Family Planning Provision by Midwives - Memory Anchors
Memory techniques work because they hijack the brain's love for stories, images, and emotion. Instead of trying to memorize dry facts, you attach them to something vivid, funny, or personally meaningful — and your brain stores them in the same deep memory networks used for experiences you actually lived. For the PRC Midwife Licensure Examination, where a single item can hinge on whether you remember 'Category 1 vs. Category 4' or 'days 8 to 19,' having a reliable memory anchor is the difference between a confident answer and a panicked guess. Work through each anchor below, visualize it fully, then test yourself with the recall chains and revision game at the end.
Memory anchors
RA 10354 — The RH Law guarantees informed choice and voluntarism; no coercion
Memory aid
Think of RA 10354 as the 'I CHOOSE' Law: Informed Choice, Honest information, Open to all methods, Universal access, Sustained voluntarism, Equality (no discrimination). The number 10354 sounds like 'TEN-THREE-FIFTY-FOUR' — imagine TEN women standing in THREE lines at the BHS, and FIFTY-FOUR packs of pills on the table, and each woman freely CHOOSES her own pack. Nobody forces anyone.
Why it works
Combining a vivid scene with the number and an acronym anchors both the law number and its core principle simultaneously.
Example usage
Exam question: 'What is the guiding principle of RA 10354 for FP services?' → Recall the ten women freely choosing → Answer: Informed choice and voluntarism.
Recall trigger
TEN women at the BHS, FREE to CHOOSE
Methods a trained midwife can independently provide: COCs, POPs, DMPA, Condoms, LAM, SDM, Counseling
Memory aid
MNEMONIC: 'Can Pretty Darling Clients Love Sweet Counseling?' — C = COCs, P = POPs, D = DMPA, C = Condoms, L = LAM, S = SDM, C = Counseling. Picture a sweet darling client at the RHU smiling because the midwife patiently counseled her through all seven options.
Why it works
An interrogative sentence (a question) is more memorable than a flat acronym because the brain naturally wants to answer questions. The 'sweet darling client' image makes it emotional.
Example usage
Exam question: 'Which of the following can a midwife provide independently without additional certification?' → Run through 'Can Pretty Darling...' to identify COCs, POPs, DMPA, Condoms, LAM, SDM, and Counseling.
Recall trigger
Can Pretty Darling Clients Love Sweet Counseling?
IUD and Implant require additional DOH competency-based certification; midwife counsels and refers without it
Memory aid
Think of IUD and Implant like driving a motorcycle versus driving a car. You may already have a driver's license (midwife license), but a motorcycle requires a SEPARATE ENDORSEMENT on your license before you can legally ride it. Without that special endorsement (the DOH certification), you are not allowed to insert — you can only point the client to someone who has the endorsement and accompany her there (counsel and refer).
Why it works
Almost every Filipino student knows someone who has a car license but needed extra steps for a motorcycle. The analogy maps directly onto the concept of 'extra certification needed.'
Example usage
Exam question: 'A midwife without IUD certification is assigned at a BHS. A client wants an IUD. What should the midwife do?' → Recall motorcycle endorsement → Counsel and refer to certified provider.
Recall trigger
Motorcycle endorsement = IUD/Implant certification
Tubal ligation and vasectomy are surgical — outside midwife's scope; counsel and refer
Memory aid
Picture a STOP sign shaped like a pair of scissors (the scissors represent surgery — cutting/tying tubes and vas deferens). The midwife sees the STOP sign, puts down the scissors, and hands the client a printed referral slip. She can TALK (counsel) but NOT CUT. Post the image mentally on the door of your BHS.
Why it works
Visual associations with universally recognized symbols (STOP sign) are recalled faster under exam pressure than verbal rules.
Example usage
Exam question: 'What is the midwife's role when a client desires tubal ligation?' → See the STOP sign scissors → Counsel and refer; it is surgical and outside midwife scope.
Recall trigger
Scissors + STOP sign at BHS door
DMPA dose: 150 mg IM every 3 months (13 weeks)
Memory aid
Chunk it as: '150 — 3 — 13' → '150 mg, every 3 months, which is 13 weeks.' Remember using the phrase: 'ONE FIFTY in THREE for THIRTEEN weeks.' Imagine a calendar with every 13th week circled in red, and '150 mg DMPA' written inside each circle. The number 13 is also helpful: 13 = a baker's dozen — the baker gives ONE EXTRA week beyond 12 (one quarter of the year), so re-injection is at week 13, not week 12.
Why it works
Chunking three related numbers together reduces cognitive load. The baker's dozen story gives the '13' a unique hook.
Example usage
Exam question: 'What is the correct dosage and schedule for DMPA?' → Baker's dozen → 150 mg IM every 13 weeks (3 months).
Recall trigger
Baker's dozen = 13 weeks DMPA
POPs (progestin-only pills) are the pill of choice for breastfeeding mothers; COCs with estrogen are avoided in the first 6 months postpartum
Memory aid
Think of ESTROGEN as a 'milk thief.' COCs have estrogen, and estrogen STEALS MILK from the baby (reduces milk supply). POPs have NO estrogen, so NO milk is stolen — POP is 'baby-safe.' Imagine Ate Maria breastfeeding her newborn, and a thief labeled 'ESTROGEN' sneaks up trying to steal her milk. She shoos it away and takes the POP instead. POP = Protect Our Pangsuso (breastmilk)!
Why it works
Filipino mothers deeply connect with the concept of protecting breastmilk (pangsuso). Making estrogen a villain creates emotional memory encoding.
Example usage
Exam question: 'A breastfeeding mother 3 months postpartum needs contraception. Which pill is appropriate?' → Recall milk thief analogy → POP (progestin-only), not COC.
Recall trigger
ESTROGEN = milk thief; POP = Protect Our Pangsuso
LAM requires ALL THREE conditions: baby under 6 months, exclusive/near-exclusive breastfeeding, amenorrhea
Memory aid
Story: 'LAM is a three-legged stool at the BHS. The THREE legs are: LEG 1 — Baby under 6 months old (the youngest leg, still growing); LEG 2 — Exclusive breastfeeding, day and night (the steady, reliable leg); LEG 3 — Amenorrhea, no period (the quiet leg). Remove ANY one leg and the stool FALLS — meaning LAM fails and the mother needs a new method IMMEDIATELY. Lola Nena always said: a stool needs all three legs to stand.'
Why it works
The three-legged stool is a universally familiar and physical image. The story of Lola Nena personalizes it for Filipino learners. 'Falls = method fails' is a clear logical consequence.
Example usage
Exam question: 'A mother using LAM reports her period returned. What should the midwife advise?' → Recall the stool with a broken leg → LAM is no longer effective; shift to another method.
Recall trigger
Three-legged stool; remove one leg → stool falls → LAM fails
SDM: cycles must be 26–32 days; avoid intercourse on days 8–19; uses CycleBeads
Memory aid
Rhyme: 'Twenty-six to thirty-two, that's the cycle range for you. Eight to nineteen, stay apart — CycleBeads will guide your heart.' Visualize a string of colorful CycleBeads: white beads for days 8–19 (danger zone, avoid), red/brown beads for safe days outside that window. The cycle must be between 26 and 32 days — not shorter, not longer.
Why it works
Rhymes exploit the brain's phonological loop — the melody-like pattern makes numbers stick far better than plain repetition.
Example usage
Exam question: 'A client has a 35-day cycle. Is she a good candidate for SDM?' → Recall rhyme '26 to 32' → No, her cycle is too long; SDM is not recommended.
Recall trigger
Rhyme: 'Twenty-six to thirty-two...'
Condoms are the ONLY method that protects against STI/HIV — promote dual protection
Memory aid
Picture a condom wearing a SHIELD and a HELMET — the shield protects against HIV/STI, the helmet protects against pregnancy. No other contraceptive method wears armor like this. When you see a condom in an exam question with the word 'HIV' or 'STI,' the answer is always CONDOM. The battle cry: 'DOUBLE DUTY!' — one method, two protections. Dual protection = condom PLUS another method for highest safety.
Why it works
The superhero image (shield and helmet) is playful and highly visual, activating the brain's imagery centers for deeper encoding.
Example usage
Exam question: 'Which contraceptive method also protects against sexually transmitted infections?' → Shield and helmet image → Condom; only method with dual protection.
Recall trigger
Condom with shield and helmet = Double Duty
WHO Medical Eligibility Criteria Categories 1–4
Memory aid
Mnemonic: 'GO — GENERALLY GO — GENERALLY NO — NO GO!' Category 1 = GO (use anytime, no restriction). Category 2 = GENERALLY GO (advantages outweigh risks). Category 3 = GENERALLY NO (risks usually outweigh advantages). Category 4 = NO GO (do not use, unacceptable risk). Think of a traffic-light system stretched to four steps: bright green → pale green → orange → red. A Category 4 is a RED LIGHT — hard stop.
Why it works
The traffic light metaphor is intuitive and culturally familiar. The four-step chant 'GO — GENERALLY GO — GENERALLY NO — NO GO' has a rhythm that encodes the categories in order.
Example usage
Exam question: 'A client with unacceptable health risk falls under which WHO MEC category?' → Red light, NO GO → Category 4.
Recall trigger
Traffic light: Green → Pale Green → Orange → Red
GATHER counseling framework: Greet, Ask, Tell, Help, Explain, Return
Memory aid
GATHER = 'Good Ate helps everyone return!' Greet warmly → Ask about needs → Tell about methods → Help client choose → Explain use and side effects → Return date set. Picture a caring Ate (older sister) at the RHU who GATHERS her younger sibling into a chair, listens, teaches, and sets a follow-up appointment before letting her leave.
Why it works
The 'Ate' (older sister) image is deeply Filipino. The phrase 'GATHER your client like Ate gathers her family' gives the counselor a role-model persona to step into.
Example usage
Exam question: 'Which step of GATHER involves setting the client's next visit?' → Recall GATHER steps → R = Return.
Recall trigger
Ate who GATHERS her sibling at the RHU
REDI counseling framework: Rapport-building, Exploration, Decision-making, Implementation
Memory aid
REDI = 'Getting READY for the client's FP journey.' R = Rapport (warm welcome, build trust — lay the foundation). E = Exploration (explore client's needs, history, concerns — dig the ground). D = Decision-making (client chooses her method freely — plant the seed). I = Implementation (start the method, teach use — water the plant). The midwife is a gardener who gets the soil READY before planting anything.
Why it works
The garden metaphor maps the four steps onto a familiar natural process with a clear progression. Filipino students connect strongly with cultivation imagery.
Example usage
Exam question: 'In the REDI framework, which phase involves the client freely selecting her contraceptive method?' → Recall gardener planting the seed → D = Decision-making.
Recall trigger
Gardener getting soil READY: Foundation → Dig → Plant → Water
FHSIS, Target Client List (TCL), and FP Client Record are the recording tools for FP services
Memory aid
Story: 'Midwife Rosario never loses a client. She keeps THREE things on her desk: a TARGET (TCL — Target Client List, to track who is due for re-injection), a CLIENT FOLDER (FP Client Record, history for each woman), and a BIG LOGBOOK (FHSIS — the national tally). When a client misses her DMPA shot, Rosario checks her TARGET, calls the client, and the community stays healthy. No client falls through the cracks.' The three desk items are vivid and specific.
Why it works
Placing tools on a midwife's actual desk creates a location-based memory (method of loci). The story of a dedicated midwife adds emotional engagement.
Example usage
Exam question: 'What record does the midwife use to follow up clients overdue for DMPA re-injection?' → Recall Rosario's TARGET → Target Client List (TCL).
Recall trigger
Rosario's three desk items: Target, Folder, Logbook
Healthy spacing: wait at least 24 months after live birth before next pregnancy; 6 months after miscarriage
Memory aid
Rhyme: 'After a baby, wait TWO YEARS to bloom. After a miscarriage, wait HALF A YEAR's room.' (24 months = 2 years; 6 months = half a year.) Imagine a flower garden — after a big bloom (live birth), the soil needs TWO FULL YEARS to recover. After a small frost (miscarriage), only SIX MONTHS rest is needed before the garden is ready again.
Why it works
Paired rhymes anchor two related numbers together. The flower garden metaphor makes the biological rationale (recovery time) intuitive.
Example usage
Exam question: 'A client had a miscarriage last month. How long should she wait before the next pregnancy according to healthy spacing guidelines?' → Recall frost/6 months → At least 6 months.
Recall trigger
Flower garden rest: 2 years after big bloom, 6 months after frost
Before starting COCs or DMPA, always measure blood pressure; estrogen-containing methods avoided in significantly elevated BP
Memory aid
Picture a large RED blood pressure cuff with the words 'CHECK FIRST' on it, hanging on the RHU wall right next to the COC pills and DMPA vial. The cuff must be squeezed BEFORE the pill or injection is given. If the reading is dangerously high, the estrogen-containing COC is pushed aside (it goes to the red 'NO' bin). This image becomes a mental SOP poster in your mind.
Why it works
Placing the BP cuff physically next to the methods in a mental image creates a conditioned association: see COC or DMPA → automatically think 'check BP first.'
Example usage
Exam question: 'Before providing combined oral contraceptives, what screening step is essential?' → Red cuff image → Measure blood pressure.
Recall trigger
Red BP cuff hanging next to COC and DMPA vial
COCs are NOT given to breastfeeding mothers in the first 6 months because estrogen reduces milk supply
Memory aid
Mnemonic: 'COC STEALS MILK FOR SIX.' COC + Estrogen = milk supply drops. The 'steals for six' reminds you the ban is for the FIRST SIX MONTHS of breastfeeding. After six months, if the baby has started complementary foods, COC may be reconsidered depending on clinical assessment. Before six months → choose POP or DMPA instead.
Why it works
The phrase 'COC STEALS MILK FOR SIX' is a punchy, all-caps warning that sounds alarming — and alarm triggers memory consolidation.
Example usage
Exam question: 'A 2-month-old baby's exclusively breastfeeding mother wants contraception. COC is offered. Is this appropriate?' → 'COC STEALS MILK FOR SIX' → No; give POP or DMPA instead.
Recall trigger
COC STEALS MILK FOR SIX
Warning signs on hormonal methods that need prompt review: severe abdominal pain, chest pain, severe headache with visual changes, heavy bleeding
Memory aid
Acronym: 'ACHE' — A = Abdominal pain (severe), C = Chest pain, H = Headache (severe, with visual changes), E = Excessive/heavy bleeding. If a client on hormonal contraception reports any ACHE, refer promptly. Think of a client who is literally ACHING — these are NOT the normal spotting and mild headaches you reassure her about; ACHE = refer, don't wait.
Why it works
ACHE is a recognizable English/Filipino word that maps beautifully onto symptoms of discomfort. The distinction 'normal spotting vs. ACHE' sharpens clinical judgment.
Example usage
Exam question: 'A client on DMPA reports heavy bleeding and severe abdominal pain. What should the midwife do?' → ACHE → Prompt referral, not reassurance.
Recall trigger
ACHE = Refer promptly
Contraceptive Prevalence Rate (CPR) is the public health outcome measure for FP programs
Memory aid
CPR in medicine revives a dying patient. CPR in family planning (Contraceptive Prevalence Rate) revives a community's reproductive health — it tells you how many women are ALIVE and PROTECTED by a contraceptive method. High CPR = healthy community. Low CPR = community in reproductive health crisis, needing intervention. 'CPR saves lives — in the clinic AND in the community.'
Why it works
Reusing a familiar acronym (CPR = cardiopulmonary resuscitation) with a new meaning leverages existing strong memory traces. The parallel meaning ('saves lives') reinforces both definitions simultaneously.
Example usage
Exam question: 'What indicator measures the proportion of women of reproductive age currently using a contraceptive method?' → Community CPR image → Contraceptive Prevalence Rate.
Recall trigger
CPR saves lives — clinical AND community
Informed choice means the midwife provides full information; the CLIENT decides the method — not the midwife
Memory aid
Story: 'Midwife Cora has her favorite method — she thinks everyone should use DMPA because it is so convenient. But client Nena has read about pills and wants to try COCs. Midwife Cora swallows her preference, explains ALL methods fully, answers Nena's questions, and hands Nena her COC pack with a smile. On the bus home, Nena thinks: that midwife really respected me. Three months later, Nena is still using COCs faithfully.' The midwife's job is to INFORM, not to choose.
Why it works
The micro-story models correct behavior and the incorrect temptation (having a favorite method), making the ethical principle concrete and emotionally resonant.
Example usage
Exam question: 'A midwife believes injectable contraceptives are best and consistently steers clients toward DMPA without explaining other options. This violates which principle?' → Recall Cora and Nena → Informed choice and voluntarism (RA 10354).
Recall trigger
Midwife Cora swallows her preference; Nena chooses freely
DMPA injection sites: deltoid or gluteal muscle; given IM (intramuscular); do not massage after injection
Memory aid
Mnemonic: 'DMPA = Don't Massage, Please, Always!' D = Don't, M = Massage, P = Please, A = Always (meaning: never massage after DMPA injection — massaging accelerates absorption and alters the slow-release mechanism). The injection goes into DELTA (deltoid) or the GLUTEUS — remember 'D or G' — just like the first and last common injection sites you learn in skills lab.
Why it works
Turning the abbreviation DMPA into a warning phrase ('Don't Massage Please Always') makes a procedural error-prevention rule automatic.
Example usage
Exam question: 'After administering DMPA, the midwife should NOT do which of the following?' → Recall DMPA acronym warning → Do not massage the injection site.
Recall trigger
DMPA = Don't Massage, Please, Always!
Revision game
I am the only contraceptive method that also fights HIV. I wear a shield AND a helmet. What am I?
Answer
Condom (dual protection against both pregnancy and STI/HIV)
Memory link
A9 — Condom with shield and helmet image
I require all three legs to stand. Remove any one and I fall immediately. My three legs are: baby's age, breastfeeding, and silence. What FP method am I?
Answer
LAM (Lactational Amenorrhea Method) — requires baby under 6 months, exclusive breastfeeding, and amenorrhea
Memory link
A7 — Three-legged stool micro-story
I am a baker's dozen of weeks. I weigh 150 mg and I go into a muscle. What injection am I, and when do you repeat me?
Answer
DMPA (Depo-Medroxyprogesterone Acetate), 150 mg IM, repeated every 13 weeks (3 months)
Memory link
A5 — Baker's dozen chunking mnemonic
I need an extra endorsement on your midwife license before you can insert me. Without it, you may only counsel and send the client elsewhere. I come in two forms — one that goes into the uterus, one under the skin. What are we?
Answer
IUD and Subdermal Implant — require additional DOH competency-based certification
Memory link
A3 — Motorcycle endorsement analogy
In my traffic light system, the number that means 'NO GO — do not use this method at all' is which number?
Answer
WHO MEC Category 4 — unacceptable health risk; method must not be used
Memory link
A10 — Traffic light WHO MEC mnemonic
I am the pill that breastfeeding mothers can safely take. I have no estrogen so I never steal milk. The window for taking me on time is very tight — what am I?
Answer
Progestin-Only Pill (POP / mini-pill) — safe for breastfeeding; must be taken within a 3-hour window daily
Memory link
A6 — Milk thief analogy (estrogen = thief; POP = Protect Our Pangsuso)
I use colored beads to count fertile days. I only work for women with regular cycles between a specific range. On which days must the couple abstain?
Answer
Standard Days Method (SDM) using CycleBeads; cycles 26–32 days; abstain on days 8–19
Memory link
A8 — SDM rhyme: 'Twenty-six to thirty-two, eight to nineteen, none for you'
I am the law that says no Filipino woman may be forced into or out of any contraceptive method, and every midwife must give her all the information she needs to choose freely. What is my Republic Act number?
Answer
RA 10354 — Responsible Parenthood and Reproductive Health Act of 2012 (RH Law); guiding principle: informed choice and voluntarism
Memory link
A1 — TEN women at BHS freely choosing; I CHOOSE Law acronym
Formula mnemonics
DMPA Dose: 150 mg IM every 3 months (13 weeks)
Mnemonic
ONE FIFTY in THREE for THIRTEEN — Baker's Dozen Injection. A baker gives 13 (not 12) — DMPA re-injection is at week 13, not week 12.
When to use
Use this whenever asked about DMPA dosage, route, frequency, or re-injection schedule.
What each part means
150 mg = the fixed dose per injection; IM = intramuscular route (deltoid or gluteus); every 3 months = quarterly schedule; 13 weeks = the calendar equivalent (13 × 7 = 91 days ≈ 3 months); a grace window of up to 2 weeks early or 4 weeks late is allowed.
LAM Effectiveness Formula: Baby < 6 months + Exclusive BF + Amenorrhea = Effective LAM
Mnemonic
LAM = 3-legged stool. All THREE legs must be present. Fail one → method fails. There is no 'partial LAM.'
When to use
Use this whenever an exam item asks whether LAM is still effective, or when one condition has changed (menses returned, baby started solids, or baby is over 6 months).
What each part means
Baby < 6 months = time-limited window (infertility only lasts this long with full BF); Exclusive/near-exclusive breastfeeding = on demand, day and night, no supplemental feeds; Amenorrhea = no return of menses since delivery. All three must co-exist simultaneously.
SDM Fertile Window: Cycle 26–32 days; Avoid days 8–19
Mnemonic
Rhyme: 'Twenty-six to thirty-two — eight to nineteen, none for you!' CycleBeads white = danger (days 8–19); brown/other = safe.
When to use
Use this when asked about SDM candidacy (cycle length question) or about which days the couple must avoid unprotected intercourse.
What each part means
26–32 days = the acceptable cycle length range (irregular cycles outside this range make SDM unreliable); Days 8–19 = the statistically fertile window regardless of exact cycle length within range; CycleBeads = the physical tool that marks each day to guide the couple.
WHO MEC Category Scale: 1 → 2 → 3 → 4 (GO → Generally Go → Generally No → NO GO)
Mnemonic
Traffic light extended: Bright Green (1) → Pale Green (2) → Orange (3) → Red (4). 'As the number goes UP, the risk goes UP and the willingness to prescribe goes DOWN.'
When to use
Use this when any exam question involves screening a client with a specific medical condition and deciding whether a method is safe.
What each part means
Category 1 = no restriction, use freely; Category 2 = advantages outweigh risks, generally use; Category 3 = risks usually outweigh advantages, not usually recommended; Category 4 = unacceptable health risk, method must not be used.
Quick recall chains
Seven Methods a Midwife Can Independently Provide
Recall test
Close your eyes and walk through Cora's garden. Name each method she encounters. Did you get all 7? COCs → POPs → DMPA → Condoms → LAM → SDM → Counseling.
Memory chain
Story chain: 'CORA (COCs) PICKED (POPs) DAISIES (DMPA) CAREFULLY (Condoms), LAUGHING (LAM) SOFTLY (SDM), COUNSELING (Counseling) her friends.' Each first letter matches the method initial: C-P-D-C-L-S-C. Walk through the garden scene: Cora (the midwife character) starts the walk picking COCs, then POPs, then DMPA, handing condoms to passersby, laughing under a LAM tree, softly singing SDM, and ends at the BHS desk giving counseling.
Items to remember
- COCs (Combined Oral Contraceptives)
- POPs (Progestin-Only Pills)
- DMPA Injectable
- Condoms
- LAM (Lactational Amenorrhea Method)
- SDM (Standard Days Method)
- Counseling
GATHER Counseling Steps in Order
Recall test
Spell out G-A-T-H-E-R aloud. For each letter, name the step AND one key action the midwife does at that step.
Memory chain
Sentence: 'Good Ates Tell Heartwarming, Educational, Reminders.' G-A-T-H-E-R. Scene: A good Ate (midwife) sits the client down → warmly Greets → Asks about her needs → Tells her about methods → Helps her choose → Explains correct use and side effects → sets the Return date. The warmth of the Ate makes each step feel like family care.
Items to remember
- Greet
- Ask
- Tell
- Help
- Explain
- Return
LAM Three Conditions in Order
Recall test
Draw a three-legged stool on scratch paper. Label each leg. Now answer: A mother's baby is 7 months old. Is she still covered by LAM? (No — Leg 1 has failed.)
Memory chain
Three-legged stool: Leg 1 = AGE (baby under 6 months — the youngest leg). Leg 2 = ACTION (exclusive BF, requires active effort — the working leg). Leg 3 = ABSENCE (amenorrhea — absence of period — the silent leg). Mentally sit on the stool: you can only sit safely if all three legs are solid. Wobble on any one → fall → refer client to another method.
Items to remember
- Baby under 6 months old
- Exclusive/near-exclusive breastfeeding (day and night)
- Amenorrhea (no return of menses)
WHO MEC Categories 1 to 4
Recall test
Without looking: Which MEC category means 'method must NOT be used due to unacceptable health risk'? (Category 4.) Which means 'advantages generally outweigh the risks'? (Category 2.)
Memory chain
Traffic light chant (say it rhythmically): '1 is GREEN — GO! 2 is PALE GREEN — GENERALLY GO! 3 is ORANGE — GENERALLY NO! 4 is RED — NO GO!' Repeat three times aloud. Tap your fingers 1-2-3-4 as you chant. The physical rhythm encodes the sequence into procedural memory.
Items to remember
- Category 1: No restriction — use the method
- Category 2: Advantages outweigh risks — generally use
- Category 3: Risks outweigh advantages — generally do not use
- Category 4: Unacceptable risk — must not use
DMPA Administration Sequence
Recall test
Recite all 7 steps of DMPA administration from memory. Did you remember 'do not massage'? That is the most common exam trap.
Memory chain
Story: 'Rosario SCREENED her client CAREFULLY, CONFIRMED no baby, PREPARED the syringe, INJECTED into the ARM (deltoid), said HANDS OFF (no massage), RECORDED everything in her logbook, and CIRCLED the 13th week on the calendar.' Each capitalized word triggers the next step. Walk through Rosario's clinic in your mind as if watching a video.
Items to remember
- Screen client (history, BP)
- Confirm not pregnant (pregnancy checklist)
- Prepare 150 mg DMPA
- Inject IM into deltoid or gluteus
- Do NOT massage injection site
- Record on FP client record and TCL
- Set return date (13 weeks / 3 months)
Diagrams
FP Methods by Midwife Scope of Practice
A comprehensive mind map showing all contraceptive methods organized by whether the midwife can provide them independently, needs extra certification, or must refer. This is the master visual for scope-of-practice questions on the MLE.
FP Client Screening and Method Selection Flowchart
A step-by-step decision flowchart for FP client screening at the RHU or BHS. Shows the midwife's systematic approach from history-taking through BP measurement, breastfeeding assessment, pregnancy checklist, and WHO MEC application, ending with informed choice and recording. This is a visual SOP for the exam.
LAM Effectiveness: Three-Condition State Diagram
A state diagram showing how LAM starts in an active (effective) state only when all three conditions are present, and transitions to a failed state the moment any single condition is broken. Each failed state leads to the same outcome: switch to another method. This diagram makes the 'all three required' rule visually undeniable.
WHO MEC Category Decision Tree for Method Safety
A flowchart that maps the four WHO MEC categories to their traffic-light equivalents. When screening clients with medical conditions, the midwife applies this framework to decide whether to provide, generally provide, generally avoid, or absolutely not provide a method. The color metaphor reinforces the memory anchor.
Postpartum FP Timeline: What to Offer and When
A timeline showing which FP methods are appropriate at different postpartum intervals. This visual helps students answer questions about what to offer a breastfeeding mother at 2 weeks, 3 months, or 7 months postpartum — a classic MLE scenario type.