The parents of a teenage girl who died of a blood clot condition, which was exacerbated while she was taking the pill, are calling for changes to the way contraceptives are prescribed.
It comes after a coroner issued a warning about the slide effects of the combined oral contraceptive pill after two women died in the same month in 2021 in similar circumstances.
One of those women, 17-year-old Isabella Rangiamohia Alexander, was walking with her parents before suddenly collapsing.
Her parents say she had been feeling unwell for the previous few months, but it didn’t concern them.
They didn’t know she was taking contraceptives, as the young girl had been to someone who wasn’t their family doctor.
She died of a thromboembolism — which was caused by a mutated gene passed through her family.
Speaking to Breakfast this morning, her mother Teresa said: “I suspect it’s wider out there than we know”.
She called for better screenings when doctors prescribe the pill to young girls.
Currently, doctors have to ask those looking for a prescription to provide their family history of blood clots — Teresa said that it’s a lot to ask from a teenager.
“Teenage girls are relatively naughty. Isabella went out, we didn’t know she was on the pill.
“Their priority is not to give a full health history. Most of them, I would suspect, wouldn’t have a clue,” she said.
She wants to see more accessible blood tests made available for girls when looking to go on the pill, as well as better education surrounding the pill's side effects for those with blood clotting conditions.
“It’s about putting protections around them, the way to protect them with this very common disorder when there’s an increased risk of getting a thromboembolism.
“Without that system, you’re allowing these young women, especially school-aged women, to go out and get these pills when they could have a risk that they don’t know about.”
When asked if blood tests could be implemented here in New Zealand, Te Whatu Ora said international guidelines recommend against it.
“This is because a previous history or a family history of venous thromboembolism in a first-degree family member is an absolute contraindication for taking the oestrogen-containing contraceptive pill, regardless of whether or not the young woman has a Factor V Leiden mutation.”
It said the “vast majority” of those who have the mutation will have a deep vein thrombosis.
“So this is denying access to a very effective contraceptive to divert pregnancy.”
Teresa said that while she understands where Te Whatu Ora is coming from, she just wants to see more protections put in place.
“We’re not saying don’t prescribe the pill. We’re saying more protections around young women, who turn up to a casual doctor or a nurse without a guardian present.
“And they tick off their obligation, their health obligation to that young woman by asking them for a full health history."
Speaking about her daughter, Teresa said: “She’s gone. We can’t just sit back and do nothing.”
Risk of clots 'relatively low' compared to pregnancy
Family Planning’s director of nursing, Julie Avery, said that while the pill increases the risks of clots “slightly”, pregnancy itself increases that risk by a lot more.
She said for women who aren't on the pill, the risk of a clot is around one in every 10,000 women.
A low dose increases this to between 5 and 7 in 10,000, while a higher dose is around nine to 12 in 10,000.
For pregnant women, this increases to 20 out of 10,000.
“So it’s a relatively small risk but is absolutely an increased risk.”
Avery said that a blood test would be a “barrier” to accessing contraceptive pills.
“I don't think there is a role for it at this stage. It’s such a small risk.
“And I think, as with any medication we prescribe, anybody can be at risk of an underlying health condition.”
Avery believes it could lead to more blood clots as more women would be getting pregnant.
She said the best course of education was for doctors and GPs to provide better education and information on the symptoms and signs of a blood clot.
Avery also encouraged young people looking to go on the pill to bring a family member along to their doctor's appointment.
“But we’re really aware that for young people, it's not reasonable at times, it’s not practical at times."
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