Reproductive Health Counseling Research Articles

Addressing Teenage Pregnancy and Reproductive Health Among Latinx Adolescents and Young Adults

Despite a national decline in teenage pregnancy rates, Latinxs and Black individuals continue to have higher teenage birth rates compared to white teens. In the United States, Latinx females (ages 15-19) are more than twice as likely to have a teenage birth compared to non-Latinx white teens. With an increasingly diverse nation, a shift towards culturally inclusive approaches to care is critical to achieving equitable patient outcomes. Improving access to preventative care, workforce diversity, and insurance coverage will lead to cost-savings and also help restore trust in a system that has failed past generations. In this commentary, targeted recommendations tailored specifically towards Latinx women will be provided including culturally competent birth control counseling, and a focus on reproductive justice. Not speaking English, low socioeconomic status, acculturation, legal status, and being uninsured are all teenage pregnancy risk factors unique to Latinx women. Cultural preferences and attitudes towards contraception must also be considered. Further expansion of Medicaid insurance coverage is also necessary to increase reproductive access among vulnerable populations. A cultural humility framework to reproductive health counseling and services is recommended. Within this framework family engagement is encouraged and women are free from reproductive coercion; they have the freedom to access over-the-counter contraception and receive guidance and support from providers and community health workers who are cognizant of culture and heritage. An integrated community-based approach that is culturally sensitive and in tune with Latinx heterogenicity is necessary to lower teenage pregnancy rates and achieve reproductive justice.

The Influence of Media Leaflet on Increasing Knowledge of Reproductive Health of Brides-to-Be in Padang City

According to WHO (2019), the Maternal Mortality Rate is the number of maternal deaths resulting from pregnancy, childbirth, and postpartum processes, which are used as indicators of women's health status. Maternal Mortality Rate (MMR) is one of the global targets of the Sustainable Development Goals (SDGs) to reduce maternal mortality (MMR) to 70 per 100,000 live births by 2030. Several efforts to reduce MMR have been carried out by the Padang City government, including implementing the Childbirth Planning and Prevention of Complications (P4K) Program, using MCH books, implementing classes for pregnant women, and health counseling activities. This quantitative research uses a pocketbook of the bride and groom using leaflet media. This is a guide for brides-to-be as part of marriage advice and guidance for those who have registered their marriage at the Regional Office of Religious Affairs (KUA). The subject of this study was a bride-to-be in Padang City. Providing reproductive health counseling on women's knowledge in premarital preparation in the working area of KUA Koto Tangah District has an influence.

Hubungan Teman Sebaya dan Media dengan Perilaku Seksual Remaja

The level of sexual behavior in adolescents has increased significantly, especially in several developing countries. Survey results in Bengkulu Province showed that 83.4% of teenagers held hands when dating, 34.2% hugged, 15.6% kissed, and 3.3% touched or stimulated sensitive body parts. This research aims to find out the relationship between peers and the media with adolescent sexual behavior. The design used in the research is cross sectional. Adolescent population at SMPN 20 Bengkulu City. The sample obtained was 87 teenagers taken using stratified random sampling technique. The research data was subjected to statistical tests using the SPSS program. The results of statistical tests showed that there was a relationship between peers (p = 0.000) and information media (p = 0.015) on adolescent sexual behavior at SMPN 20 Bengkulu City. It is hoped that schools can limit teenagers' exposure to risky sexual information media, namely by providing space for teenagers to do physical activities at school and collaborating with health agencies in the area to be able to carry out reproductive health assistance and counseling activities for teenagers so that teenagers can adapt to the process of change. towards adulthood.

Reproductive Health Counseling for Gilt and Sow

Heifer and sow pig farms in Golo Wua village are experiencing problems in managing reproductive health. To overcome this problem, the community service team from the Indonesian Catholic University Santu Paulus Ruteng conducted outreach using the lecture method directly for breeders using qualitative research. Data collection methods were carried out through observation, interviews, and documentation. The target of this extension activity is pig farmers, especially those raising heifers and sows. This counseling was carried out at the Golo Wua village hall and was attended by 33 breeders. The results of the outreach activities showed that participants' knowledge regarding reproductive health management for heifers and sows increased after attending the outreach. Therefore, counseling is the right method to increase pig breeders' understanding in overcoming problems related to the reproductive health of heifers and sows. The implications of this research are improving animal reproductive health and optimizing productivity. The main objective of this research is to increase farmer awareness about the importance of reproductive health in gilts and sows. This involves education about the reproductive cycle, signs of good reproductive health, and the impact of management practices on animal reproductive health.

Contraceptive Attitudes and Beliefs of Women With Sickle Cell Disease: A Qualitative Study

ObjectivesWe aimed to qualitatively explore factors influencing contraceptive use in women living with sickle cell disease (SCD). Study DesignWe conducted a semi-structured qualitative study using data from interviews with reproductive-aged women with SCD. The Theory of Planned Behavior, which describes an individual's attitudes, subjective norms, and perceived behavioral control as drivers of a health behavior, served as a framework for data collection and thematic analysis. ResultsWe analyzed interviews from 20 participants. Attitudes toward contraception showed skepticism regarding hormonal contraception and concern about adverse effects of contraception related to SCD. The role of subjective norms in contraceptive choice depended on whether participants possessed trusted sources of information, such as health care providers, family, and friends, or whether they relied on themselves alone in their contraceptive decision-making. The influence of health care providers was complicated by inconsistent and sometimes conflicting counseling. Finally, with regard to participants’ perceived control in their contraceptive choices, some were motivated to alleviate menstrual pain or prevent SCD-related pregnancy risks, but many reported feeling disempowered in contraceptive decision-making settings because of ways that healthcare providers exerted pressure or responded to participants’ demographic characteristics. ConclusionsWomen living with SCD are influenced by many factors similar to those documented for other populations when making decisions about contraception. However, SCD amplifies both the importance and risks of contraception and may also complicate individuals' autonomy and contraceptive access. Hematology and reproductive health providers should recognize the risk of coercion, maximize patients’ reproductive agency, and coordinate reproductive health counseling for patients with SCD.

Adolescent Reproductive Health Counseling in The Framework of Stunting Prevention

Adolescents/teenagers are the age group from 10 years to before the age of 18 years. Efforts to maintain adolescent health aim to prepare adolescents to become healthy, intelligent, qualified, and productive adults and to participate in maintaining, maintaining, and improving their health. Adolescent health is very important to pay attention to because, during this period, teenagers experience significant physical, psychological, and social changes. Adolescent health efforts include positive development, accident prevention, violence prevention, reproductive health, prevention and control of infectious diseases and prevention of non-communicable diseases, nutrition and physical activity, mental health, and adolescent health in crises. This community service takes the topic of reproductive health to increase participants' knowledge about reproductive health. This community service method uses an educational approach through counselling with a total of 136 participants who are students of SMPN 2 Jatigede, Ciranggem Village, Sumedang Regency, West Java. Counselling is carried out by involving resource persons who are experts in their fields. The results of the counselling showed that there was a significant increase in participants' knowledge, as indicated by the results of the post-test. Participants in the "good" category increased in number from 3 people (2.2%) at the pre-test to 98 people (72.1%) at the time. Post-test, as well as participants who had sufficient knowledge, experienced a reduction in numbers from 73 (53.7%) to the remaining 37 people (27.2%).

Sexual and reproductive health screening and counseling in adolescent and young adult transplant recipients.

Adolescents and young adults with and without chronic illnesses partake in risk-taking behavior. Clinicians in transplant clinics should be aware of the prevalence of risk-taking behavior in their adolescent and young adult solid organ transplant patients in order to provide complete care. Creating an environment where teens and young adults feel comfortable discussing risky behavior is important and includes creating a privacy policy and increasing comfort of the healthcare provider in asking sensitive questions. This review is intended to help the providers in the transplant clinic screen for and counsel about risk-taking behaviors with their adolescent and young adult patients, specifically around sexual and reproductive health.

130. Use of Digital Flashcards for Reproductive Health Counseling among Adolescents

130. Use of Digital Flashcards for Reproductive Health Counseling among Adolescents

Perceptions of prospective brides about reproductive health in Pauh District on 2023

The concern of prospective brides for reproductive health is still low.This research aims to explore prospective brides and grooms' perceptions of reproductive health. This study was a qualitative study with a phenomenological approach. The study was conducted at the Community Health Centers and Religious Affairs Office in Pauh District from February to December 2023. The selection of informants was done by purposive sampling and snowball sampling techniques, with prospective brides serving as the main informants. Supporting informants included midwives involved in the prospective brides' program and immunization program, nutritionists, several Religious Affairs officials, and speakers from reproductive health counseling. The researcher himself was the instrument of the study, employing data collection methods such as in-depth interviews, observations, and document reviews.The analysis results found that prospective brides had a variety of understandings about reproductive health. Some prospective brides had good perceptions and some were less good. These differences were influenced by several factors such as: knowledge, attention, experience, culture owned by the brides.The conclusion of this study is that prospective brides have diverse perceptions in interpreting reproductive health. Unfortunately, this topic have yet to become a significant concern for them. The study hopes to encourage cross-sectoral cooperation from the government, health, and religious sectors to increase the awareness of prospective brides about the importance of these services.

Fertility preservation in pediatric solid tumors: A report from the Children's Oncology Group.

Treatment for childhood solid tumors may lead to an increased risk for gonadal dysfunction/infertility. Discussion of risk should occur at diagnosis, any changes in therapy, and during survivorship. Gonadotoxic therapies were abstracted from 32 Children's Oncology Group (COG) phase III, frontline solid tumor protocols, in use from 2000 to 2022. Risk for gonadal dysfunction/infertility was assessed based on gonadotoxic therapies, sex, and pubertal status and assigned as minimal, significant, and high following the Oncofertility Consortium Pediatric Initiative Network (PIN) risk stratification. Most protocols (65.6%, 21/32) contained at least one therapeutic arm with a high level of increased risk. Solid tumor therapies present challenges in risk stratification due to response-adjusted therapy and the need to account for radiation field in the risk assessment. This guide hopes to serve as a tool to assist in standardizing gonadotoxic risk assessments across disciplines and improve referral for fertility services and reproductive health counseling for patients receiving COG-based solid tumor therapy. Internationally, many solid tumor therapies follow similar paradigms to COG studies, and risk stratifications may be generalizable to similar styles of therapy. In addition, this model may be applied to other international groups with the goal of standardizing fertility assessments.

(191) Contraception: How Ecology and Gender Equality are the New Deal

Abstract Introduction Since more than 10 years health care providers often hear from their patients that they want a natural contraception without hormones because of their potentials side-effects on bodies and environment by water contamination. In fact numerous scientific articles available on the web etablish that steroid hormones in wastewater are micropollutants and endocrine disruptors, especially wastewater treatment plants can not eradicate synthetic progestins after excretion. Nevertheless the situation remains paradoxical since the morning-after pill contains up to 50 times more hormones than the daily pill and is widely used, in France 2,2 millions of morning-after pills are sold each year. Looking for "green solutions", users are turning to menstruations apps, but are they aware of the pollution generated by materials and operations of digital industries? This is another paradox in the new contraceptive behaviours. Objective know different possible causes of contraceptive refusal take into account potential environmental effects when prescribing contraceptives and opt for the least polluting solutions. be aware of the environmental impact of digital health techniques take account of claims for gender-equal contraception Methods Literature review on PubMed for the 12 last months, Google Scholar since 2 years and mainstream media with the keywords: hormonal contraception and water pollution contraception and ecology Contraceptives residues and health Data Centers pollution contraception and gender equality Male contraception Results On Google Scholar numerous articles deal with the pollution of waste water and drinking water by steroid hormones at concentrations ranging from ng/L to g/L. Synthetic hormone compounds toxicity is widely recognized and can affect cell metabolism, causing various diseases such as obesity, infertility, endocrine disorders, even neoplasia or neuro-degenerative disease, although the effect of environmental synthetic hormones on the nervous system is still poorly documented. These data are public and can influence contraceptive behaviours On PubMed the focus is on endocrine-disrupting chemicals such as phtalates, dioxins, polychlorinated-biphenyl, biphenol A and analogs, I found only 2 surveys about residues of synthetic human hormones. 21 relevant surveys are found on PubMed about gender equality in contraception: these studies show an emerging interesr among men in controlling their fertilizing power, but a low support of pharmaceutical industries, leading them to use restrictive methods such as thermal contraception. Conclusions This work aims to highlight the contraceptive shift in progress. Consumers claim an ecological position, but use methods that contradict their stated convictions, such as morning-after pill or menstruations app causing digital pollution. Men want to involve themself in their reproductive health but are they heard enough? A low-risk, inexpensive and non-pollutante method such as vasectomy is still subject to false beliefs due to a lack of information and education, male hormonal contraception remains anecdotal (only in France). These observations highlight the role of the health care providers in sexual and reproductive health education and counselling, and of the industry's support, listening to people. Disclosure No.

Prevention and care strategies for people with HIV/AIDS in Primary Health Care

The present work aims to address the main prevention and care strategies for people with HIV/AIDS in Primary Health Care, through an integrative review of the literature. This is an integrative review of the literature, carried out in the Virtual Health Library (VHL). The databases selected were: Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Spanish Bibliographic Index in Health Sciences (IBECS) and Nursing Database - BDENF. Using this search parameter, 937 articles were obtained and, after applying the inclusion and exclusion criteria, only 24 studies were selected to compose the final sample. The results show that prevention and care for people with HIV/AIDS are crucial aspects in the context of PHC, as its approach at this level of care seeks to promote health, prevent diseases and offer comprehensive assistance to the community, playing a role vital role in the comprehensive response to this health condition. The patient-user-centered approach, combined with education and health promotion, regular testing, encouraging the use of condoms, sexual and reproductive health care, counseling and psychological support, antiretroviral treatment, access and availability of PrEP and PeP, Combating stigma and discrimination, integrating RAS, epidemiological monitoring and training professionals is essential to guarantee prevention practices, the quality and effectiveness of the care provided.

EDUKASI TENTANG KESEHATAN REPRODUKSI PADA REMAJA AWAL DI SD NEGERI 2 JABON MOJOANYAR KABUPATEN MOJOKERTO

Reproductive health promotion is still not free to convey, and is considered taboo, so some formal school-level institutions are still hesitant to carry out reproductive health counseling for their students. Adolescents are a group that has a high vulnerability to reproductive health problems. The purpose of this activity as a form of community service carried out by the Lecturer Team and students of Majapahit College of Health Sciences is as an effort to educate students at SD Negeri 2 Jabon Mojoanyar Mojokerto Regency about reproductive health education in early adolescents. Education by lectures, discussions and counseling demonstration. The activity which was carried out for one month was able to improve students' understanding of reproductive health in early adolescents and how to overcome if they experience problems related to reproductive health. This activity is expected to be a concern, especially in the world of education, increasing education on reproductive health promotion programs
 Keywords: reproductive health, early adolescence, health promotion

“It Means Being Safe, Having Power over One's Body”: Black Female Adolescent Experiences with Reproductive Health Counseling in Primary Care

Study ObjectiveThere is limited research examining the sexual and reproductive health (SRH) care needs and experiences of Black adolescents who are assigned female at birth (AFAB). This study aimed to understand the perspectives of Black AFAB adolescents in their receipt of SRH counseling in primary care and elicit preferences for SRH-related communication with clinicians. MethodsWe interviewed English-speaking Black AFAB adolescents, ages 13-17, living in North Carolina between February and June 2022 about their SRH care experiences. The interviews were conducted via video conferencing, audio-recorded, professionally transcribed, and analyzed using a thematic approach. ResultsWe interviewed 23 adolescents (mean age 15.8 years) across 10 geographically diverse counties in North Carolina. Most conveyed positive perceptions of clinicians regarding trust and comfort. However, many expressed concerns about clinicians not doing enough to ensure patient confidentiality, provide them with enough information to make informed and autonomous decisions, and destigmatize discussing SRH issues during the clinical encounter. Suggested improvements include sociodemographic congruence between patients and clinicians (eg, younger Black women), ensuring time alone with clinicians across adolescence, and proactively sharing information to promote respect and autonomy. ConclusionAlthough Black AFAB adolescents had positive perceptions of their health care providers regarding relational components of care, many participants shared significant gaps and areas for improvement in the quality of care received to better align services with their preferences for SRH care. These findings can inform the development of SRH counseling best practices and clinician education to support respect and autonomy, which are routinely denied to Black AFAB adolescents.

37. The Need to Improve Sexual and Reproductive Health Counseling and Screening by Pediatric Subspecialists for Adolescents Prescribed Teratogenic Medications

37. The Need to Improve Sexual and Reproductive Health Counseling and Screening by Pediatric Subspecialists for Adolescents Prescribed Teratogenic Medications

Preferences and experiences of parents/guardians of youth with epilepsy and intellectual disability on reproductive health counseling

ObjectiveTo explore the experiences and preferences of parents/guardians of adolescents and young adults (AYA) of childbearing potential with co-occurring epilepsy and intellectual disability (ID) regarding counseling by neurologists on sexual and reproductive health (SRH) topics such as pregnancy, contraception, menstruation, and folic acid supplementation. MethodsWe conducted semi-structured interviews with parents/guardians of AYAs (12–28 years old) of childbearing potential with co-occurring epilepsy and ID, recruited from a tertiary-care children’s hospital. We confirmed the diagnoses of epilepsy and ID with the patient’s neurologist and parent/guardian. All degrees of ID (e.g. mild/moderate/severe) were eligible. We audio-recorded and transcribed interviews. Two coders performed qualitative thematic analysis. ResultsTwenty-five parents/guardians completed interviews. Themes included: (1) Parents/guardians believe their child to be immune from sexual abuse due to their supervision, yet desire counseling about abuse recognition and prevention, which they also report not occurring (2) A common opinion was that counseling on menstruation was more relevant to their child's life than counseling about pregnancy-related topics (3) Parents/guardians reported a lack of counseling on pregnancy-related topics such as folic acid supplementation and teratogenesis and generally also reported some degree of interest in hearing about these topics from neurologists (4) Parents/guardians also reported a lack of counseling on drug interactions between contraception and ASMs, and were highly interested in learning more about this topic (5) Parents/guardians want neurologists to initiate annual comprehensive SRH counseling at puberty about most topics, but report that they often initiate SRH discussions themselves. ConclusionParents/guardians of AYAs with epilepsy and ID prefer more frequent, neurologist-initiated, comprehensive conversations surrounding SRH particularly emphasizing menstruation and sexual abuse recognition/prevention. Findings may inform professional and patient education and health systems interventions including development of discussion guides and/or decision aides to improve SRH care for AYAs with epilepsy and ID.

Subjective Experiences of Pregnancy, Delivery, and Nursing in Transgender Men and Non-Binary Individuals: A Qualitative Analysis of Gender and Mental Health Concerns

Studies of how gender-diverse individuals experience pregnancy, childbirth, and nursing remain few, mainly focus on the US and contain scarce information about mental health concerns peri-partum. This hinders informed reproductive health decisions and counseling. We used in-depth interviews to examine how gestational gender-diverse individuals in Sweden experience the process of planning and undergoing pregnancy, delivery, and nursing. In total, 12 participants, identifying on the masculine side of the gender spectrum or as non-binary, who had attended Swedish antenatal care and delivered a live birth, were included in the study. Data were analyzed using qualitative thematic content analysis. The analysis resulted in one overarching theme: sustaining gender congruence during pregnancy and three main categories: (1) considering pregnancy; (2) undergoing pregnancy and childbirth; and (3) postnatal reflections. The association between childbearing and being regarded as female permeated narratives. Participants renegotiated the feminine connotations of pregnancy, accessed gender-affirming treatment, and concealed their pregnancy to safeguard their gender congruence. Mis-gendering and breast enlargement triggered gender dysphoria. Social judgment, loneliness, information shortages, hormonal influence and cessation of testosterone increased gender dysphoria and strained their mental health. Depression exacerbated gender dysphoria and made it harder to claim one’s gender identity. Dissociation was used to handle a feminized body, vaginal delivery, and nursing. Pregnancy was easier to envision and handle after masculinizing gender-affirming treatments. The results deepen the understanding of gender dysphoria and may be used to inform reproductive counseling and healthcare development. Research outcomes on mental health concerns provide a basis for further research.

Hubungan Pola Menstruasi Dengan Kejadian Anemia Pada Remaja Putri Di SMPN 6 Tapung Kabupaten Kampar

Anaemia is a public health problem that occurs throughout the world, especially in developing countries such as Indonesia, the prevalence of anaemia in women of reproductive age between the ages of (15-49) in the world in 2019 ranged as much as 29.9%. This study aims to determine the relationship between menstrual pattern variables and the incidence of anaemia. The design of this study was cross sectional. The sample in this study was 100 respondents. The hypothesis test used was the Chi-square test. The results of this study are that there is a significant relationship between menstrual patterns and the incidence of anaemia in adolescent girls at SMPN 6 Tapung Kampar Regency in 2023, the value of P value = 0.002 OR (95% CI: 1.778-9.87), and there is a significant relationship between menstrual patterns and the incidence of anaemia in adolescent girls at SMPN 6 Tapung Kampar Regency. It is expected for health workers to be able to make creative and innovative policies in the prevention of anaemia through increasing health education and promotion in schools and fostering the PIK-KRR program (Adolescent Reproductive Health Information and Counseling Center) and UKS (School Health Unit), as well as facilitating adolescents to participate.

Patient perspectives of using reproductive autonomy to measure quality of care: a qualitative study

BackgroundCurrent measures of reproductive health care quality, such as rates of “unintended” pregnancies, neglect to incorporate patients’ desires and center their reproductive autonomy. This study explores patients’ perspectives on and receptivity to alternative metrics for measuring quality of such care.MethodsAn online research recruitment firm identified eligible participants living in New York, ages 18–45, self-identifying as women, and having visited a primary care provider in the last year. We conducted five virtual focus groups and eight in-depth interviews with participants (N = 30) in 2021. Semi-structured guides queried on ideal clinic interactions when preventing or attempting pregnancy and their perspectives on how to measure the quality of such encounters, including receptivity to using our definition of reproductive autonomy to develop one such metric: “whether the patient got the reproductive health service or counseling that they wanted to get, while having all the information about and access to their options, and not feeling forced into anything.” We employed an inductive thematic analysis.ResultsParticipants wanted care that was non-judgmental, respectful, and responsive to their needs and preferences. For pregnancy prevention, many preferred unbiased information about contraceptive options to help make their own decisions. For pregnancy, many desired comprehensive information and more provider support. There was considerable support for using reproductive autonomy to measure quality of care.ConclusionsPatients had distinct desires in their preferred approach to discussions about preventing versus attempting pregnancy. Quality of reproductive health care should be measured from the patient’s perspective. Given participants’ demonstrated support, future research is needed to develop and test a new metric that assesses patients’ perceptions of reproductive autonomy during clinical encounters.

Abstract 13983: Reproductive Health Counseling and Experiences Among Females With Congenital Heart Defects: Results From the Congenital Heart Survey to Recognize Outcomes, Needs, and Well-Being

Introduction: The American Heart Association (AHA) recommends clinicians discuss reproductive health with women with congenital heart defects (CHD) beginning in adolescence due to their unique pregnancy and contraceptive needs. Therefore, we assessed reproductive health counseling and experiences among women with CHD, and differences by CHD severity. Methods: Women with CHD ages 19 to 38 years, identified in active, population-based birth defects registries from Arkansas, Arizona, and Atlanta, GA, completed the Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) from 2016 to 2019, including questions about reproductive health counseling, concerns and experiences. Prevalence estimates standardized to all CH STRONG-eligible women and adjusted prevalence ratios (aPR), calculated with multivariable Poisson regression, assessed differences by CHD severity. Results: Of 765 female respondents, 40.7% were 19-24 years, 66.7% were non-Hispanic white, and 67.7% had > high school education. Overall, 21.3% received CHD-specific contraceptive counseling, 28.3% pregnancy counseling, and 12.8% advice to avoid pregnancy (Fig). Women with severe, compared to non-severe CHD, were more likely to receive clinician counseling about safe contraception (aPR=3.0, 95% confidence interval [CI]: 2.2-4.0), pregnancy (aPR=3.5, 95% CI: 2.7-4.6), and advice to avoid pregnancy (aPR=4.3, 95% CI: 2.9-6.5), and they were more likely to be concerned about their ability to have children (aPR=1.4, 95% CI: 1.1-1.8) and delay/avoid pregnancy (aPR=2.2, 95% CI: 1.5-3.2). No differences were seen in ever being pregnant (aPR=0.83, 95% CI: 0.6-1.1). Conclusions: Results suggest most women with CHD are not receiving AHA-recommended reproductive health counseling. Almost one in three women with severe CHD received clinician advice to avoid pregnancy, although AHA guidelines state pregnancy is contraindicated for few women with CHD.