Preventing pregnancy among women with chronic illnesses: A study of the roles of non-gynecologists practicing in Zaria, Nigeria

Abstract

Background: Women all over the world suffer from chronic illnesses such as hypertensive diseases, cardiac diseases, diabetes mellitus, mental illnesses, cancers, and HIV/AIDS. Unprotected sex in the presence of preserved fertility could lead to unplanned pregnancies that could pose additional challenges to the ongoing chronic morbidities especially in low-resource settings. We assess the knowledge of non-gynecologists on contraceptive requirements for women with chronic and debilitating illnesses and how these requirements are met within their practice. Patients and Method: A cross-sectional descriptive study using a structured pretested and self-administered questionnaire, administered to non-gynecologists physicians providing care to chronically ill patients in Zaria, northern Nigeria. Data were collected, cleaned, and analyzed using IBM SPSS v19.0. Results: The response rate was 71% (85). Most respondents (88.2%) practice in the teaching hospital and 77.8% (66) had at most 10 years of medical practice. The majority (92.9%) manage women of the reproductive age group (WRAG) with debilitating illnesses. Up to 95.3% (84) agreed that pregnancy affects the management of chronic or debilitating diseases, and 91.8% agreed that these women can benefit from modern contraceptive methods to delay or prevent pregnancies. 74.1% had diagnosed pregnancy among women they managed for chronic or debilitating diseases. Sixty six (76.6%) referred their patients to a contraceptive provider while 9.4% offered them contraception. Up to 51.8% are willing to be trained as counselors in contraception to improve their practice. Conclusions: Training on counseling, especially in the form of Continuous Medical Education can help improve the capacity of non-gynecologists to offer contraceptive services in the context of chronic disorders among WRAG.