Archive for the ‘Birth Control & Family Planning’ Category

October 31, 2012

What’s Scarier, Creepy Cats or an Uneducated Congress? Take the Quiz!

by Rachel Walden & Christine Cupaiuolo

This Halloween, ask yourself: Which is scarier — Furry creatures that scamper in the night? Or a Congress ignorant of how reproduction and women’s bodies work?

Unsure? Take a quick quiz to find out which frightens you more!

1. (A) Possessed Vampire Kitty

Possessed Vampire Kitty


(B) Legislators claiming that pregnancy from “legitimate rape” is really rare because women’s bodies can just “shut that whole thing down,” and suggesting that pregnancies resulting from rape are “something that God intended to happen.”

2. (A) Golden-Eyed Vampire Kitty

Golden-Eye Vampire Kitty


(B) A member of Congress believing that thanks to ”modern technology and science, you can’t find one instance” of abortion being necessary to protect the health or save the life of the mother.

3. (A) Fork-Tongued Vampire Kitty

Forked Tongue Vampire Kitty


(B) Forcing women to undergo unnecessary and medically unwarranted procedures,  such as a transvaginal ultrasound, in order to obtain an abortion [HR 3805]. (If you’re in Pennsylvania and you don’t want to view the images, just close your eyes!)

4. (A) Lord Cattula

Lord Cattula


(B) Holding a Congressional hearing on contraception with no women present?

From left, Reverend William E. Lori, Roman Catholic Bishop of Bridgeport, Conn., Reverend Dr. Matthew C. Harrison, President, The Lutheran Church Missouri Synod, C. Ben Mitchell, Graves Professor of Moral Philosophy Union University, Rabbi Meir Soloveichik, Director Straus Center of Torah and Western Thought, Yeshiva University and Craig Mitchell, Associate Professor of Ethics of the Southwestern Baptist Theological Seminary, testify on Capitol Hill. | AP Photo

If you consistently selected “B,” then you’re more scared of misinformed policy and inaccurate statements about how women’s bodies work!

What can you do to change the conversation and protect yourself from misinformation? Join the Educate Congress campaign!

We’re delivering copies of “Our Bodies, Ourselves” to every senator and representative so they have access to accurate, evidence-based information about reproductive health — and you can be part of this important effort.

Because nothing is more scary than legislators drafting policy that harms women — not even Meow Mix …

Credit: Cat photos

1. Possessed Vampire Kitty / Opacity on Flickr
2. Golden-Eyed Vampire Kitty / Digidave on Flickr
3. Fork-Tongued Vampire Kitty / mohd fahmi on Flickr
4. Lord Cattula / sgatto on Flickr


October 12, 2012

Ryan/Biden Debate: Science, Religion and Women’s Health Questions Never Asked

Last night’s quick-fire sparring between Vice President Joe Biden and GOP candidate Rep. Paul Ryan made for an engaging debate — and a well-organized one, thanks to the moderator, ABC news reporter Martha Raddatz.

Still, there were many subject areas that went left un-touched — immigration, rights of workers and equal pay, environmental regulation, LGBT issues, for starters — and it took quite a while to get to one of the most important issues framing this campaign: women’s access to reproductive health care.

Imani Gandy, who tweets as Angry Black Lady, called it out with this tweet:

You have 23 minutes to start talking about uteri before I cut mine out and send it to Paul Ryan. Seriously. Don’t make me do it. #VPdebates

The question did eventually come, sort of:

Martha Raddatz: We have two Catholic candidates, first time, on a stage such as this. And I would like to ask you both to tell me what role your religion has played in your own personal views on abortion. And, please, this is such an emotional issue for so many people in this country. Please talk personally about this, if you could.

Asking two Catholic men to talk personally about abortion is, well, problematic. The issue begs for a serious discussion around facts and policy, not men’s feelings.

“I really wish she hadn’t framed abortion as a personal issue for a couple of Catholic guys,” Lucinda Marshall wrote today. “Not to mention that we really need to discuss reproductive rights as a whole, not just reduce it to the abortion question.”

Amy Davidson, however, noted the opening it provided: “Making religion the frame meant that the discussion could range well beyond the dilemma of abortion in women’s lives. (Ryan: ‘Look at what they’re doing through Obamacare with respect to assaulting the religious liberties of this country.’)”

Amanda Marcotte wrote that the candidates gave “polished, talking-point heavy answers,” but Ryan bringing up contraception, without prodding and in the context of religion, was notable:

The only remarkable thing about the exchange is that contraception is now such an important target for the anti-choicers that Ryan brought the subject up, even though Raddatz didn’t ask about it, pivoting quickly from abortion to talk about the Catholic Church’s issue with contraception: “Look at what they’re doing through Obamacare with respect to assaulting the religious liberties of this country. They’re infringing upon our first freedom, the freedom of religion, by infringing on Catholic charities, Catholic churches, Catholic hospitals.”

As with abortion, Ryan’s religion teaches that contraception is wrong, though, when pressed, he wasn’t as eager to suggest that what is taught in the pews should be enforced by the law. Instead, he spoke of “religious liberty,” by which he means giving the employer the right to deny an employee insurance benefits she has paid for because he thinks Jesus disapproves of sex for pleasure instead of procreation.

Ryan made the point that his Catholic faith isn’t all that guides his views on abortion. “That’s a factor, of course,” he said. “But it’s also because of reason and science.” Here’s Davidson again:

“Science,” in this case, meant looking at an ultrasound image of his first child with his wife—an experience that is widely shared and rightly regarded with wonder. (The tiny image he saw was the source of his daughter’s nickname, Bean, he said.) And then, “the policy of a Romney administration will be to oppose abortions with the exceptions for rape, incest, and life of the mother”—carefully construed, as even this very restrictive list is more than Ryan, left to his own devices, would allow. Ryan doesn’t think that rape victims should have access to abortion.

We don’t look to personal views on religion to frame debates about when to involve ground troops in global conflicts or how to shape tax policy, but we allow our politicians to fall back on their religion when it comes to women’s health. And that’s a problem.

Here’s a sampling of questions I wish Raddatz would have asked, using the same level of specific questioning she brought to other topics: You mentioned science and reason — why are faulty scientific claims being used to justify opposition to contraception, which has been shown to decrease the rate of unintended pregnancies and abortion? How can someone be “pro-life” and support a bill that shows no regard for the life of the mother? What, exactly, is the definition of “forcible rape”?

If we really want to go to religion: Since Italy, which is overwhelmingly Catholic, approved the sale of the emergency contraception Ella (which an Ella representative says wouldn’t have happened if it were considered to induce abortion), why is there still so much debate around the morning-after pill?

And in response to Ryan’s assertion during the debate that the Democratic party supports abortion “without restriction and with taxpayer funding”: Isn’t that, in fact, malarkey?

Raddatz did return to the question of abortion with a different angle: “If the Romney-Ryan ticket is elected, should those who believe that abortion should remain legal be worried?” to which Ryan responded: “We don’t think that unelected judges should make this decision; that people through their elected representatives in reaching a consensus in society through the democratic process should make this determination.”

That led to a brief discussion of Supreme Court nominees, with Biden stating: ”The next president will get one or two Supreme Court nominees. That’s how close Roe v. Wade is. Just ask yourself, with Robert Bork being the chief adviser on the court for — for Mr. Romney, who do you think he’s likely to appoint?”

And shortly thereafter, it was over, leaving many viewers as frustrated as they were before the first question about uteri was asked.

October 10, 2012

Birth Control Reduces Unintended Pregnancies and Abortions, So Why Do Myths Persist?

Today in “Yeah, no kidding!”: A new article in the journal Obstetrics & Gynecology reports on a study that found when women are provided with free birth control, women choose more effective long-term methods, and unintended pregnancies and abortion rates drop.

Here are the essential details from the study’s abstract (emphasis below is mine):

OBJECTIVE: To promote the use of long-acting reversible contraceptive (LARC) methods (intrauterine devices [IUDs] and implants) and provide contraception at no cost to a large cohort of participants in an effort to reduce unintended pregnancies in our region.

METHODS: We enrolled 9,256 adolescents and women at risk for unintended pregnancy into the Contraceptive CHOICE Project, a prospective cohort study of adolescents and women desiring reversible contraceptive methods. Participants were recruited from the two abortion facilities in the St. Louis region and through provider referral, advertisements, and word of mouth. Contraceptive counseling included all reversible methods but emphasized the superior effectiveness of LARC methods (IUDs and implants). All participants received the reversible contraceptive method of their choice at no cost. We analyzed abortion rates, the percentage of abortions that were repeat abortions, and teenage births.

RESULTS: We observed a significant reduction in the percentage of abortions that were repeat abortions in the St. Louis region compared with Kansas City and nonmetropolitan Missouri (P<.001). Abortion rates in the CHOICE cohort were less than half the regional and national rates (P<.001). The rate of teenage birth within the CHOICE cohort was 6.3 per 1,000, compared with the U.S. rate of 34.3 per 1,000.

CONCLUSION: We noted a clinically and statistically significant reduction in abortion rates, repeat abortions, and teenage birth rates. Unintended pregnancies may be reduced by providing no-cost contraception and promoting the most effective contraceptive methods.

The study’s researchers have set up an excellent website, The Contraceptive Choice Project, along with a YouTube video (see above) on what would happen if women had access to birth control methods that worked best for them, and the project is on Facebook. You can also read more about the findings at Women’s Health Policy Report.

While the study seems pretty intuitive — removing a major obstacle to birth control use (cost) means that more women use it and the rate of unintended pregnancies goes down — strangely enough, this argument rarely seems to convince abortion foes to support contraception.

Why is that? For starters, some conservatives are unwilling to concede that contraception lowers the rate of unintended pregnancies. As Amanda Marcotte smartly explains, their real opposition is to sex, not to reducing the number of abortions.

Anti-abortion groups have also promoted a specious argument attempting to redefine how contraception works. One provision of the Affordable Care Act requires coverage of women’s preventive services, including contraception, without cost sharing in new health plans. This provision has been decried by those who have religious objections to birth control in general, and by a segment of the anti-reproductive rights crowd that believes contraception is equivalent to abortion.

The conservative group Focus on the Family, for example, sent an alert to its supporters claiming that “the federal government is requiring both religious and secular employers to fund possible abortion-inducing drugs.” The email was sent in response to a federal judge in Missouri’s recent dismissal of a lawsuit challenging the contraception mandate of the federal health care law.

It would take you about two seconds of Googling to find many, many other examples of anti-abortion groups and individuals claiming that contraception is a form of abortion, especially if there is even the remotest possibility that the method may interfere with the implantation of a fertilized egg, which they have insisted is the case with emergency contraception.

But as The New York Times recently reported, emergency contraception (also known as the morning-after pill and marketed under the brand names of Plan B and Ella) doesn’t prevent fertilized eggs from implanting in the womb:

Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents’ definition of abortion-inducing drugs.

Medically, women aren’t considered pregnant until a fertilized egg implants, and it’s not possible to carry a pregnancy to term without successful implantation. Despite these medical definitions and standards, the belief that contraception equals abortion persists.

So, where does that leave us? Certainly findings like the St. Louis study provide important evidence of what works to reduce abortion rates, and the study bolsters our arguments for contraception access. What’s less clear, though, is what works to counter the notion that birth control = abortion.

If opponents sincerely believe this, how well do fact-based arguments work to change their minds? Have we seen any evidence of other fact-based appeals resulting in shifts in opinion? Share your thoughts in the comments.

September 12, 2012

Today is Global Female Condom Day!

global female condome day 9/12/2012Today is the first ever Global Female Condom Day, intended to help raise awareness of the female condom as an option for pregnancy and HIV prevention. The female condom is the only available woman-initiated method available that offers dual protection.

You can get involved by reviewing and sharing talking points on female condoms, downloading and posting sheets that invite onlookers to share why female condoms are important, and joining the conversation online.

To find out more about what’s happening today and what you can do, check out the National Female Condom Coalition page and the Global Female Condom Day event on Facebook.  The National Female Condom Coalition is also tweeting and encouraging online participation using the hashtag #GlobalFCDay.

To learn more, check out our web content on female condoms and read our previous posts.

September 7, 2012

Medical Students Interested in Reproductive Health? Check Out This Conference.

Medical Students for Choice, an organization that works to destigmatize abortion and increase training opportunities for medical students and residents, has opened registration for its annual conference.

The Conference on Family Planning will take place Nov. 10-11 in St. Louis, MO. Registration closes Oct. 26.

Topics to be covered include surgical techniques, psycho-social issues in abortion care, patient counseling, legal issues, abortion pain management, and unsafe abortion in global conflict settings. In addition, the conference includes sessions on family planning issues such as contraceptive choice and barriers to obtaining birth control.

Medical Students for Choice stat

Statistic via Medical Students for Choice

There’s also a session titled “The Pro-Choice Medical Student’s Guide to Applying to Residency” — an important issue when so many hospitals are denying women access to the full range of reproductive health services.

J. Joseph Speidel, MD, the director for communication, development and external relations at the Bixby Center for Global Reproductive Health, will deliver the opening keynote. Merle Hoffman, publisher and editor of On The Issues Magazine, and the founder and CEO of Choices Women’s Medical Center, will deliver the luncheon address, “The Courage to Defend—The Will to Resist.”

August 30, 2012

Our Bodies, Our Votes: Protecting Women’s Access to Reproductive Health Services

Our Bodies Our Votes

Judy Norsigian, OBOS executive director, wrote the lead article today in Cognoscenti, a new public opinion space at WBUR, Boston’s NPR’s station, that aims to foster conversations about issues that matter.

And what matters right now? Women’s access to reproductive health services.

In her column titled “Our Bodies, Our Votes,” Judy discusses the unprecedented level of attacks on women’s access to care. She points to recently enacted laws that restrict abortion and contraception and addresses the importance of defeating attempts to rescind the Affordable Care Act, which benefits millions of women by mandating that insurance companies cover preventive health care, including birth control, without additional co-pays.

For many of us who have been working in women’s health for decades, it is both surreal and discouraging to bear witness to these recent setbacks. What can we do, especially in this critical election year, to reverse these trends and to preserve the gains established in the ACA? We can start by making people, especially young people, aware of the increasing threats to women’s health and family planning.

Head over to Cognoscenti to read the rest. Then find out what you can do to help protect women’s reproductive rights at OurBodies,

August 8, 2012

Getting the Word Out About Female Condoms

The FC2 Female Condom

How did one guy come to love using the female condom? Science journalist David C. Holzman answers that very question in a recent piece for Boston’s NPR affiliate, WBUR.

Holzman describes his own iffy approach to male condom use, and how his experience of improved sensation with the female condom  made him a convert. He also talks about some reasons why female condoms may not have yet taken off, and how they may offer better protection than male condoms against sexually transmitted infections.

Holzman also was recently interviewed for WBUR’s CommonHealth segment, alongside OBOS’s own Judy Norsigian, which you can listen to online.

Many sexual health advocates have been working for greater availability of female condoms, both in the United States and around the world. For more information, check out our previous post on a paper doll campaign to demonstrate demand for female condoms, and the Female Condoms 4 All campaign, which strung together all ~20,000 of those paper dolls to display in conjunction with the recent International AIDS Conference.

You can learn about FC2, the only female condom available in the United States, from this excerpt from the 2011 edition of Our Bodies, Ourselves. Health workers can get online training on the FC2 at this website.

July 26, 2012

What’s in the New Health Care Law for Women? Well-Woman Visits That Can Improve Your Health

What's in it for women?

Countdown to Coverage is a campaign to help women understand the concrete ways that the Affordable Care Act can improve our health. This blog entry is the first in a series designed to answer the question, What’s in it for women?

by Leana S. Wen, MD

As an emergency physician, I tend to work on the other side of preventive care services. I see what happens when women don’t know about safer sex and birth control, and end up with complications from sexually transmitted infections. I see what happens when women do not get routine screening for cervical cancer and struggle with life-threatening cancer. I see what happens with out-of-control hypertension and diabetes, and the heart attacks and strokes that are detected far too late.

These experiences have shown me that prevention is the best medicine. That’s one big reason why the Affordable Care Act provision requiring new insurance plans to cover women’s preventive care without any extra charges or co-pays is a real victory for women. These requirements, which go into effect Aug. 1, will be phased into existing insurance plans over time.

Because of this change, women will be able to obtain complete contraceptive care, screening for sexually transmitted infections, and screening and counseling for intimate partner violence. This builds upon earlier requirements that insurance companies cover — at no additional cost to women — mammograms and screenings for cervical cancer. It’s clear to me that these mandates will significantly improve women’s health and lives and ultimately lead to a reduction in health care costs.

The Well-Woman Visit
One of the easiest ways to obtain preventive services is through a well-woman visit. These visits, which will soon be covered with no co-pay, give you the opportunity to ask key questions about birth control, sexually transmitted infections, and other reproductive issues, along with questions about diet and exercise and any health concerns you may have. You can also discuss changes in your family’s medical history that are important for your health care provider to consider. For example, when my mother was diagnosed with breast cancer, my doctor recommended that I get earlier screenings.

Along these same lines, your health care provider may have questions or issues to discuss with you. Smoking, drinking and recreational drug use can create and contribute to health problems, and often need to be discussed and addressed multiple times before change happens. Well-women visits also give your health care provider a chance to screen for potential high blood pressure, diabetes, depression, domestic violence, and more.

The well-woman visit is important for another reason: It gives you and your health care provider a chance to get to know each other. Most people go to their provider or to a clinic only when there’s a problem, but the best time to get to know your provider isn’t when you’re in distress from a painful or troublesome condition. Studies have shown that health care providers make more accurate diagnoses when they know their patients and can put the symptoms in the context of your life. A well-woman visit is a precious opportunity to build this trusted relationship.

As an emergency physician, I am excited about the new provisions taking effect Aug. 1, which include annual well-women visits for those who want them. I would much rather women regularly visit their health care providers than come to the E.R. later suffering from preventable problems. So please take this opportunity and make an appointment with your provider. The importance of investing in your health is too crucial to ignore.

Plus: Want to learn more about the Affordable Care Act? These resources from Countdown to Coverage provide detailed information about coverage for women, including specific information for LGBT people, women of color, young women, older women, moms and families, and more. 

Leana S. Wen, M.D., is an emergency physician at Brigham & Women’s Hospital and Massachusetts General Hospital and a clinical fellow at Harvard Medical School. She is the author of a forthcoming book on patient advocacy, “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests.” For more information, visit her blog When Doctors Don’t Listen or her website. You can also follow her on Twitter @DrLeanaWen.

June 25, 2012

Our Bodies, Our Votes: Fight Back Against Lawmakers Restricting Women’s Access to Reproductive Health Care

Our Bodies, Our Votes photo submissionAs OBOS readers are all too aware, politicians have consistently prioritized their own agendas over women’s health — and never more so than in the past couple of years. With lawmakers stepping up efforts to impose severe restrictions on contraception and the full range of reproductive health services, a woman’s access to basic health care in the United States is not guaranteed.

Our Bodies Ourselves is responding to these attacks with a national education campaign — Our Bodies, Our Votes — that urges everyone to use their political power to thwart attacks on women’s reproductive rights and access to essential health services.

We hope you’ll join us and spread the word! Here’s a handy press release in an easy-to-share format, and if you’re on Twitter use #obov2012.

We’re kicking off the campaign with:

* Our Bodies, Our Votes bumper stickersorder stickers here for a minimal donation to OBOS (3 stickers for $10!).

* A Tumblr site,, where people can post photos of Our Bodies, Our Votes stickers appearing across the country.

* A new, with information on contraception and abortion, along with resources on reproductive health and justice.

Our Bodies, Our Votes photo submissionThe uptick in laws affecting women’s health isn’t only frustrating patients. As Rachel noted earlier today, physician and abortion provider Deborah Oyer has a letter in The New England Journal of Medicine — “Playing Politics with the Doctor–Patient Relationship” — that outlines how laws restricting abortion access threaten the relationship between doctors and patients.

It’s a point Marcia Angell, former editor-in-chief of The New England Journal of Medicine, made in today’s press release announcing Our Bodies, Our Votes:

Requiring doctors to perform procedures that are not medically indicated, or to provide false information about medical evidence, violates women’s rights and leaves doctors with an untenable dilemma: Violate state law, or betray their professional obligations to patients.

At, we’ve compiled historical and current information about abortion and contraception, including helpful phone numbers and resources. And there are a number of news organizations and advocacy groups listed that provide smart coverage and analysis of reproductive health issues.

Tell us what you think! We welcome your involvement in making Our Bodies, Our Votes a campaign for change.

June 22, 2012

Hormonal Contraception and Heart Risks

Hormonal birth control (like the Pill), especially modern lower dose medicines, are generally safe for most women. Like all medicines, though, there is the potential for adverse effects for some users. The potential for cardiovascular effects from using hormonal contraceptives has been known for some time; women who smoke cigarettes or who have severe high blood pressure are advised not to take the Pill, and hypertension, heart attack, and blood clots are rare but possible serious side effects.

As a new study in the New England Journal of Medicine points out, though, most research on adverse effects of hormonal contraceptives has focused on blood clots (deep vein thrombosis and pulmonary embolism), with little research focusing on heart attack or clot-related stroke.

The authors of the new study set out to figure out just how common stroke or heart attack are among a group of more than a million Danish women who used oral or other hormonal contraceptives. They looked at the medical records for contraceptive prescriptions and cardiovascular events, and excluded women who had cancers or during pregnancy – both factors that would increase women’s risk of stroke on their own.

The good news is that the study found that blood clots related to hormonal contraception are rare. They did, however, find that women who used combined (estrogen plus progestin) methods showed an increased risk of heart attack and stroke. The amount of increase varied by estrogen dose and other factors. As expected, smoking raised women’s risk of heart attack and stroke. Women who had diabetes, high blood pressure, or high cholesterol were also at an increased risk.

Risk of stroke was elevated among users of the patch and vaginal ring, but was only statistically significant for the ring. Women who used progestin-only methods did not have increased risks. The researchers also found that among women who had stopped using hormonal contraceptives, their risks were similar to women who had never used them.

The authors summarize the risks:

…the risk was increased by a factor of 0.9 to 1.7 with oral contraceptives that included ethinyl estradiol at a doseof 20 μg and by a factor of 1.3 to 2.3 with those that included ethinyl estradiol at a dose of 30 to 40 μg, with relatively small differences in risk according to progestin type.

They also point out that “the absolute risks of thrombotic stroke and myocardial infarction associated with the use of hormonal contraception were low,” meaning that while the increase seems high, very few women will actually experience these outcomes compared to how many women use these methods of birth control. As an accompanying editorial explains:

Considering the absolute risks of cerebral thrombosis and myocardial infarction among nonusers of hormonal contraceptives and the relative risks among users, the number of “extra” arterial thrombotic events attributable to hormonal contraceptives is about 1 to 2 per 10,000 women per year or, equivalently, 10 to 20 per 100,000 women per year for the combined estrogen–progestin formulations that might cause arterial events. These are small numbers. For an individual woman, the probability of an event is quite small.

They also say that “Although hormonal contraception is not risk-free, the evidence is convincing that the low and very low doses of ethinyl estradiol <50 μg) in the combined estrogen–progestin contraceptives studied by Lidegaard and colleagues — whatever the progestin and whether delivered orally or by means of the patch or the ring — are safe enough.”

Although estimates vary, rates of pregnancy-related stroke (during or immediately after pregnancy) are thought to generally be higher than those associated with hormonal contraceptives.

May 9, 2012

New CDC Report Finds Trends Toward More, Better Contraceptive Use Among Sexually Active Teen Girls

The CDC recently released a report on sexual experience and birth control use among female teenagers in the United States. The agency used data from the National Survey of Family Growth for 1995, 2002, and 2006-2010 to look at sexual activity and birth control use among girls ages 15-19.

The percentage of teen girls who reported that they had never had vaginal intercourse rose from 48.9% in 1995 to 56.7% in the 2006-2010 period.

Of the girls who had had sex in the month before the interview, 59.8% used a highly effective contraceptive method (IUD or hormonal contraception), 16.3% used a moderately effective method (i.e., condoms alone), 6.1% used a less effective method (withdrawal, rhythm method, cervical cap, diaphragm, etc.). 17.9% did not use any contraception.

There was a trend over time toward more use of the highly effective contraceptives, but racial disparities exist. White teens were more likely than Black or Hispanic teens to use a highly effective contraceptive, and to use a contraceptive at all.

The study is limited somewhat in that the teenagers reported on their own sexual activity and contraceptive use. And since the researchers defined “sexual activity” as only heterosexual vaginal intercourse, the study also doesn’t give us information about overall trends in teen sexual activity.

The editors of the report note that the teen birth rate has also fallen to its lowest rate in several decades, and provide several suggestions for further reducing teen pregnancy, including:

  • Providing evidence-based sexual and reproductive health education in schools
  • Connecting teens to reproductive health services
  • Having health care providers encourage use of highly effective contraceptives along with condoms
  • Also having health-care professionals provide culturally competent, evidence-based sexual and reproductive health counseling on the importance of correct and consistent use of contraception and a variety of contraceptive methods.

Hat tip: More Teens Using Effective Birth Control, CDC Study Finds – Women’s Health Policy Report, National Partnership for Women and Families.

Random note: the Policy Report links to Healthy People 2020 goals for reducing teen pregnancy; I created the PubMed searches for those and other HP2020 family planning objectives. For any objective, click on “View Details” and then on the PubMed search link to find citations in the medical literature about the specific topic.

April 12, 2012

Sign on to Support Native American Women’s Access to Emergency Contraception

Native American women are subjected to much higher levels of sexual violence than other women in the United States; the Department of Justice estimates that more than 1 in 3 Native American women will be raped in their lifetime, and they are often denied access to justice.

According to a new report, Native American women are also denied access to emergency contraception through the Indian Health Service (IHS). The report, from the Native American Women’s Health Education Resource Center, includes the personal experiences with sexual assault and the perspectives of women of a diverse number of Tribes. It describes the barriers Native American women face when attempting to access emergency contraception and outlines steps that should be taken in order to provide them with on-demand access to emergency contraception.

According to the organization’s 2009 research:

1) Only 10% of IHS unit pharmacies surveyed have Plan B available over the counter (OTC); 2) 37.5% of pharmacies surveyed offer an alternative form of emergency contraception; and 3) The remaining have no form of EC available at all.

At, a petition has been created to ask IHS Director Dr. Yvette Roubideaux to issue a directive to all IHS service providers to make emergency contraception available on demand without a prescription or doctor visit to all women 17 or older.

In the report’s introduction, Charon Asetoyer the Center’s director writes:

As the country debates the access to Plan B as an OTC for women 16 years and younger, Native American women 17 years and older have yet to receive access to Plan B as an OTC by their primary health care provider, the Indian Health Service. No one but Native American women are concerned about this denial of service. As Native American women we are the only race of women that is denied this service based on race. To make an exception to a legal form of contraception based on race is not acceptable. To deny a Native American woman access to Plan B as an OTC when every other woman in this country can access it is a denial to a basic health care service, which violates her human rights. It is a direct violation to her sovereign right to make decisions for her own health care, it removes her from the decision making process concerning a potential pregnancy resulting from a rape and puts that responsibility of decision in the hands of a government agency.

Sign the petition to support Native American women’s right to access emergency contraception.

See also:
Why Native American Women Are Battling for Plan B – at Colorlines, an interview with Charon Asetoyer. In it, Asetoyer notes that another possible solution is for the Department of Health and Human Services to mandate that all Indian Health Service providers to make Plan B or its generic form available OTC. Contacting HHS on this issue may be another avenue for action.

NAWHERC’s Plan B National Awareness Campaign, including the PSA below for Native women:

March 29, 2012

Questions Remain about Effects of Stopping Depo-Provera

Our 2009 post on side effects of stopping the injectable birth control Depo-Provera (depot medroxyprogesterone acetate, or DMPA) continues to generate important discussion — more than 100 women have shared their stories of adverse effects after stopping the drug.

Although a quick internet search finds many women complaining of or asking about post-Depo symptoms, there isn’t much published scientific evidence on the topic. Frustratingly, there is really not much new on the topic in the 2 1/2 years since we first posted on this. There don’t appear to be ongoing or upcoming studies on the concerns we’ve heard, either. A few studies here and there report some effects, like how long it took for menstruation to return, how long periods lasted, and how long it took to become pregnant after stopping.

Most of the existing research on women who stop using Depo-Provera seems to focus on bone mineral density. The drug comes with a “black box” warning that it may cause significant bone density losses, although research suggests that it’s possible that these losses may be made up after women stop taking the drug. The Society for Adolescent Medicine has said that “The data from all of these studies [of bone density in adolescent users] are encouraging, although it is unknown whether girls ultimately achieved the same peak bone mass as they would have in the absence of DMPA.” They also suggest that the advantages of preventing pregnancy may outweigh the risk for bone loss, but that patients should be informed of the potential for bone loss. Because of this concern, though, research on what happens when women stop using this birth control method tends to focus on understanding changes in their bone density.

Studies of “discontinuation” of birth control methods also tend to focus on the side effects of taking a drug and the reasons women stop using them, rather than what happens – aside from pregnancies – after they make that decision. It is thought that about half of women who quit Depo in order to get pregnant are able to do so by 10 months later, but that some women have longer waits before they are fertile. According to the drug label, “it is expected that 68% of women who do become pregnant may conceive within 12 months, 83% may conceive within 15 months, and 93% may conceive within 18 months from the last injection.” It also notes, though, that almost 40% of who discontinued the drug to become pregnant could not be followed up on, so they are not represented in those percentages.

What would you like to know about stopping Depo-Provera? What should researchers be examining? If you would like to share your own story of stopping Depo, please add them to the previous post.

March 24, 2012

Concerns About the FDA’s Review of the Safety of Yasmin and Similar Contraceptives

Last December, a joint meeting of the FDA’s Reproductive Health Drugs and Drug Safety and Risk Management advisory committees met to discuss the safety of birth control pills containing drospirenone, such as Yasmin and YAZ (both Bayer products). Concerns have been raised about the increased risk from the drugs of venous thromboembolism – blood clots in the legs or that travel to the lungs, which can be fatal.

The committees were asked to consider, among other things, the conflicting evidence on these risks in reported studies, whether the benefits of using drospirenone-containing drugs for pregnancy prevention outweigh the risks, and whether users of these drugs are at an increased risk of clots (VTE) compared to users of other oral contraceptives.

According to the background documents for the advisory committee meeting, the studies funded by the drug company did not find any difference in the risk of VTE between women taking dropsirenone-containing drugs (Yasmin) compared to women taking other combined oral contraceptives.

The FDA funded a separate study combaring Yasmin to other oral contraceptives, and this study did find an increased risk of VTE with Yasmin, especially in women younger than 35 years old. They explain that because of the different designs of the different studies, and because the different results can’t be reconciled just by looking at these different study designs, “none of the studies to date provides a definitive answer” about the safety of drugs like Yasmin in terms of VTE risks.

The FDA also noted that all of the studies examined focused on Yasmin or its equivalent (3 mg drospirenone and .03 mg estrogen), while none of the studies reviewed by the committees examined YAZ (3mg drospirenone and .02 mg estrogen).

Former OBOS board member Pamela Bridgewater testified at the meeting, urging the committee to consider why “the studies that had the closest ties to Bayer show no evidence of an increase in blood clots.” Cindy Pearson of the National Women’s Health Network also testified, asking the agency to “take these more dangerous and no-more-beneficial products off the market, and get back to the arc of history and progress that protects women while supporting their contraceptive choices.”

While the committee members voted 15 to 11 that the benefits of drugs like Yasmin outweigh their risks, the transcript of the meeting provides illuminating comments they made as they voted. Many of those who voted yes said they believed that the risks of unwanted pregnancy are greater, and that the absolute risk of VTE is small. Others, however, expressed concerns about the conflicting data, and suggested that they’d change their vote to no if the standard was how the drug compared to other types of oral contraceptives. Many of the members voting no also expressed concerns that these drugs may be no better and may be more harmful that other oral contraceptives on the market.

For example, Dr. Jacqueline Gardner explained:

I don’t usually vote against choices, but this time I did. And the reason is because on the benefit side, I didn’t see any improved benefit over the existing available choices; and there are so many of them, I believe that as far as oral contraceptives are concerned, women could find alternatives. I don’t see that the alternative to this product is necessarily unintended pregnancy. That’s not the balance, but rather, other safer alternatives. And I, too, believe that when all of the studies are analyzed adequately, that we may find that the risk is even higher, and that translates to a large number of women, in public health terms.

Our Bodies Ourselves has signed onto a letter to FDA Commissioner Margaret Hamburg expressing concerns about the composition of the panel and the focus on comparison of risks and benefits of these oral contraceptives compared to pregnancy, rather than on whether the risks and benefits of drugs like Yasmin outweigh the risks and benefits compared to other oral contraceptives.

Bayer was previously required by the FDA to run corrective ads because their television commercials for the drug were found by the agency to be “misleading because they broaden the drug’s indication, overstate the efficacy of YAZ, and minimize serious risks associated with the use of the drug.” There have also been reports that Bayer previously withheld harms information about Yasmin and blood clots from the FDA.

Related reading:

March 12, 2012

Doonesbury Starts Week-Long Abortion Storyline

This week, Garry Trudeau’s Doonesbury strip is taking on abortion, Texas-style – the state’s forced ultrasound bill has taken effect, to much less national attention that that of the recent Virginia forced ultrasound bill.

Because the law requires providers to describe the fetus and play the heartbeat, physicians have indicated that “they almost always must use the transvaginal probe to pick up the heartbeat and describe the fetus in the early stages of pregnancy.”

Trudeau is expected to refer to these non-medical, forced vaginal probes as rape – a sentiment many women have expressed in regard to such bills – and stood up for this position in an interview with The Washington Post:

Texas’s HB-15 isn’t hard to explain: The bill says that in order for a woman to obtain a perfectly legal medical procedure, she is first compelled by law to endure a vaginal probe with a hard, plastic 10-inch wand. The World Health Organization defines rape as “physically forced or otherwise coerced penetration — even if slight — of the vulva or anus, using a penis, other body parts or an object.” You tell me the difference.

Although Doonesbury has a long history of tackling political issues, focusing on abortion was apparently “too much” for some newspapers – the LA Times is moving the strip to the op ed section, and The Oregonian is among the papers that have refused to run it.

The Center for Reproductive Rights is asking supporters to send a quick message of thanks to newspapers who are carrying the abortion-themed installments of the strip, which should run from today through Sunday. The Center has previously filed a lawsuit challenging the Texas requirement.

The strip can be viewed online; today’s installment greets a woman seeking abortion at a Texas clinic, and invites her to wait in the “shaming room,” where “a middle-aged, male state Legislator” will be with her in a moment.

Meanwhile, Texas is expected to lose federal funding to its Medicaid Women’s Health Program which provides family planning and health screening services, because the state has moved to exclude Planned Parenthood from receiving any funding to provide those services.

See also:

  • Forced Ultrasound, “Informed Consent,” and Women’s Health in Texas: The Sad State of the State – at RH Reality Check
  • Guttmacher’s summary of forced ultrasound requirements throughout the United States.