COUNSELLING ON ANTI-HYPERTENSIVE MEDICATIONS PRESCRIBED TO WOMEN OF CHILDBEARING AGE ATTENDING HYPERTENSION CLINIC: AN AUDIT

Objective: There is an ethical, legal and professional obligation for doctors to inform women of childbearing age of the benefits and risks associated with antihypertensive medications, including in pregnancy and breastfeeding, and facilitate informed consent. This audit aims to identify whether women of childbearing age attending hypertension clinic at Birmingham Heartlands Hospital (BHH) are asked about contraception, pregnancy intentions and breastfeeding, are on antihypertensives that are harmful in pregnancy and/or breastfeeding and counselled on associated risks.Design and method: Women aged 45 years and younger, referred to the secondary hypertension clinic and with at least one clinic letter from the past five years, were eligible for inclusion. Data were retrospectively extracted from electronic patient records between May and July 2024. Results: A total of 94 eligible women aged 45 years and younger who attended the hypertension clinic at BHH within the last 5 years were included. A small proportion of women were asked about contraception (5.3%), pregnancy intentions (8.5%) and breastfeeding (1.1%). Additionally, 60.6% and 61.7% of women were prescribed antihypertensives potentially harmful during pregnancy and breastfeeding, respectively. However, there was no documented evidence that these women were counselled on the risks associated with these medications. Conclusions: This audit found that the majority of women attending the hypertension clinic were not asked about their reproductive history and were prescribed antihypertensive medications potentially harmful in pregnancy and breastfeeding. Most importantly, there is no documented evidence that women are receiving adequate counselling on these medications. Questionnaires should be used to collect data on women’s experiences of counselling on antihypertensive medication use in pregnancy and breastfeeding. Future interventions should include awareness raising among clinic providers and information leaflets targeted at women of childbearing age.