‘We are rarely documenting contraception’: Rheumatologists can improve pregnancy planning
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Rheumatologists can help patients with lupus and other rheumatic diseases avoid potentially dangerous unintended pregnancies by regularly documenting their contraception use, according to a presenter at the 2023 AWIR annual conference.
“The thought in the general family planning community is that an unintended pregnancy doesn’t necessarily have to be a bad thing,” Mehret Birru Talabi, MD, PhD, of the University of Pittsburgh School of Medicine, told attendees during the meeting. “I think it is a little bit different in our patient population, because we have seen some preliminary data that unintended pregnancies in lupus are associated with worse pregnancy outcomes.”
The circumstances surrounding unplanned pregnancy in patients with lupus and other rheumatic diseases tend to be more “fraught” with potential complications, she added.
Meanwhile, the rate at which patients with lupus receive routine contraception remains low, according to Talabi.
“I think another important point is that we know that patients with rheumatic diseases are rarely prescribed contraception,” she said.
However, in a study conducted by Talabi and colleagues, patients were more likely to be prescribed contraceptive care if they were regularly visiting their primary care or gynecologic provider.
“We are serving as the primary care providers for many of our patients, and if we don’t address contraception, they may not be getting it addressed anywhere else,” Talabi said.
As such, rheumatologists can, and should, document contraception use among their patients, she added.
“We are rarely documenting contraception in our encounters,” Talabi said. “Only about 9% of reproductive-age women with RA or lupus had any documentation of contraception in their rheumatology encounters, and we know that is meaningful because we are also prescribing teratogenic medications.”
Due to the use of such medications, Talabi urged rheumatologists to think carefully about the way they handle patients who can become pregnant.
“In the context of talking about abortion care, we also have to start thinking about contraception care for these patients,” she added.
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Talabi MB, et al. Understanding the impact of unintended pregnancy, contraception and abortion on the care of people with rheumatic disease. Presented at: Association of Women in Rheumatology annual conference; Aug. 10-13, 2023; Orlando, Florida (hybrid meeting).
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