Unintended Pregnancy: A Systematic Review of Contraception Use and Counseling in Women With Cancer.
Laura Britton
PMID 28315546WHAT IT FOUND
Women with cancer often lack effective contraception counseling, leading to unintended pregnancies.
Counseling significantly increased the use of highly effective methods, but many women remained sexually active without protection due to misconceptions about fertility.
Key findings
01No studies captured the overall rate of unintended pregnancy or abortion among women with cancer.
02Women who received contraception counseling had almost seven times greater odds of using highly effective methods than those who did not.
03Some women believed they were infertile despite having no clinical diagnosis, which led them to skip contraception and experience unintended pregnancy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 16 studies, and the findings were fragmented due to variations in sample size, rigor, and setting. No studies reported the overall rate of unintended pregnancy or abortion, so prevalence remains unknown. The time frame (2000-2015) means some included research is dated. Comparing rates was difficult because the number of women at risk was not defined consistently across studies. Some studies used menstruation as a proxy for fertility, which excludes women who have not yet menstruated or have occult ovarian failure. Many studies did not document pregnancy intentions, which can influence contraception choices.
Declared interests
The text does not state any conflicts of interest or funding sources.
The easy way to misread this
Do not assume that general fertility counseling prevents unintended pregnancy. The review notes that pretreatment general counseling about fertility did not diminish the risk of unintended pregnancy after controlling for age and desire to parent. Specific, high-quality contraception counseling is required.