Reasonable certainty a woman is not pregnant

For the purpose of starting birth control

1. No symptoms or signs of pregnancy, and
2. Any one of the following:
   1. ≤7 days after the start of normal menses.
   2. No had sexual intercourse since the start of last normal menses.
   3. Been correctly and consistently using a reliable method of contraception.
   4. ≤7 days after spontaneous or induced abortion
   5. Within 4 weeks postpartum.
   6. Fully or nearly fully breastfeeding (exclusively breastfeeding or the vast majority ≥85% of feeds are breastfeeds), amenorrheic, and <6 months postpartum.
      

Should you wait to start birth control?

In situations in which the health-care provider is uncertain whether the woman might be pregnant, the benefits of starting the implant, depot medroxyprogesterone acetate (DMPA), combined hormonal contraceptives and progestin-only pills likely exceed any risk; therefore, starting the method should be considered at any time, with a follow-up pregnancy test in 2-4 weeks. For IUD insertion, in situations in which the health-care provider is not reasonably certain that the woman is not pregnant, the woman should be provided with another contraceptive method to use until the health-care provider can be reasonably certain that she is not pregnant and can insert the IUD.

When starting a new form of birth control, if >5 days after menses started, use back-up method or abstain for 7 days. Exception: Copper-containing IUDs are immediately effective.

Documentation

Pregnancy was reasonably excluded based on the patient having no symptoms or signs of pregnancy and:

• [_] ≤7 days after the start of normal menses.
• [_] no sexual intercourse since the start of last normal menses.
• [_] been correctly and consistently using a reliable method of contraception.
• [_] ≤7 days after spontaneous or induced abortion
• [_] within 4 weeks postpartum.
• [_] fully or nearly fully breastfeeding (exclusively breastfeeding or the vast majority ≥85% of feeds are breastfeeds), amenorrheic, and <6 months postpartum.

Reference: