Long term health conditions

Contraception, pregnancy and sexual health

At some point in their teens most of the young women we talked to said that their doctors had raised the subject of contraception, pregnancy and sexual health. If they were not yet sexually active, or if their mum was in the room, this could be rather embarrassing. It doesn't seem to be easy for doctors to get the timing right for these chats - one young person thought that she had been a bit young at 14 years old, a 17 year old said no one had yet raised it with her and a 23 year old thought she was still too young to think about such things. Routinely seeing young people without their parents for part of the consultation time can avoid uncomfortable conversations in front of parents. Many doctors are being told that discussing sexual health and family planning issues, in relation to chronic health conditions or disabilities, is an important part of preparing young people for the future.

The young people interviewed usually knew why they needed to be particularly careful about the timing of any pregnancy - and felt it was better to be told this too early than too late. By age 14 most young people will have received at least some sex education in school. It is also to inform young people before they become sexually active, so that when the first time comes they are empowered to make more appropriate choices.

Sexual transmitted infections (STI’s) are a potential problem for all young people. Using a condom reduces the risk of catching an STI and should be used in addition to other forms of contraception. 

Young women often know that antibiotics can affect the oral contraceptive pill (the pill) and had been warned to use additional contraception - such as condoms - while they were using antibiotics. Condoms would also protect them against STIs. One said that the discussion about contraception and medication was one of the main differences between the child and adult services. Another said that since she was about 17 years old she was asked at every consultation whether she was planning to start a family.

Some medications can have a harmful effect on an unborn baby. Young women with epilepsy talked about the effects of medication on their fertility, pregnancy and in particular, about the risk of there being problems for the baby. There are some forms of progestogen only contraception that are affected by anti-epileptic medications, such as implanon or the depo provera injection. Girls were often told by their consultants about potential risks, the importance of using contraception appropriately and the need to talk to their doctors if they decided to start a family so that they could plan changes to their treatment.

Some people had been told that they needed to take particular care before becoming pregnant. Girls with cystic fibrosis (CF) were advised that their partner should have a genetic test to check that they didn't also carry the gene for CF. Genetic counselling is widely recommended for young people with many inherited conditions, when they were thinking of starting a family. If both mother and baby had CF there would be a danger that they might 'cross-infect' one another. 

Young women with CF were told that they would need to make sure that they were as healthy as possible before becoming pregnant, because pregnancy puts a strain on any woman's health. Parents too could be worried: a mother who dearly wanted to be a grandmother was very concerned about how her daughter's health would be affected by the pregnancy.

A married 23 year old with CF said that having a baby would be 'the icing on the cake' for her and her husband, but felt that some people thought it was irresponsible of her to consider having a baby when she might not live beyond her early 30s. 

A woman with chronic pain said that she and her husband had been on a roller coaster ride over whether she might be able to have a baby. They thought they wouldn't be able to have a pregnancy without medical help. They felt that they couldn't bear the financial and emotional costs of infertility treatment.

A young woman with diabetes was told that there was no reason why she shouldn't have a baby although she would need extra care. She was advised to raise the question with her doctors again and told that new research on diabetes and pregnancy is coming out all the time.

For more about sex, contraception and STIs see our section on sexual health in young people.

Last reviewed May 2014.

Last updated February 2012.

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