Only 26.2% of women with hypertension receive contraceptive counseling
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Key takeaways:
- Only 26.2% of women with hypertension received contraceptive counseling.
- Women with hypertension had 8.2% and 9.45 higher likelihood of contraceptive counseling and receiving contraception vs. those without.
BALTIMORE — Just over one-quarter of U.S. women with hypertension who are at risk for unintended pregnancy received contraceptive counseling between 2015 and 2019, according to a poster presented at the ACOG Annual Clinical & Scientific Meeting.
Using data from the 2015 to 2017 and 2017 to 2019 National Survey of Family Growth, researchers compared contraceptive counseling and contraceptive use in the previous year among 8,625 women with and without hypertension.
Overall, 8.7% of women in the sample had hypertension. Contraceptive counseling was given to 26.2% of women with hypertension and 20.7% of women without hypertension. In addition, researchers noted contraceptive use among 39.8% of women with hypertension and 35.3% of women without hypertension.
“Women who do have hypertension and are using a form of contraception, they're using the contraception pill, which is an estrogen-containing pill that's actually CDC Medical Eligibility Criteria Category three, which means that patients with hypertension should try to use another method. It can increase your risk of blood clots,” Katherine A. Panushka, MD, a resident in the department of obstetrics, gynecology and women’s health at Albert Einstein College of Medicine Montefiore Medical Center, Bronx, told Healio. “The CDC Medical Eligibility Criteria Category three means is that you should consider an alternative form of contraception if there's one that's appropriate for the patient. You'd want to use something with progesterone.”
Women with hypertension had an 8.2% higher likelihood of receiving contraceptive counseling and a 9.4% higher likelihood of receiving contraception compared with women without hypertension. The most reported contraception method among women with hypertension was oral contraceptive pills with 54%.
According to the researchers, improving contraceptive delivery among this patient population may provide an opportunity to prevent pregnancy-related morbidity given the association between hypertension and maternal health.
Most patients with hypertension had increased rates of contraceptive counseling except for Black patients who had decreased counseling contraception rates.
“We're currently working on a paper that's investigating this and hashing out what that means that implicit bias of patients who are Black and have hypertension, and they are receiving decreased rates of contraceptive counseling,” Panushka said.