title: Balancing act: safe and evidence-based prescribing for women of reproductive age.
abstract: Teratogenic medications are commonly prescribed to women of reproductive age. Caring for women who may benefit from the use of teratogenic medications requires clinicians to engage patients in shared decision-making on the risks and benefits of medication use in the context of the patient's fertility goals, the implications of the patient's medical condition for a pregnancy and the risks and benefits of various contraceptive methods. Effective communication about all of these issues is essential to avoiding medication-induced birth defects. However, data suggest that such communication remains inadequate, leading some women to face unintentional exposure of a pregnancy to a teratogen, undesired pregnancy or, sometimes, the need for pregnancy termination services. This review outlines key information needed to ensure safe prescribing to women of childbearing age. It includes recommendations for changes in medical education, healthcare delivery and health policy to facilitate thoughtful prescribing and comprehensive care.
authors: Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. pace.lydia@gmail.com
authors: Lydia E
authors: LE
authors: Pace
authors: Eleanor Bimla
authors: EB
authors: Schwarz
mesh_terms: D000293:Adolescent; D000328:Adult; D000013:Congenital Abnormalities; D004363:Drug Utilization; D019317:Evidence-Based Medicine; D005260:Female; D006291:Health Policy; D006801:Humans; D008427:Maternal Health Services; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011247:Pregnancy; D055553:Prescription Drugs / Q000009:adverse effects; D060728:Reproductive Health; D012307:Risk Factors; D013723:Teratogens / Q000592:standards; D014481:United States; D014486:United States Food and Drug Administration; D055815:Young Adult
chemical_list: D055553:Prescription Drugs; D013723:Teratogens