Thesis

“Women, Birth Control Pills, and Thrombophilia: An Analysis of Risk Communication” was originally published in May 2009. Access the full text here.

Abstract

The Surgeon General recently issued a call to action to reduce the incidents of blood clots, which can cause pulmonary embolism, deep vein thrombosis, and stroke. This research study was conducted to assess what risk information is available to women regarding thrombosis (blood clots) and thrombophilia (clotting disorders) in combination with birth control pills, what women know about this issue, and how to increase this awareness. A media analysis showed that very little information is available to women about thrombosis and thrombophilia with regard to birth control pills. It also demonstrated that the information that is available is often inadequate or inaccurate.

The survey of women who have taken or are taking birth control pills showed a lack of awareness of the side effects of birth control pills, thrombophilia, thrombosis, or the symptoms of thrombosis. Most women taking this medication that increases their risk of blood clots are not even aware of the symptoms of blood clots. Additionally, only one woman out of 311 could correctly identify all of the health risks associated with birth control pills. The survey results also showed that the majority of women would not only be willing to take a blood test to determine if they have thrombophilia, but more than half would be willing to pay for it.

In order to reduce thrombosis, awareness of these conditions can be increased by pharmaceutical manufacturers taking a greater responsibility for producing easily understandable risk information. Also, health care providers and patients must communicate more effectively. At a minimum, testing should be offered to women, if not required, before prescribing birth control pills.

Preface

The educated differ from the uneducated as much as the living from the dead.
-Aristotle

I opened my eyes and saw my husband, Josh, leaning over me. I was on my side in the emergency room and the doctor had just asked Josh to hold me steady while he gave me a spinal tap to check for meningitis. Josh held me so firmly, understanding the consequences of a misplaced needle, that his arms were shaking from the strain. The doctor attempted a lighthearted joke about me getting an epidural in the future and Josh laughed nervously. I wanted to tell him, “Don’t worry about holding me steady. I can’t move anyway.” I had lost the use of my limbs hours before, maybe even days. And now it seemed my power of speech was gone, as well.

It was not the first time Josh had to hold me down. Earlier that day, he had tried to restrain me while my body thrashed wildly, nearly bucking him off the couch. During the seizure, I told myself that if I just calmed down, it would stop. It must be all in my head, since I had already been sent home from the emergency room twice in as many days. When the shaking finally subsided, we locked eyes, both of us terrified of what was happening to me. Josh asked me if he should call 911 again. All I could do was nod.

I did not have meningitis. I had a common blood condition that predisposed me to getting blood clots. And when combined with the estrogen in my birth control pills- pills that I had been taking for ten years- this common condition was nearly fatal. The blood clots were in my brain, and because they had not been treated right away, one of the veins in my head had burst and was bleeding into my brain.

 

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