Our Summary

This research study looked at how common it is for women on Medicaid in Pennsylvania to be prescribed and to fill opioid prescriptions after giving birth vaginally. The study did not include women who were already using opioids during pregnancy or who had an opioid addiction. It found that 12% of women filled an opioid prescription within 5 days after giving birth. Of these women, 14% filled another opioid prescription between 6 and 60 days after giving birth. The study also found that women who smoked or had a mental health condition were more likely to fill an opioid prescription, even if they didn’t have a condition causing pain at the time of delivery. Women who had a substance use disorder other than opioid use were not more likely to fill an opioid prescription within 5 days after giving birth, but were more likely to fill a second opioid prescription later on. The researchers concluded that over 1 in 10 women on Medicaid fill an opioid prescription after giving birth vaginally, suggesting that national guidelines around prescribing opioids after childbirth may be needed.

FAQs

  1. What percentage of women on Medicaid filled an opioid prescription within 5 days of giving birth according to the study?
  2. Are women with a mental health condition or who smoke more likely to fill an opioid prescription after childbirth?
  3. According to the study, what is the likelihood of women with a substance use disorder other than opioid use filling a second opioid prescription after childbirth?

Doctor’s Tip

A doctor might advise a patient undergoing bilateral tubal ligation that it is a permanent form of birth control and is not reversible, so they should be certain about their decision before proceeding with the procedure. They may also recommend discussing alternative forms of contraception and the potential risks and benefits of the procedure before making a final decision. Additionally, the doctor may advise the patient to follow post-operative care instructions carefully to minimize the risk of complications and ensure a smooth recovery.

Suitable For

Bilateral tubal ligation is typically recommended for patients who are looking for a permanent form of contraception and do not wish to have any more children. This procedure is often recommended for women who have completed their desired family size, are at high risk for complications during pregnancy, have a medical condition that would be worsened by pregnancy, or have a family history of genetic disorders that they do not want to pass on to future children. Additionally, bilateral tubal ligation may be recommended for patients who have a high risk of ectopic pregnancy or who are unable to use other forms of contraception consistently and effectively. It is important for patients to discuss their individual circumstances and options with their healthcare provider to determine if bilateral tubal ligation is the right choice for them.

Timeline

  • Before bilateral tubal ligation:
  1. Patient meets with their healthcare provider to discuss the procedure and its benefits and risks.
  2. Patient undergoes pre-operative testing and evaluations to ensure they are a suitable candidate for the procedure.
  3. Patient may be required to sign consent forms and make arrangements for the procedure, such as scheduling time off work and arranging for transportation to and from the hospital or surgical center.
  4. On the day of the procedure, patient undergoes the surgery under general anesthesia, where both fallopian tubes are cut, tied, or blocked to prevent pregnancy.
  • After bilateral tubal ligation:
  1. Patient is monitored in the recovery room for a few hours before being discharged home.
  2. Patient may experience some pain, cramping, and discomfort in the days following the procedure, which can be managed with pain medications prescribed by their healthcare provider.
  3. Patient is advised to rest and avoid strenuous activities for a few days to allow their body to heal.
  4. Patient may experience some vaginal bleeding or discharge for a few days following the procedure, which is normal.
  5. Patient follows up with their healthcare provider for a post-operative appointment to ensure proper healing and discuss any concerns or questions they may have about the procedure.
  6. Patient resumes their normal activities and can typically return to work within a few days after the procedure.

What to Ask Your Doctor

  1. What are the potential risks and benefits of bilateral tubal ligation?
  2. How does bilateral tubal ligation work as a form of permanent contraception?
  3. What is the success rate of bilateral tubal ligation in preventing pregnancy?
  4. Are there any potential long-term effects or complications associated with bilateral tubal ligation?
  5. What is the recovery process like after undergoing bilateral tubal ligation?
  6. Are there any alternative forms of contraception that may be more suitable for me?
  7. How will bilateral tubal ligation affect my menstrual cycle or hormone levels?
  8. Will bilateral tubal ligation impact my sexual function or libido?
  9. Are there any lifestyle changes or restrictions I need to follow after undergoing bilateral tubal ligation?
  10. How soon after the procedure can I resume normal activities, including sexual intercourse?

Reference

Authors: Jarlenski M, Bodnar LM, Kim JY, Donohue J, Krans EE, Bogen DL. Journal: Obstet Gynecol. 2017 Mar;129(3):431-437. doi: 10.1097/AOG.0000000000001868. PMID: 28178050