Besides abstinence, what are the best contraceptive choices for a sickle cell warrior? For men of course that would be the condom, but for the ladies, with all the choices out there it gets a bit more complicated. You don't want to try anything that is too heavily based on hormones, because they have a risk of causing blood clots...and that is not something that someone with SCD should be messing with. So that gives a wary eye to most oral contraceptives.
I've used the Nuvaring and Patch for a while, but they stressed me out hardcore. Those PMS-ey symptoms on a regular basis are not my cup of tea. A low dose hormonal would be recommended but be sure that you assess for side effects, as everyone reacts differently to the meds. If you are planning on not having kids for a while the Intrauterine Device aka the IUD is also recommended, mainly because it has no hormones at all.
This is one of those things is based on your choice, but it's essential to talk with your docs about your concerns before you leap into one. Remember, the people at Planned Parenthood rarely come across questions related to sickle cell, so they might not be your most informed source. When all else fails, fall back on condoms, they suck but they work about 99% of the time when used correctly.
Please don't think that because you have sickle cell you don't need to be on contraceptives, that is just foolhardy. There is no way that I would wish what I have on anyone, and that includes my offspring, so I'd rather not have kids then to pass this ish on. It's better to make good decisions and choose when you get pregnant and with whom, that way you can research the HgB gene of your potential baby daddy.
Pregnancy is hard, you are high risk, but it's doable. If you want a child, just make sure that your baby daddy is prescreened for the HgbS gene because you don't want to pass sickle cell on. Amp up on your folic acid. Most people with SS report that when they are pregnant they don't have any crises and very little pain, however that is not the same for everyone. If you do have pain, you have to make sure that whatever meds you take don't cross the placental barrier or your baby would be addicted to narcs (not a cool thing btw). A good doctor will help you through the transition, and make sure that you are in a genetic counseling program as well as a high risk pregnancy group.
Hmmm, what else? If you are on Hydroxyurea, DON'T GET PREGNANT. That's a warning that is to be shouted from the rooftops. Hydrea does cross the placental barrier and your child could be affected even in the early developmental phases. Effected as in all kinds of documented as well as undocumented problems including mental and physical deficits. I know you what your little offspring to be perfect, so make sure that you double up on birth control or abstain from sex altogether if you are on Hydrea. If you do want to get pregnant, you have to get off Hydrea for several months BEFORE you try to sperminate. It has to be out of your system BEFORE you get pregnant. I cannot stress this enough.
All in all the big question is that can people with sickle cell have children? The answer, a solid loud resounding YES. You can have children, you can go through labor, delivery and childbirth, you can produce a beautiful bundle of joy. But you have to be more educated, more prepared and have more support than any run of the mill Nancy. I know a woman with sickle cell that has 6 children, and none of them have the disease. That's the kind of success story you want so be smart and line your ducks in a row before you take the plunge.