NFP and Coumadin: A dilemma
I have an interesting dilemma on my hands and I want to hear your thoughts…
Since I’ve been diagnosed with the crazy clotting gene, that in the unlikeliest of events I inherited from both of my parents, I am going to be treated intensely with blood thinners. I’m currently taking two different kinds. The hematologist may recommend putting me on one of them, a pretty hard core drug called Coumadin, for life; at the very least I’ll be on it for quite a few months.
So Coumadin is really incompatible with pregnancy. If you get pregnant while taking it it’s not good. Here’s what one medical journal has to say about it:
One of the drawbacks for Coumadin is the potential for birth defects and/or hemorrhage in the offspring of mothers taking the drug. There is a link between some birth defects and Coumadin taken by the mother during early pregnancy. Coumadin should be avoided in women of child bearing age unless there is absolutely no other option.
If a young woman needs to start Coumadin during the child-bearing years, it is very important to educate the patient on the potential harm to the unborn child and establish an effective birth control plan. Before starting therapy, female patients should be asked about their intent to bear children in the future, their birth control methods at present, and their religious beliefs.
For the woman who is not planning or desiring further children, sterilization by tubal ligation or hysterectomy would be the most reliable preventative step. In younger women anticipating a new or enlarging family, Coumadin should not be prescribed if any other possible choice can be used. If Coumadin is still required for clinical reasons, then birth control intervention must be prescribed as well.
A longer acting form of birth control such as an IUD or Norplant are probably best, since daily birth control pills could be accidentally or purposefully discontinued, risking an unwanted or unexpected pregnancy while taking Coumadin. Educational services like Planned Parenthood can assist in selecting birth control methods that are acceptable to the patient and their lifestyle and/or values. Prevention is far better than dealing with the consequences after a pregnancy has occurred.
Evidently I’m one of these “no other choice” people. I should really be on Coumadin. My doctor has not yet discussed birth control options with me, but I’m sure he’s going to push hard for me to do Norplant or some other form of birth control. (As this article suggests, I could always talk to our good, honest friends at Planned Parenthood about it!)
So here’s the situation: I’m on a drug that could cause big problems to an unborn child if I should get pregnant while I’m on it. I have a history of weird cycles so it’s not unlikely that I could get pregnant accidentally and be pregnant for a while and without realizing it.
I want to trust God and the Church and shun contraception, but there are a few different ways I could do that:
1. Take the Coumadin and have an intimacy-free marriage, practicing abstinence indefinitely (I don’t think this is really a serious option).
2. Take the Coumadin and trust that God will take care of any unexpected children that may come along and that the drug wouldn’t harm them.
3. Get off of Coumadin and trust that God will take care of me and the blood clot issue without it.
And then I suppose the other option would be to blow off Church teaching and go ahead and use contraception. So what do you think?
There’s another post coming about my thoughts on the struggle of trusting Church teaching on this very controversial issue as someone so new to the faith, but I’ll save that for later. Meanwhile, what would you do if you were me?
[NOTE: I know that one obvious answer is "talk to your hematologist and see about getting on some other drug." I do plan to do that, but since I don't know what the answer will be let's assume for the sake of argument that Coumadin is my only option for treatment.]
UPDATE: I am about to pass out. Right after I hit Publish my pharmacy called about my Lovenox prescription, the alternative to Coumadin that I’m also taking right now. She said that my insurance didn’t cover all of the one month refill I just called in and asked if I still wanted it if I had to pay for part of it. I asked her what my portion was. Anyone want to guess? No? It’s $875!!!! Is this some sort of liquid gold/diamon mixture? This is the price after my insurance actually covered part of it?!?! So…this one’s out as a long term solution as a possible alternative to Coumadin. Almost $900/month is a bit out of my budget.