Diabetic women not getting birth control advice

Women with diabetes are less than half as likely as non-diabetic women to receive counseling on birth control from their doctors, a new study shows - despite the risk to the baby if a woman with diabetes conceives before optimal blood sugar control is achieved.

Dr. Eleanor Bimla Schwarz of the University of Pittsburgh and her colleagues explain in the medical journal Obstetrics & Gynecology that an unplanned pregnancy is a particular concern for diabetic women, who face twice the risk of having a child with a birth defect. But if blood sugar is under good control, Schwarz told Reuters Health, there's a much better chance of having a problem-free pregnancy and delivery.

Schwarz and her colleagues analyzed data on 40,304 physician visits by women aged 14 to 44 between 1997 to 2000, collected by the National Ambulatory Medical Care survey, an annual survey of 3,000 office-based US doctors.

Overall, they found, just 4 percent of physician visits by diabetic women included contraceptive counseling. Women with diabetes were 58 percent less likely to discuss contraceptives during physician visits than non-diabetic women.

"I think in all the bustle of taking care of all the other diabetic issues, somehow pregnancy is getting shuffled off the table," Schwarz said.

Schwarz urges all diabetic women of reproductive age to set aside one visit with their primary care doctor or gynecologist each year to discuss family planning. "The message for diabetic women is that it's really important to take charge of deciding to get pregnant, and that when pregnancy is desired it should be a carefully planned thing," she said.

SOURCE: Obstetrics & Gynecology, May 2006.