Women with chronic medical conditions can be at higher risk for complications during pregnancy and therefore require specialized preconception and contraceptive care and counseling. However, many medical providers are hesitant to prescribe contraception to these women due to concerns about the safety of various contraceptives with co-existing medical disorders.
Rebecca H. Allen, MD, MPH, an obstetrician/gynecologist with expertise in family planning at Women & Infants Hospital of Rhode Island and an assistant professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University, has published a book that offers advice on how to meet the contraceptive needs of women with chronic medical problems. "Contraception for the Medically Challenging Patient" was edited in collaboration with Carrie A. Cwiak, MD, MPH, Department of Gynecology and Obstetrics, Emory University School of Medicine, Altanta, GA.
Dr. Allen explained, "The hesitance in prescribing contraceptives must be balanced against the fact that certain adverse outcomes and disease progression are likely to be greater during pregnancy than during contraceptive use. Therefore, these women deserve more, not less, family planning care so that an appropriate contraceptive can be found to meet their needs."
"Despite published guidelines by the Centers for Disease Control and Prevention, there is a substantial gap in medical practice regarding the use of contraception in women with chronic medical conditions," she continued. "This book fills that gap and addresses the complex contraceptive needs of today's medically challenging patients with HIV/AIDS, uterine fibroids, obesity, or cardiovascular, neurologic or thyroid diseases, among many others."
The chapter about women with hematologic conditions was co-authored by Dr. Allen's colleague, Tina Rizack, MD, a hematologist/medical oncologist at Women & Infants' Program in Women's Oncology and assistant professor at the Alpert Medical School.
"Contraception for the Medically Challenging Patient" is now available through Springer at http://www.
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. A U.S.News 2014-15 Best Children's Hospital in Neonatology, in 2009, Women & Infants opened the country's largest, single-family room neonatal intensive care unit.
New England's premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the National Institutes of Health's Pelvic Floor Disorders Network.