Cardiologists need to address the risk of pregnancy appropriately with women of child-bearing age, and encourage contraception planning for women with heart disease, according to a paper published in the Journal of the American College of Cardiology.
Pregnancy can create further health problems for people with cardiovascular disease, leading to an increased risk of morbidity and mortality. Some medications used to treat cardiovascular disease can also be harmful to foetuses. This means that women with cardiovascular disease should discuss reproductive planning with their cardiologists, but it’s not currently known how frequently this happens.
“It is important for cardiovascular clinicians to assess for the need for contraception and appropriateness of contraceptive method both at the time of initial assessment and at subsequent annual encounters in all reproductive age women (age 15-44) with cardiovascular disease,” says Kathryn J. Lindley, lead author on the paper.
“If a patient identified to be at increased risk for pregnancy complications is also noted to be using a contraceptive method with low effectiveness, a discussion of reproductive goals and safe and effective methods of contraception is recommended.”
Cardiovascular disease is on the rise among women of childbearing age, according to the paper, and is particularly high in areas of the USA where it’s difficult to get contraception. More than 19 million women in the US currently live in ‘contraception deserts’, counties without contraceptive care or reproductive planning services.
The paper emphasises that shared decision-making between patient and doctor is critical to address this problem. Similarly, a range of available contraceptive methods is required to tailor to different people’s needs.
Ellen Phiddian is a science journalist at The Royal Institution of Australia.
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