Counseling of Female Veterans About Risks of Medication-Induced Birth Defects

BACKGROUND: Medications that may increase risk of birth defects if used during pregnancy or immediately preconception are dispensed to approximately half of female Veterans who fill prescriptions at a VA pharmacy. OBJECTIVE: To assess receipt of counseling about risk of medication-induced birth defects among female Veterans of reproductive age and to examine Veterans’ confidence that their healthcare provider would counsel them about teratogenic risks. DESIGN AND PARTICIPANTS: Cross-sectional analysis of data provided by 286 female Veterans of Operation Iraqi Freedom and/or Operation Enduring Freedom who completed a mailed survey between July 2008 and October 2010. MAIN MEASURES: We examined associations between demographic, reproductive, and health service utilization variables and female Veterans' receipt of counseling and confidence that they would receive such counseling. KEY RESULTS: The response rate was 11 %; the large majority (89 %) of responding female Veterans reported use of a prescription medication in the last 12 months. Most (90 %) of the 286 female Veterans who reported medication use were confident that they would be told by their healthcare provider if a medication might cause a birth defect. However, only 24 % of women who received prescription medications reported they had been warned of teratogenic risks. Female Veterans who used medications that are known to be teratogenic were not more likely than women using other medications to report having been warned about risks of medication-induced birth defects, and fewer were confident that their health care providers would provide teratogenic risk counseling when needed. CONCLUSIONS: Female Veterans may not receive appropriate counseling when medications that can cause birth defects are prescribed.