Best mode of contraception for a newly married lady with rheumatic heart disease:

Barrier contraceptives (diaphragm/condom) are the ideal contraceptives for patients with medical complications such as heart disease. “The primary advantage of the diaphragm is the almost total absence of risks and medical contraindications.” Combined oral contraceptive pills are contraindicated in a woman with cardiac disease.  IUCD is carefully considered in a cardiac and diabetic woman because of the possibility of pelvic infection. Depoprovera (DMPA) a progesterone only injectable contraceptive also is not a preferred agent for patients with cardiac disease although it is not contraindicated. Sterilization should be considered with completion of family at the end of first week in the puerperium under local anesthesia through abdominal root by minilap technique. If the heart is not well compensated, the husband is advised for vasectomy.