30 Nov 2023

Pregnancy poses far greater risk than oral contraceptives - health expert

6:00 pm on 30 November 2023
Contraception/ contraceptive pill

Photo: filmfoto/123RF

Being pregnant is far riskier than taking oral contraceptives, a women's health specialist says.

University of Auckland clinical fellow Dr Orna McGinn was commenting after the deaths in 2021 of two young women who had both been taking a combined oral contraceptive.

A coroner has warned women and doctors to take care over the combined oral contraceptive, the country's most commonly prescribed contraceptive.

The two women died 10 days apart in similar circumstances in 2021 after taking the combined form of the pill.

It contains both oestrogen and progesterone and is very effective at preventing pregnancy, Dr McGinn told Morning Report.

The other kind of oral contraceptive is the mini-pill which contains progesterone only, she said.

She was asked if women taking the combined pill should be worried in the aftermath of the two deaths.

Auckland GP and women's health advocate Dr Orna McGinn

Dr Orna McGinn Photo: supplied

She said the coroner handled the situation well. He was not advising women against taking the pill, but instead advocated more education around some of the risks "which are far lower than the alternative which is being pregnant".

Those not taking the pill had a two to four chance in 10,000 of developing a clot or thrombosis.

On the pill a user's risk was doubled and with a few brands the risk was even higher.

However, pregnant women were 30 times more likely to develop blood clots compared with taking the combined oral contraceptive, Dr McGinn said.

"So it's much safer actually to be on the pill than to be not taking contraception at all and to fall pregnant."

Dr McGinn said when GPs were screening women before they started on an oral contraceptive they asked about any family history of clotting.

"In these two young women who died tragically there was no family history and they were found afterwards to have an unusual mutation which we don't screen for because it's not common and it's not cost effective to screen.

"Sometimes, the screening can give a false negative result."

Other risks GPs did screen for included obesity and smoking. It was not recommended obese women took oral contraceptives.

Those women would be better off using the coil, an IUD or an implant, Dr McGinn said.

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