Contraceptive options for women with preexisting medical conditions.
Most healthy women have normal pregnancies; however, even healthy women may experience serious morbidity during pregnancy. Women with chronic medical problems face increased pregnancy-related risks compared with their healthy peers. Planning pregnancy improves maternal and fetal outcomes; medical conditions can be stabilized, teratogens can be avoided, and early antenatal intervention and surveillance can be instituted. The safest and most effective forms of contraception should be offered to women with medical conditions. Overestimatation of risk associated with the use of contraception among clinicians and women limits access to effective contraception. Contraception decision making should include consideration of the risks and benefits of a given method vs. the consequences of an unintended pregnancy. Published guidelines can inform contraceptive management of women with chronic medical conditions. Patient counseling should focus on helping women understand the need for contraception while optimizing their health for pregnancy.
Dragoman
Monica
M
Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10461, USA. mdragoma@montefiore.org
Davis
Anne
A
Banks
Erika
E
D002908:Chronic Disease / Q000188:drug therapy; D003267:Contraception / Q000009:adverse effects / Q000379:methods*; D044363:Contraception, Postcoital; D003271:Contraceptive Agents, Female; D004347:Drug Interactions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D049168:Pregnancy, Unplanned; D012306:Risk
D003271:Contraceptive Agents, Female