Documentation of reproductive health counseling and contraception in women with inflammatory bowel diseases

ObjectiveInflammatory bowel diseases (IBD) are commonly diagnosed during women's reproductive years. Counseling is important to avoid unintended pregnancy in a disease-poor state. We sought to determine reproductive counseling documentation by gastroenterologists in women with IBD.MethodsAn electronic query identified women, age 18–45, with IBD in an academic gastroenterology practice from 2010 to 2012. A random sample (15%) chart review determined contraception documentation and content/frequency of reproductive counseling.Results100 patients were analyzed. Median age was 35 (range 19–45), 53% were married, and 69% had Crohn's disease. Median time since IBD diagnosis was 9 years (range 1–32) with a 5 visit median (range 1–45) over 31 months (range 1–105). A contraceptive method was identified in 24% of all patients.Nineteen patients (19%) had documentation of reproductive counseling. Only 1/100 patients had a specific reference to using contraception to avoid pregnancy. The remaining counseling included (1) medication effects on pregnancy, (2) disease control before pregnancy, or (3) mode of delivery planning.ConclusionsOutside of listing contraception as a “current medication”, documentation of reproductive counseling at gastroenterology visits for IBD is sparse.Practice implicationsIn light of the importance of reproductive planning for women with IBD, future research on incentives and barriers to counseling is warranted.