Invited Commentary

Commentary on "Prenatal Care, Pregnancy Outcomes, and Postpartum Birth Control Plans among Pregnant Women with Opiate Addiction"

Authors: Michael S. Cardwell, MD, MPH

Abstract

In this issue of the Southern Medical Journal, Parlier and colleagues present evidence of the underutilization of postpartum care and contraception by women with opiate addictions during their pregnancies.1 Only 62.5% of all eligible patients received postpartum contraception and those who did were more likely to have had a preterm birth or have attended their scheduled postpartum appointment. This group of special needs patients should be offered a variety of options when postpartum contraception is considered; however, the American College of Obstetricians and Gynecologists has identified the reluctance that physicians and other healthcare providers may feel in undertaking the care of the patient with opiate addiction.2 The healthcare providers’ barriers to care for these patients include time restraints, lack of proper training, and the general unwillingness to take on these special needs patients.

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References

1. Parlier AB, Fagan B, Ramage M, et al. Prenatal care, pregnancy outcomes, and postpartum birth control plans among pregnant women with opiate addictions. South Med J 2014;107:676-683.
 
2. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 422: at-risk drinking and illicit drug use: ethical issues in obstetric and gynecologic practice. Obstet Gynecol 2008;112:1449-1460.
 
3. Thiel de Bocanegra H, Chang R, Menz M, et al. Postpartum contraception in publicly-funded programs and interpregnancy intervals. Obstet Gynecol 2013;122(2 Pt 1):296-303.
 
4. Hernandez LE, Sappenfield WM. Is effective contraceptive use conceived prenatally in Florida? The association between prenatal contraceptive counseling and postpartum contraceptive use. Matern Child Health J 2012;16:423-429.
 
5. Gopman S. Prenatal and postpartum care of women with substance use disorders. Obstet Gynecol Clin N Am 2014;41:213-228.
 
6. Guttmacher Institute. Fact sheet: unintended pregnancy in the United States. http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html. Published December 2013. Accessed August 19, 2014.