A newly published article in the journal Nursing for Women's Health highlights the importance of a woman's ability to time her childbearing. The author asserts that contraception is a means of health promotion and women who work with their health care providers to ensure they are healthy prior to conceiving can minimize their risk of complications during pregnancy and childbirth.
According to the Centers for Disease Control and Prevention (CDC) there were more than four million births in the U.S. in 2009. A study by Kuklina et al. (2009) shows an increase in severe obstetric complications from 1998-1999 to 2004-2005, with renal failure increasing by 21%, pulmonary embolism by 52% and the need for blood transfusion by 92%. Moreover, maternal mortality has risen sharply in the past 20 years with a low of 6.6 maternal deaths per 100,000 live births in 1987, rising to 12.7 in 2007.
"There is a new urgency to ensuring that women have access to affordable contraceptive services given the rising rates of maternal morbidity and mortality in the U.S," explains Catherine Ruhl, CNM, MS, Director of Women's Health Programs at the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) in Washington, DC. "If women are able to choose when, and if, to become pregnant, they can protect themselves and their baby from pregnancy-related complications by ensuring they enter pregnancy in good health."
Ruhl points out that contraception counseling and birth control methods should be considered prevention, which in turn promotes good health. In the U.S. health conditions such as obesity, diabetes and hypertension have increased in women, increasing the risk of pregnancy complications. Federal data sources report that slightly less than half of women who gave birth in 2007 had a healthy pre-pregnancy weight.
A certified nurse-midwife, Ruhl suggests that women discuss their reproductive goals and contraception options with their health care providers. "Women deserve to have a full understanding of the benefits of being in the best health possible prior to pregnancy, and have providers who will partner with them to achieve their goals," she concludes.
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Contraception is Health Promotion." Catherine Ruhl. Nursing for Womens Health 2012; (DOI: 10.1111/j.1751-486X.2012.01703.x )