Chuang, C. H., Chase, G. A., Bensyl, D. M., & Weisman, C. S. (2005).Women's Health Issues, 15(4), 167-173.

Chuang and associates used the Behavioral Risk Factor Surveillance System in 11 states to report on family planning in women with chronic conditions as compared to women without obesity or diabetes. In regression analysis, obesity was significantly related to nonuse of contraceptives, but there were no significant differences in contraceptive use in women with diabetes. Women who were more mature, African American/Black, Hispanic, married, less educated, and those without health insurance were also less likely to use contraceptives. Because obese women are more at risk for pregnancy-related complications and adverse perinatal outcomes, educational interventions are recommended to promote appropriate use of contraceptives and avoidance of unintended pregnancies. Since nearly 50% of pregnancies in the United States are unintended and 50% of women 15-44 years report at least one unintended pregnancy (Moos, Petersen, Meadows, Melvin, & Spitz, 2005), this study provides important information on vulnerable women. If pregnancies are unintended, especially in such high-risk women, nursing interventions, including counseling, should be nonjudgmental, unbiased, and nondirective (Simmonds & Likis, 2005). The contributions of healthcare access and use of healthcare should be evaluated, with further use of population-based databases to improve outcomes for women with chronic medical conditions.

Comment by Lynn Clark Callister

References