Family Planning (PPFP) within the Integrated Reproductive, Maternal, Neonatal, and Child Health (IRMNCH) framework. The scope encompasses all patients in the immediate postpartum period (0–48 hours) through the extended postpartum phase (up to 12 months). Compliance with WHO Medical Eligibility Criteria (MEC) for Contraceptive Use is mandatory.

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2. Prerequisites & Tool Requirements

• Certification: Current BLS/ACLS and clinical competency in LARC (Long-Acting Reversible Contraception) insertion.
• Software Access: Access to the Electronic Health Record (EHR) Module: "Family Planning Registry."
• Equipment: WHO-prequalified contraceptive stock (IUD kits, Implants, POPs), sterile procedure packs, and patient education visual aids (WHO Wheels).
• Regulatory: Institutional IRMNCH protocol compliance sheet.

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3. Roles & Responsibilities (RACI Matrix)

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4. Step-by-Step Operational Procedure

Phase I: Counseling & Informed Choice (Prenatal/Early Labor)

• Verify patient has received basic family planning counseling during antenatal visits.
• Review patient history for medical contraindications to specific contraceptive methods.
• Document informed choice in the "Decision Support" section of the EHR.

Phase II: Postpartum Counseling (Immediate 0–48 Hours)

• Confirm patient status (hemodynamically stable, no active hemorrhage).
• Assess infant feeding method (Lactational Amenorrhea Method - LAM readiness).
• Provide WHO MEC visual aids to confirm method appropriateness.
• Secure written/electronic consent for selected method.

Phase III: Implementation & Documentation

• Conduct procedure per sterile field protocols.
• Enter batch numbers/expiry dates for IUDs/Implants into EHR.
• Schedule follow-up appointment (6-week postpartum visit).
• Provide written "Return-to-Clinic" instructions for adverse effect management.

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5. Quality Assurance & Verification Criteria

• Acceptance Benchmarks: 95% of patients must receive counseling before hospital discharge.
• Verification: Monthly audit of 10% of patient records to confirm consistency between counseling documentation and actual method provision.
• Tolerance Threshold: 0% tolerance for non-consensual procedures or provision of contraindicated methods per MEC categories 3 and 4.

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6. Practical Troubleshooting Scenarios

Scenario A: Patient Refusal Post-Procedure

• Trigger: Patient expresses regret or desire for removal immediately post-insertion.
• Corrective Action: Immediate removal at patient request without coercion. Document "Request for Removal" in the EHR and provide emergency contraception counseling if necessary.

Scenario B: EHR System Outage During Documentation

• Trigger: Digital registry is inaccessible during the critical 48-hour window.
• Corrective Action: Utilize the mandatory Paper-Based Backup Log (Form TR-402). Transfer data to the digital registry within 4 hours of system restoration.

Scenario C: Postpartum Hemorrhage (PPH) Complication

• Trigger: PPH occurs during or immediately following IUD insertion.
• Corrective Action: Cease contraceptive procedure immediately. Prioritize PPH clinical management protocols (Uterotonic administration, uterine massage). Re-evaluate PPFP method suitability at the 6-week postnatal check.

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Authorized by:

Julian Vance Chief Operations Architect, Template Registry