Reproductive health in the pharmacy

mother holding baby's hand

Should women’s reproductive health be a core competency for all pharmacists?

Quality Use of Medicines is vital to supporting women before conception and beyond delivery, says a pharmacist researcher in the latest issue of the Journal of Pharmacy Practice and Research (JPRR).

“The importance of a healthy start to life is increasingly recognised as playing a critical role in influencing immediate and long-term health outcomes for future generations,” writes Dr Luke Grzeskowiak from the Flinders Medical Centre, WA.

“This begins well before conception and extends beyond delivery, with pharmacists playing a critical role in the provision of evidence-based pharmacotherapy at various stages.”

Dr Grzeskowiak says that knowledge and awareness of women’s reproductive health and associated medication use should be viewed as “core competencies for all pharmacists”.

Areas the pharmacists can support and intervene in reproductive health include:

  • Preconception care: Management of chronic diseases (e.g. diabetes, asthma); vaccination.
  • Pregnancy care: Promoting healthy behaviours such as smoking cessation or vitamin supplementation.
  • Quality Use of Medicines: Provision of information on medication safety in lactation; providing adequate contraception; reducing potential harms of medication use on fertility and pregnancy outcomes.
  • Breastfeeding: Recent studies show a need for more knowledge, confidence and training in order the support pharmacist involvement in breastfeeding advocacy.
  • Supplying treatment and products: Nipple pads and topical treatments for cracked and sore nipples; advising on pumps.

Postnatal care is a vital area for pharmacists to provide support, with new parenthood being a “hectic” and confusing time in a person’s life, explain Jarrod McMaugh, Adam Greco and Vanessa Kee in a recent AJP education article.

New parents will often have questions about frequency of feeding, how long each feeding session should last, latching/attachment issues, fussiness, reflux, allergies or intolerances, mastitis or cracked nipples and more, they say.

Lifestyle factors impacting on milk production or quality is especially important for pharmacists as this is influenced by medications, smoking, alcohol and other drugs.

“Medications may impact on feeding by reducing or increasing the production of milk; they may be present in milk in concentrations that could impact the child; and breastfeeding itself may impact on the effectiveness of some medications,” says Mr McMaugh, Mr Greco and Ms Kee.

“It is widely accepted that mother’s own milk is the best source of nutrition for infants. For women managed on complex medication regimens this poses certain dilemmas,” explains Dr Karen Whitfield in the JPRR.

Pharmacists who work in the antenatal clinic will be able to build a rapport with patients early in the pregnancy, allowing them to discuss and plan medication safety – both as the pregnancy progresses, and postnatally for those wishing to breastfeed.

“A general understanding of medication safety during pregnancy and feeding would be valuable to many hospital pharmacists,” she says.

For more information on pharmacy and reproductive health, the Society of Hospital Pharmacists of Australia (SHPA) offers a specialty practice stream in women’s and newborn health.

SHPA has also recently launched the first of its thrice-yearly publication on women’s and children’s therapeutics.

The theme of Women’s and Children’s Therapeutics for the Journal of Pharmacy Practice and Research will complement its other three editions themed around Geriatric Therapeutics, as part of the journal’s six editions per year.

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