More contraceptive counseling needed when prescribing class D/X drugs

About one in six women of reproductive age has a prescription filled at some point for a class D or X (potentially teratogenic) medication, but only about half of them receives contraceptive counseling, fewer than half are filled by women using a prescription contraceptive or who are sterilized, and these women are only slightly less likely than those filling a prescription for a class A or B drug to have a documented pregnancy in the following 3 months (1.0% vs. 1.4% of prescriptions, respectively).

The findings come from a large retrospective cohort study involving almost 500,000 female members of a large health maintenance organization in Northern California.

The authors of the study say the findings underscore the importance of contraceptive counseling, which other studies have found affects the use of contraception and the rate of unintended pregnancy. They hope the findings are also noted by policymakers in a position to influence whether contraception is covered by health insurance plans, since the cost of contraception often plays a role in whether or not it is obtained and used.