281905
Unintended pregnancy versus contraception: Reproductive risks juxtaposed
J. Joseph Speidel, MD, MPH,
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Corinne Rocca, PhD, MPH,
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Kirsten M.J. Thompson, MPH,
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Cynthia C. Harper, PhD,
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA
The Obama Administration's decision to require insurance coverage of the full cost of all FDA-approved contraceptives in the Affordable Care Act (ACA) has incited controversy, with some opponents arguing that contraceptive care is not a preventive health service. In this poster, we present empirical data to repudiate this claim. We reviewed the scientific literature on the health risks of both pregnancy and contraceptive use, juxtaposing the risks of each for healthy women and those with preexisting medical conditions. Results indicate that, although contraceptives are not without risks, they are far safer than pregnancy and childbirth. For instance, one of the most serious risks of hormonal contraceptives is adverse cardiovascular events/venous thromboembolism (VTE). However, while VTE risk is increased 2-3 times by oral contraceptive use, it is increased up to 29 times in pregnancy and 300-400 times in the immediate postpartum period. The risks of pregnancy are amplified for women with pre-existing conditions (e.g. cardiovascular disease, kidney disease, thyroid disease, asthma, diabetes). Including the 33% of caesarian births, almost half of deliveries involve at least one medical complication (e.g. obstetric trauma and laceration, infection, hemorrhage, eclampsia). Studies indicate that women tend to underestimate the risks of pregnancy and childbirth and overestimate those of contraceptive use. We compare the risks of the most common and serious morbidities for these two reproductive events. Results will be useful to family planning practitioners for the development of counseling protocols and to advocates supporting family planning legislation, such as contraceptive coverage in the ACA.
Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Learning Objectives:
Describe the health risks most commonly associated with pregnancy and contraceptive use
Compare the frequency and severity of health risks associated with pregnancy to those of contraceptive use
Demonstrate that the risks of carrying an unintended pregnancy to term are higher for most women than preventing unintended pregnancy with contraception
Keyword(s): Risk Assessment, Pregnancy
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a Harvard trained MD, MPH with more than 40 years of experience directing and carrying out reproductive health research. In my current role as a professor in the UCSF Bixby Center for global Reproductive Health I am actively carrying our family planning and reproductive health research. I have more than 100 publications in these fields.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
