This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
A para 2 poorly compensated cardiac patient has delivered 2 days back. You will advice her to: 
Select and explain. 
A. Undergo sterilization (tubectomy) after 1 week, B. Undergo sterilization after 6 weeks, C. Suggest her husband to undergo vasectomy, D. Take oral contraceptive pills after 6 months
C: Suggest her husband to undergo vasectomy
Answer: C: Suggest her husband to undergo vasectomy 
Explanation: Contraception in patient of heart disease:
Temporary contraception of choice:

Barrier contraceptives (condoms) but they have high failure rate, so nowadays progesterone only contraceptives like minipills are being advised (Ref Mgt of high risk pregnancy, Manju puri, S Strivedi p376)
Contraception to be avoided:

– OCPs
– Intrauterine devices
Permanent contraception of choice:

Best: Husband should be advised vasectomy especially in patients whose heart is not well-compensated.
If husband refuses or, if heart of the patient is well-compensated-Tubectomy is advised.

Female sterilisation:

Best time: At the end of first post partum week.
Method: Mininlaparotomy (never do laproscopic sterilisation in heart disease patient).
Anaesthesia of choice: Local anaesthesia.