Women with chronic medical conditions can be at higher risk for complications during pregnancy and therefore require specialized preconception and contraceptive care and counseling. However, many medical providers are hesitant to prescribe contraception to these women due to concerns about the safety of various contraceptives with co-existing medical disorders.
Rebecca H. Allen, MD, MPH, an obstetrician/gynecologist with expertise in family planning at Women & Infants Hospital of Rhode Island and an assistant professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University, has published a book that offers advice on how to meet the contraceptive needs of women with chronic medical problems. "Contraception for the Medically Challenging Patient" was edited in collaboration with Carrie A. Cwiak, MD, MPH, Department of Gynecology and Obstetrics, Emory University School of Medicine, Altanta, GA.
Dr. Allen explained, "The hesitance in prescribing contraceptives must be balanced against the fact that certain adverse outcomes and disease progression are likely to be greater during pregnancy than during contraceptive use. Therefore, these women deserve more, not less, family planning care so that an appropriate contraceptive can be found to meet their needs."
"Despite published guidelines by the Centers for Disease Control and Prevention, there is a substantial gap in medical practice regarding the use of contraception in women with chronic medical conditions," she continued. "This book fills that gap and addresses the complex contraceptive needs of today's medically challenging patients with HIV/AIDS, uterine fibroids, obesity, or cardiovascular, neurologic or thyroid diseases, among many others."
The chapter about women with hematologic conditions was co-authored by Dr. Allen's colleague, Tina Rizack, MD, a hematologist/medical oncologist at Women & Infants' Program in Women's Oncology and assistant professor at the Alpert Medical School.
"Contraception for the Medically Challenging Patient" is now available through Springer at http://www.springer.com/medicine/gynecology/book/978-1-4939-1232-2.