Reproductive healthcare is a key part of my post-transplant regimen

Last October, I had an annual checkup with my OB-GYN, where I renewed my birth control prescription, which helps to control excessive bleeding in my uterus. This is vital for me because my hemoglobin levels are consistently low due to chronic kidney disease, and I can’t afford regular blood loss. I also had a routine Pap smear to check for cancer and human papillomavirus, which is part of my preventive healthcare management as a transplant patient.

The details of the appointment, coupled with recent public discussions about women’s reproductive rights, have brought the topics of pregnancy and birth control within the context of pulmonary hypertension (PH) and organ transplant to the forefront of my mind.

Regardless of one’s political or personal views, it’s important for PH and transplant patients to be educated about these topics. Because I was diagnosed with PH at the age of 4 and received a heart and lung transplant at 23, I don’t remember a day when I wasn’t aware of the threat that pregnancy poses to my body.

PH is a textbook example of a rare illness that makes pregnancy a severe risk to a patient’s health. While I now live as a transplant patient, the risks are still present, just for different reasons. Despite a change in diagnosis, these discussions are still firmly integrated into my overall health plan.

Recommended Reading

January 25, 2023 News by Joana Vindeirinho, PhD

Pregnancy With Idiopathic PAH May Be Riskier Than Other Types

Reproductive care for PH and transplant patients

When I was diagnosed with PH, doctors told my parents I wouldn’t be able to have children. While the recommendations regarding this topic are different for the various types and stages of PH, my doctors always believed that pregnancy could have a fatal outcome for me or the fetus, or both.

For most of the two decades I lived with PH, I didn’t think too much about this threat. Beyond knowing that if I wanted children, I’d have to adopt or turn to surrogacy, thoughts about the intersection of reproduction and PH had little impact on my life.

Later on, the responsibility of preventing pregnancy became more detailed. Primarily, doctors made sure to stress the importance of using two types of birth control. Additionally, my lifestyle reflects the fact that I’ve known for years about the devastating risks I’d face if I became pregnant.

My introduction to transplant happened right around the time I was transitioning into adulthood. The process to be put on a transplant waiting list started right before my freshman year of college. After my transplant, I began my education regarding reproductive care within the context of transplant.

While it is technically possible to become pregnant and give birth as a transplant patient, it’s very complicated and requires a great deal of forethought. I have physical complications that exclude this option, but for a healthier transplant patient, one major concern are the immunosuppressive medications that maintain the health of a transplanted organ.

For a healthy transplant patient, hypothetically, those medications could be adjusted to sustain a pregnancy if the patient deeply desires to pursue it. With that said, it doesn’t seem that people frequently pursue this course of action, given how essential immunosuppressive medications are for transplant health and to mitigate other risks that may be involved. For this reason, birth control is once again an important topic.

It’s also essential to monitor a transplant patient’s reproductive health overall. Immunosuppressants can increase the risk of cancer or infection. Regular testing, such as Pap smears, is integrated into a transplant patient’s plan of care.

Being educated about this topic while implementing my health plan is a key part of the decisions I make in my daily life.

Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.