ABSTRACT
All couples should be seen as potentially fertile until proved otherwise and unless the risk of pregnancy is acceptable, some method of contraception should be used. Once a pattern of behavior is learnt it is often unshakeable and some learning disabled people become extremely efficient users of oral contraception. Adequate prescribing of the oral contraceptive Pill where an enzyme-inducer is being used entails taking at least 50 meg, and this dose may need to be increased to 90 meg to avoid breakthrough bleeding. The timing constraints needed for reliable contraceptive efficacy with the progestogen-only Pill mean that it is even more important to have a good memory; otherwise the contraceptive failure rate will be increased. Many women use Pills or injectables for menstruation suppression whether or not they require contraceptive cover. Sterilization is often suggested if there is a severe degree of disability or if the risks of pregnancy are high for the woman.
