When clinicians prescribe adolescents and young women potentially teratogenic medications, they rarely provide counseling about contraception, finds a retrospective study in Pediatrics.
Researchers examined the records of nearly 1700 females aged 14–25 who received prescriptions for teratogenic medications (FDA category D or X) during 4200 clinic visits at a Midwestern academic pediatric medical center. The most commonly prescribed teratogens were topiramate, methotrexate, diazepam, isotretinoin, and enalapril.
Overall, contraceptive provision — defined as a prescription for contraception, or patient counseling or referral — was documented in just 29% of visits.
A commentator writes: “Even if a provider does not think it is within his or her scope of care to provide a contraceptive method, asking the questions to assess whether a contraceptive method might be needed from another provider is essential. In addition, all providers should be aware of the newer recommendation that all adolescents should be offered the option of a long-acting reversible contraceptive method to prevent pregnancy.”