A Complex Contraception Registry
Condition: Diabetes; Cardiovascular Disease; Epilepsy; Migraine; Neurological Disorders; Cancer; Bariatric Surgery Candidate; Organ or Tissue Transplant; Complications; Lupus Erythematosus, Systemic; Other Hematologic Conditions; Other Venous Embolism and Thrombosis
MeSH terms: Nervous System Diseases; Cardiovascular Diseases; Thrombosis; Embolism; Embolism and Thrombosis; Lupus Erythematosus, Systemic
Study type: Observational [Patient Registry]

Summary: 
      The investigators will conduct a prospective observational cohort study to investigate
      factors that influence contraceptive method utilization among women with medical conditions.
      The investigators will also investigate how women with medical conditions access to
      contraception and family planning fellowship trained specialist. After the baseline
      questionnaire, there be a 3 month and 6 month follow up questionnaire to investigate
      continuation and satisfaction with the contraceptive method. This study is unique because it
      will allow us to explore doing collaborative family planning research at the multiple UC
      medical campuses.
    

Detailed description: 
      Many women with complex medical conditions who do not desire pregnancy do not receive
      contraception counseling from their primary or subspecialty care clinicians, and often they
      are not using contraception. This is an important deficiency as many have conditions that
      could worsen with pregnancy or for whom pregnancy can be complicated by the medical
      condition. Thus it is important for women with chronic disease to only become pregnant if
      they intend to do so. The United States Medical Eligibility Criteria for Contraceptive Use
      (USMEC), released in 2010, has greatly enhanced the ability of clinicians to counsel patient
      with complex medical conditions about their contraceptive options. It summarizes the safety
      of specific contraceptives when used on women with medical conditions. However, little is
      known about the contraceptive care of these women. We do not know if the availability of the
      USMEC has translated into evidence-based contraceptive counseling for these women. Further,
      little is known about their understanding of the interaction between their disease and
      pregnancy, their past experience and knowledge about contraception, and their contraceptive
      decision-making, satisfaction and continuation.

      The purpose of the Complex Contraception Registry to is to recruit a cohort of women with
      complex medical conditions who are seen in contraception referral practices run by family
      planning fellowship trained physicians. We will assess their past experiences and baseline
      knowledge, their post-counseling experiences and choice of contraception, and their long-term
      satisfaction with and continuation of contraception. A multi-center registry is necessary
      because individual institutions see relatively few women with rare diseases such as a history
      of transplant surgery. The UC Family Planning Collaborative will facilitate recruitment of
      participants from the 5 UC medical campuses and will oversee their follow-up for one year.

      Specific Aim include (1.) To investigate what factors influence contraceptive method
      utilization among women with complex medical conditions and their perceived risk of
      unintended pregnancy (2) To investigate how women with complex medical conditions access
      family planning fellowship trained specialist for contraception counseling and (3.) To assess
      satisfaction and continuation of contraceptive methods among women with complex medical
      conditions.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study population will consist of women 18-45 years old and seeking contraception with
        the medical condition listed in inclusion criteria. Participants will be recruited from
        obstetrics and gynecology clinic at UCSD, UCLA, UCSF, UC Irvine and UC Davis. 250
        participants will be enrolled. Approximately 50 cases will be recruited at each site.
      
Keywords: contraception; family planning; complex medical conditions