ACOG: All women should have reproductive life plan

Obstetrician–gynecologists should use each visit to discuss the short- and long-term reproductive plans of their patients, according to a new opinion issued by The American College of Obstetrics and Gynecologists.

"Right now in the United States, roughly half of all pregnancies are unintended," Wanda K. Nicholson, MD, MPH, chair of The American College of Obstetrics and Gynecologists (ACOG) Committee on Health Care for Underserved Women and lead author of the opinion, said in a press release. "Clearly, we are not meeting the needs of all women in terms of preventing pregnancy and counseling about reproductive life planning."

The committee, noting the HHS Healthy People 2020 goals that call for a 10% decrease in unintended pregnancies over 10 years, said obstetrician–gynecologists and other health care providers have a large role to play.

"Every woman who is capable of having a child should have a reproductive life plan," the opinion stated. "In order to reduce the rate of unintended pregnancy, obstetrician–gynecologists must focus on having respectful, meaningful conversations with patients about pregnancy intentions and must be willing to support efforts that promote access and consistent use of all contraceptive methods."

ACOG recommends that care providers engage patients in a supportive and respectful dialogue regarding their reproductive plans at every visit. Discussions should include preconception or contraceptive counseling, especially various contraceptive methods and perceived barriers to contraception and involve shared decision making. Care providers should also educate patients on pregnancy planning and child spacing in relation to pregnancy outcomes.

Additionally, ACOG urged obstetrician–gynecologists to stay up-to-date regarding contraception coverage provisions in the Affordable Care Act and community initiatives for accessing low- or no-cost contraception. The organization asked health care providers to support initiatives that reduce poverty and racial and ethnic health inequities, acknowledging the role they play in unintended pregnancies.

"Thanks to the wide range of contraceptive methods available, we are able to meet the varied health needs and preferences of women, from preventing initial pregnancy to aiding in birth spacing, for example through postpartum insertion of long-acting reversible contraception," Nicholson said in the release. "By including conversations about reproductive preferences in every interaction with our patients, we are acknowledging the essential role that birth control has in a woman's well-being." – by Chelsea Frajerman Pardes

Reference:

Reproductive life planning to reduce unintended pregnancy. Committee Opinion No. 654. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2016;127:e66-69.