Do We Deliver? Contraception Counseling Practices in Solid Organ Transplant Providers

Women of childbearing age represent a significant proportion of solid organ transplant (SOT) patients and often regain fertility within 1-year post-transplant. Societal guidelines exist for best contraceptive/family planning practices post-SOT but are often not well implemented. This study aimed to summarize current SOT providers' knowledge of contraception guidelines and counseling practices at a single institution.

This was a cross-sectional consented survey of current knowledge and practice of contraception guidelines and counseling. SOT providers included nurses, advanced practice providers (APP), coordinators, pharmacists and physicians. The primary outcome, consistency with societal guidelines, was defined as counseling patients and recommending at least 1 contraception type as per guidelines.

The survey was sent to 235 participants, of which 38 (16%) consented and completed it. Respondents included 42% physicians, 39% coordinators, and 18% APPs. Almost all respondents (97%) indicated that they believe transplant providers hold responsibility to provide reproductive health counseling to SOT patients. Twenty-nine respondents (76%) indicated that they provide some level of contraception counseling, but only 2 (7%) indicate they make specific recommendations. Due to this small number, we were unable to further analyze the primary outcome. Reported barriers to providing contraception counseling included time (58%), lack of knowledge (44%), and the belief that it did not fall within one's role (34%).

Although almost all respondents believe that transplant providers share responsibility of contraception counseling for SOT patients, they are not actively providing it. Solutions include creating a unique SOT provider role for contraception counseling and collaboration with obstetrics/gynecology.