For Brianna Henderson, birth control is not only about preventing pregnancy.
The Texas Maa of two revealed a rare and potentially fatal heart condition after her second child had. Apart from avoiding another pregnancy, the one who can be life-threatening, Henderson must ensure that the contraceptive he uses does not endanger its health.
For more than a decade, a small team of people at the Disease Control and Prevention Center worked to do so, issuing national guidelines for physicians how to safely determine the contraceptive for millions of women with underlying medical conditions – including heart disease, lupus, sickle cell disease, and obesity. But Department of Health and Human ServicesThe CDC, who oversees the CDC, fired the workers as part of the rapid downs willing of the Trump administration.
It also reduced the large division of breeding health of the CDC, where the team was placed – a step that a doctor, advocacy group, and removed workers say that women and their children will endanger the health.
Physicians said in the interview that it is relatively straightforward to consult patients about birth control and determine it. But for women with conditions that put them at high risk of serious health complications, special care is required.
“We were actually the only source of security monitoring in this country,” said a CDC employee who worked on guidelines, which is known as US Medical Eligibility Criteria for contraceptive use, or MEC. “There is no one who can actually do it.” KFF Health News agreed not to name the worker and others, who were not authorized to talk to the press and feared vengeance.
Betus are high for people like Henderson. About six weeks after having his second child, he said, his heart was “running.”
Desiree Rios for KFF Health News 
“I think I’m under water,” said Henderson. “I felt as if I couldn’t breathe.” She eventually went to the hospital where she was told that she was “completely in heart failure,” she said.
Henderson was diagnosed with peripartum cardiomyopathy, an abnormal type of heart failure that may occur immediately after the end of pregnancy or immediately after giving birth. Risk factors for the condition include at least 30 years old, African origin, having high blood pressure and obesity.
CDC Contraceptive guidelines It is said that combined hormonal contraceptive, including both estrogen and progestin to prevent pregnancy, can cause “unacceptable health risk” for most women with peripartum cardiomyopathy, also known as PPCM. For some women with diagnosis, a birth control injection that is commonly known by the brand name Dipo-Priva also risks that leads to its benefits, showing guidelines. Progestin-cavalry pills or a birth control transplant, inserted into a person’s arm, are the safest.
Henderson said his cardiologist had to greenlite what contraception she could use. She uses a progestin-cavalry birth control transplant that is more than 99% effective in preventing pregnancy.
“I didn’t know some things could cause blood clots,” Henderson said, “or makes your heart failure worse.” Heart failure is a major cause of maternal mortality and sickness in America, with accounting for PPCM Up to 70% of heart failure during pregnancy.
broom HHS Sorting CDC’s reproductive health divisions began in late March and early April, given the several programs designed to protect women and infants, three removed workers said.
A worker said about two-thirds of the division 165 employees and contractors were cut through firing, retirement, or revaluation in other parts of the agency.
Among them were CDC employees who carried out the pregnancy risk evaluation monitoring system, a survey was set up about 40 years ago, which was to improve maternal and child health results by asking detailed questions of recently born women. The survey was used to help “to help inform and help reduce the contribution factors that causes maternal mortality and sickness,” a fired worker said, “Government workers can be allowed to examine the medical care people before pregnancy and during the pregnancy, if any, and other risk factors that can lead to poor maternal and child health.”
Firing also removed CDC workers, who collected and analyzed data in in vitro fertilization and other reproductive remedies.
“He left nothing,” a worker said.
After the CDC customized guidance developed by the World Health Organization, the American contraceptive guidelines were first published in 2010. The latest version was published in August 2024. This includes information about the safety of a variety of contraceptives for more than 60 medical conditions. Physicians said that this is a major source of evidence about the protection of birth control.
“It gave us so much information that was not available to doctors on his fingers,” said fertility at Michael Polar, a physician and professor of maternity science, gynecology and reproductive science, at the California-San Francisco School of Medicine.
“If you have got with a person, it is said, long-running type 2 diabetes, someone who has a connective-euphemical disease like lupus, which has received a high blood pressure or maybe they have been treated for lime cancer for a precursor-something?
The CDC updates the guidelines widely every five years. On the weekly basis, however, government workers would monitor the evidence about the use of contraceptives of patients and safety of various methods, something when they were doing when HHS suddenly removed them in this spring, said two removed workers. This work is no longer done, one of them said.
Sometimes the agency continues interim changes outside the large update if new evidence warned it. Now, if something new or immediate comes, “there is no way to update the guidelines,” said a shell worker.
In 2020, for example, CDC Revised your contraceptive recommendations For high -risk women of HIV infection, after new evidence, various methods were shown to be safe than before.
HHS spokesperson Emily Hiliard refused to say why CDC personnel were worked on issues of contraceptive guidelines and other reproductive health issues, or other questions raised by reporting KFF Health News were answered.
Most women of reproductive age in the US use contraceptives. CDC data has been available since 2019, the most recently available, it shows that More than 47 million women Rely on birth control at the age of 15 to 49 years. In 1 of the 10, long -term acting methods such as intrauterine devices and transplant have been used; 1 out of 7 used oral contraceptives.
The latest guidelines include updated security recommendations for women that are sickle cell disease, lupus, or PPCM, and those who are breastfeeding, among others. Physicians are now being told that joint hormonal contraceptives pose an unacceptable health risk for women suffering from sickle cell disease, as it can increase the risk of blood clots.
“This can actually come down to life or death,” said Tona Wulford, CEO of sickle cell reproductive health education directive, said, a non -profit organization that advocates better reproductive health care for people with disease.
“We really saw the CDC guidelines as a win, as a win – they are really going to pay attention,” he said.
The 2024 guidelines first included birth control recommendations for women suffering from chronic kidney disease. Research has shown that such women are at greater risk of serious pregnancy complications, including preclampsia and preterum delivery. Their medical condition also increases the risk of blood clots, which is why it is important for them not to use the joint hormonal contraceptive, CDC workers and physicians said.
CDC information “The last in security says,” Patty Kaisan, a family nurse businessman and the chairman of Envision sexual and reproductive health said. It is “very scary” by having only stable information about the safety of different types of birth control, he said, because new evidences can come out and new methods of contraception are being developed.
Henderson said it took two years to recover. He created a non -profit organization late PPCM, which was diagnosed with PPCM to educate women about the type of heart failure, in which what forms of birth control they are protected.
“We don’t want blood clots, spoiling heart failures,” Henderson said. “They already feel that they cannot trust their doctors, and we don’t need extra.”
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