Provision of contraceptive services to women with diabetes mellitus

Eleanor Schwarz, Debbie Postlethwaite, Yun Yi Hung, Eric Lantzman, Mary Anne Armstrong, Michael A. Horberg

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND: Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes. OBJECTIVE: To compare rates of provision of contraceptive services among women with diabetes mellitus and women without chronic medical conditions. DESIGN: A retrospective cohort study of 459,181 women aged 15-44 who had continuous membership and pharmacy benefits in a managed care organization in Northern California between January 2006 and June 2007. Rates of documented provision of contraceptive counseling, prescriptions, and services were compared between women with diabetes and women without chronic medical conditions. RESULTS: Among 8,182 women with diabetes and 122,921 women without any chronic conditions, women with diabetes were less likely than women without a chronic condition to have documented receipt of any contraceptive counseling, prescriptions, or services (47.8% vs 62.0%, p < 0.001). After controlling for age and race, women with diabetes were more likely to have undergone tubal sterilization compared to women without a chronic condition (OR = 1.41, 95% CI 1.30-1.54), but less likely to have received highly effective, reversible methods of contraception such as intrauterine contraception (OR = 0.68, 95% CI 0.61-0.75). In addition, more women with diabetes had undergone hysterectomy, which is rarely performed solely for contraceptive purposes. CONCLUSIONS: Women with diabetes were less likely to receive highly effective reversible contraception and more likely to undergo sterilization procedures. Increasing the use of highly effective reversible contraceptives may help diabetic women who want to retain their fertility to delay pregnancy until glycemic control is achieved.

Original languageEnglish (US)
Pages (from-to)196-201
Number of pages6
JournalJournal of General Internal Medicine
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2012
Externally publishedYes

Fingerprint

Contraceptive Agents
Diabetes Mellitus
Contraception
Prescriptions
Counseling
Tubal Sterilization
Pregnancy
Managed Care Programs
Pregnancy Outcome
Hysterectomy
Fertility
Cohort Studies
Retrospective Studies

Keywords

  • Contraception
  • Diabetes mellitus
  • Preconception counseling
  • Pregnancy
  • Women

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Schwarz, E., Postlethwaite, D., Hung, Y. Y., Lantzman, E., Armstrong, M. A., & Horberg, M. A. (2012). Provision of contraceptive services to women with diabetes mellitus. Journal of General Internal Medicine, 27(2), 196-201. https://doi.org/10.1007/s11606-011-1875-6

Provision of contraceptive services to women with diabetes mellitus. / Schwarz, Eleanor; Postlethwaite, Debbie; Hung, Yun Yi; Lantzman, Eric; Armstrong, Mary Anne; Horberg, Michael A.

In: Journal of General Internal Medicine, Vol. 27, No. 2, 01.02.2012, p. 196-201.

Research output: Contribution to journalArticle

Schwarz, E, Postlethwaite, D, Hung, YY, Lantzman, E, Armstrong, MA & Horberg, MA 2012, 'Provision of contraceptive services to women with diabetes mellitus', Journal of General Internal Medicine, vol. 27, no. 2, pp. 196-201. https://doi.org/10.1007/s11606-011-1875-6
Schwarz, Eleanor ; Postlethwaite, Debbie ; Hung, Yun Yi ; Lantzman, Eric ; Armstrong, Mary Anne ; Horberg, Michael A. / Provision of contraceptive services to women with diabetes mellitus. In: Journal of General Internal Medicine. 2012 ; Vol. 27, No. 2. pp. 196-201.
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