Sadia Haider, MD, MPH, talks about the latest guidelines from the Society of Family Planning regarding contraception for trans patients, RH testing during pregnancy, and Depo-Provera self-administration at the 2023 ACOG Annual Clinical and Scientific Meeting.
Sadia Haider, MD, MPH:
Hi, I'm Sadia Haider, MD, MPH. I'm an ob-gyn and complex family planning specialist at Rush University in Chicago, Illinois. I'm also the president elect of our Society of Family Planning.
What were some of the highlights from your presentation at the American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting?
Yeah, so our presentation, really is to bring information to the broader ob-gyn audience on some new clinical guidelines that Society of Family Planning has put together. Specifically, 3 of them are covered in our presentation today. One, looking at contraception for trans patients, and really, there's a lot of lack of information in that area. And then also looking at doing RH testing during pregnancy and sort of new guidelines around that. And the last clinical guidelines that we covered, which are new as well, is around subcutaneous use of Depo-Provera for patients to self-administer, as opposed to what we used to do, which is in clinic based with intramuscular Depo-Provera.
What are some takeaways from your presentation?
I think number one, that all patients should be offered contraception, regardless of their gender identity, and specifically that those patients that are on testosterone for gender affirming care, that should not be relied on for contraception. So, testosterone is not to be used as contraception. The second takeaway would be that we do not need to do RH testing for patients that are having miscarriages or abortions prior to 12 weeks gestation. So, before 12 weeks of pregnancy, for miscarriages, and terminations, we do not need to do testing that we used to do, which is specific to RH factor. And the last takeaway is that now we have an option for our patients to self administer Depo-Provera at home safely and comfortably through the subcutaneous route.
How can physicians talk to their patients about Depo-Provera if they are interested in that route?
What we know from some of the practice guidelines we have and from the literature and the evidence so far is that patients are very comfortable doing this at home with some counseling. And there are a couple of different ways that providers could approach this. They could have a conversation in the office about saying, if you're interested in this hormonal option for contraception, there's an option to come back to the office every 12 to 15 weeks and get it administered here vs doing it at home. And for patients that are interested in that like really introducing it as a very safe thing to do at home. There can be counseling that can be done in the office or by even telehealth or through a nurse communication that allows them to kind of walk them through that injection and how they can self-administer it at home, what the steps are, what it would entail and what to watch out for. And then kind of really guide them through the process. I think we know that once patients have been introduced to it properly, they can do it comfortably at home.