Chronic diseases pose significant risk during pregnancy, and affect one in three women
Less than 8% of these women with conditions such as heart diseases, breast cancer, epilepsy, high blood pressure, and diabetes, use the most effective forms of birth control, shows analysis
One in three women have serious health conditions that could complicate pregnancy. Yet only a few of these women rely on the most effective forms of contraception to prevent unplanned pregnancies, finds a study.
According to medical records from the Utah Population Database, less than eight percent of these women with conditions such as heart disease, breast cancer, epilepsy, high blood pressure, and diabetes, were using the most highly effective forms of birth control.
"The prevalence of chronic health conditions among reproductive-age women is surprising because we think of them as being one of our healthiest populations," says Dr. Lori Gawron, first author of the study and an assistant professor in the Department of Obstetrics & Gynecology at the University of Utah Health. "Unfortunately, many of these women are not seeing an OB/GYN until they are pregnant. That suggests to me that there are a lot of missed opportunities in the health care system to make sure these women understand the risks of pregnancy, particularly if their disease isn't under control," says Dr. Gawron.
According to CDC, about 45% of all pregnancies are unintended. Past studies have shown that women with chronic diseases are at increased risk of having unintended pregnancies. For these women, CDC recommends that they use effective birth control methods such as an intrauterine device (IUD) or contraceptive implant, to prevent unintended pregnancies until the preexisting conditions are stabilized and the woman chooses to become pregnant.
To determine how these recommendations played out in Mountain West, scientists studied women of reproductive age — 16-49 years. They obtained information on their medical history over a five-year span, starting 2010, from the Utah Population Database.
With this information, scientists checked if they had conditions that could complicate pregnancies. In addition to the ailments listed by the CDC, the researchers looked at several other conditions that may pose problems for pregnancies such as depression, asthma, and thyroid problems.
Of the 742,000 women studied, they found that nearly 33% of them had at least one chronic condition that could adversely impact their health while pregnant. And according to the medical records, less than 8 percent of those women were using the most highly effective forms of birth control.
Less women preferred effective forms of birth control, according to the team, due to factors such as cost, personal preference, and insurance. Their team found that women with government insurance were more likely to use effective birth control methods than women with no insurance or private insurance.
Another major factor, says the team, is misinformation. Some women believe or are told that they are infertile because of their chronic health conditions, making them less likely to rely on good contraceptive methods.
Patients have to be better informed about the potential risks involved with pregnancy, the author explains. "It is completely up to the woman with a chronic condition and her family to determine if she wants to become pregnant," Dr. Gawron says. "But I want her to understand what the risks are ahead of time. If she isn't willing to take those risks, then she should be using the safest and most effective birth control method that works for her."