For the past decade there has been an increased interest in nonhormonal contraceptive methods. In the United States the trend is an increase of 1.1–2.2% users with almost 1.4 million women in 2014 and an estimated 2.5 million women in 2020 in this category [1]. Nonhormonal, traditional or natural methods of contraception include fertility awareness–based methods (FABM), barrier, rhythm (periodic abstinence), withdrawal and lactational amenorrhea, abstinence, breastfeeding, douching or traditional folk methods. Sterilization and copper intrauterine devices (Cu-IUDs) are also nonhormonal but are not discussed further in this chapter. Here we cover methods that are not hormone-based and that are included in the barrier/spermicide or natural/traditional categories (Figure 13.1). It is important to mention that there is an abundance of adequate resources on the Internet for counseling. A limited but carefully chosen list is provided at the end of the chapter (Appendix 1).

Abortion has been available in Sweden, since 1975, on request and without regards to reason, for up to 18 weeks’ gestation and in specific circumstances through 21 +6 weeks’ gestation. Abortion care is viewed as core component of obstetric and gynecological and midwifery care. Medical students in Sweden all receive theoretical training and are offered clinical rotation to abortion care. Similarly, all students in midwifery receive theoretical training in abortion and some clinical training. Core competencies for the registered nurse-midwives include the ability to care for women in abortion care including post abortion contraceptive counselling and provision. For residents in obstetrics and gynecology, training in abortion care is mandatory. Not permitting conscientious objection for any professional cadre guarantees prompt access to services for women seeking abortion care in Sweden, consistent with the principle that abortion is a right and a core service to which access should not be delayed.