Women with Chronic Condition Need to Know More About Fertility, Study Concludes

A lot of women with a chronic disease like cystic fibrosis fail to receive enough information from doctors on preventing or facilitating pregnancy, an Australian study reports.

The result is that many of the four million women in this category become pregnant young, have an unintended pregnancy, or an abortion, the researchers reported. One reason for this could be the mistaken believe that it is harder for women with a chronic condition to become pregnant, the team said.

Their study, published in the Maternal and Child Health Journal, is titled “The Fertility Management Experiences of Australian Women with a Noncommunicable Chronic Disease: Findings from the Understanding Fertility Management in Contemporary Australia Survey.

Most women with chronic diseases want children — although fewer than women in the general population, according to the study. They often identify their health status as a barrier, the researchers said.

Even though almost a third of Australian women of childbearing age have a chronic disease, little research has been done on what they do to prevent pregnancy or to facilitate conception when they’re ready to have a child.

Dr. Sara Holton of Monash University’s School of Public Health and Preventive Medicine decided to study the subject.

At the heart of the research was a survey that about 1,500 women of childbearing age participated in. Cystic fibrosis was one of more than 10 chronic conditions the participants  could list.

A key finding was that women with a chronic illness were more likely to report becoming pregnant young, having an intended pregnancy, and having an abortion.

Another finding was that even though women with a chronic condition anticipated having fewer children than women without one, they were less likely to have seen a fertility expert before becoming pregnant.

“It is likely that women’s consultations with a healthcare provider are focused on managing or treating their disease and, therefore, women with a chronic illness may not be receiving pertinent or timely advice about managing their fertility,” Holton said in a press release.

“As a result, women with a chronic illness may not have the opportunity to ask questions or make informed decisions or plans about childbearing.” In addition, “women with a chronic illness may also assume that they will have difficulty conceiving because of their illness and, therefore, do not need to use contraception.”

Man women with chronic conditions were also using contraception without being aware that it could interact with their condition-related medication, the researchers said. This suggested that some might not be using contraceptive methods that fit their illness. It also suggested that healthcare providers might not be fully aware of the need to select contraceptives according to their patient’s disease.

Based on the results, Holton said she believes that many women with chronic conditions would benefit from personalized reproductive health information. It could help them make more informed decisions about contraception and childbearing, she said.

“The findings of this study have implications for healthcare providers and women with a chronic illness,” she said. The results “highlight the importance of addressing possible assumptions about the inability of women with a chronic illness to become pregnant, and ensuring women receive information about suitable methods of contraception and pre-pregnancy care.”