Access to Medically Necessary Reproductive Care for Individuals with Pulmonary Hypertension

• Published in: American journal of respiratory and critical care medicine 2023-08, Vol.208 (3), p.234-237
• Main Authors: Sonntag, Elizabeth, Akgün, Kathleen M, Bag, Remzi, Rosensweig, Erika B, Bernardo, Roberto J, Burnetti, Colleen, Chybowski, Amy, de Jesus Perez, Vinicio A, Diwan, Johnell, Guthrie, Kate M, Halscott, Torre, Lahm, Tim, Vaught, Jason, Ventetuolo, Corey E, Hemnes, Anna R
• Format: Article
• Language: English
• Subjects: Abortion; Birth control; Health care access; Health Services Accessibility; Humans; Hypertension, Pulmonary - therapy; Pregnancy; Pulmonary hypertension; Reproductive Health Services; Viewpoint: Turning the Air Blue
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.202302-0230VP

Pulmonary arterial hypertension (PAH) disproportionately affects young females and is associated with poor survival rates. Access to comprehensive reproductive health care, including contraception and abortion services, is crucial for these patients. PAH therapy involves drugs with known or suspected teratogenicity, requiring patients to enroll in risk evaluation programs and use reliable birth control. Pregnancy poses significant risks to both the patient and the fetus, including increased pulmonary artery pressure, right ventricular failure, and death. Patients with PAH who become pregnant should receive care at specialty centers. Some patients may not be diagnosed with PAH until pregnancy, and options such as therapeutic abortion should be offered. However, with the recent overturning of Roe v. Wade, access to abortion varies across states, creating access deserts for patients with PAH. Traveling to other institutions for reproductive care is often not feasible or safe for these complex patients. This lack of access may result in delays in necessary abortion care, endanger the lives of patients with PAH, and impose emotional and financial burdens on patients and their families.