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Unjust Stigma, Lack Of Physician Training Hinder Market For IUDs, Opinion Piece Says
Intrauterine devices "seem like the perfect form of contraception: simple to use, long-lasting, reversible, hormone-free, economical," Slate columnist Kate Klonick writes. She asks, "So why are American women so late to this party? Perhaps the better question is: Why did they leave the party to begin with?"Klonick explains the benefits of IUDs, calling them a "foolproof method of birth control" and noting that they are 99% effective and "can last up to 10 years." Although IUDs can cost between $300 and $500, it is a one-time expense that is often covered by insurance, according to Klonick. She notes that although efficacy studies show that birth control pills, patches and vaginal rings can be "99% effective in a clinical setting, real-life compliancy -- like forgetting to take the pill at the same time every day -- reduces its success rate." Klonick adds that the availability of hormone-free IUDs makes them an "ideal" option for "women prone to some of the negative effects of hormonal birth control, like weight gain, mood swings, acne or high blood pressure."According to Klonick, IUDs were used by almost 10% of U.S. women taking birth control in the late 1970s but are now used by less than 2% of such women. She writes that Katharine O"Connell, a gynecologist at Columbia University who specializes in contraception, believes IUDs still carry a stigma "due to the erroneous belief that they"re highly dangerous" partly due to a number of deaths that occurred in the early 1970s tied to a specific brand of IUD known as the Dalkon Shield. Because of bad publicity surrounding the devices, "the U.S. pharmaceutical industry abandoned the research and manufacturing of IUDs in the mid-1980s, claiming the devices were no longer profitable," Klonick states. According to O"Connell, most experts now agree that the Dalkon Shield"s problems were related to its design, which made users more susceptible to infection, and a lack of testing for sexually transmitted infections before insertion.There are now two major brands of IUDs -- Mirena and ParaGard -- on the U.S. market, but physican training remains a problem, according to Klonick. She writes that studies show that premedical students are not educated regarding IUDs to the extent they are about oral contraceptive pills. O"Connell also noted that many medical schools limit classes on contraception to one lecture, which often omits IUDs. Klonick writes, "This lack of training can leave many doctors feeling uncomfortable recommending the once-controversial devices to their patients." She adds that many physicians who know how to insert and remove IUDs "still refuse to recommend it to childless patients because of the device"s checkered history." She concludes, "With Mirena advertising on television, the downturn in the economy forcing people to economize, and more women concerned about the long-term effects hormones have on their bodies, perhaps the IUD"s stigma will finally become a thing of the past" (Klonick, Slate, 7/29).
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Utopia Honors Michelle Harris With Its Fifth Annual "Caregiver Of The Year" Award
Utopia Home Care, Inc. has announced that Michelle Harris will be its 2009 Caregiver of the Year. At the company"s annual corporate breakfast meeting this morning, Utopia Home Care, Inc. President and CEO Manuel F. Martinez and Executive Vice President Manuel G. Martinez presented Ms. Harris with a commemorative plaque and a check for $1,000. The presentation was made before approximately 125 staff members representing Utopia offices in New York, Connecticut, Florida, South Carolina and Pennsylvania.
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Washington Post Examines Lack Of Information About Stillbirths, Bill To Expand Data Collection

Centers for Disease Control and Prevention data show that stillbirth occurs in about one in every 160 pregnancies in the U.S., but physicians rarely warn pregnant women or their partners about the possibility, Washington Post staff writer Alan Goldenbach writes in an article discussing his experience when his wife"s pregnancy ended in stillbirth. In the U.S., the clinical definition for stillbirth is the death of a fetus after 20 weeks" gestation or weighing 350 grams if the age is unknown.There are about 26,000 stillbirths annually in the U.S., according to CDC. Goldenbach writes that this is "10 times the number of deaths attributed to sudden infant death syndrome, which has been identified as a key public health issue, and four times the incidence rate of Down syndrome, for which prenatal testing has become almost ritual." He continues that many doctors told him and his wife "that they don"t see any point in discussing stillbirth, that it"s a catch-all term for an event, and one that is frequently unexplained." Doctors contend that if they knew the causes or signs of stillbirth, they would warn patients or take preventive action, he adds. Noting that awareness of SIDS spurred research into preventive measures, Goldenbach writes that "[w]e can"t know if improved technology or more stringent standards of monitoring can lower stillbirth rates unless we do the research."Ruth Fretts, an assistant professor of obstetrics and gynecology at Harvard Medical School and chair of the scientific committee for the International Stillbirth Alliance, said, "It"s a trade-off -- you are going to frighten a lot of people" by discussing stillbirths. According to Fretts" research, the leading cause of fetal death after 28 weeks" gestation is an unexplained . Goldenbach writes, "Several doctors told us privately that many ob-gyns fear charges of malpractice following a stillbirth, leading them to avoid citing a cause of death."Stillbirth Legislation in Development Sen. Frank Lautenberg (D-N.J.) is drafting legislation similar to a stillbirth prevention bill that then-Sen. Barack Obama (D-Ill.) introduced in June 2008. According to s familiar with the bill, it will be brought to the Senate floor before the August recess. The legislation will expand stillbirth registries already in operation in Iowa and metropolitan Atlanta. The bill"s supporters hope to have as many as 12 states participating in the registry and installing a standard protocol for data collection after each stillbirth. Another provision would create a campaign to increase public awareness and strengthen grief support services, Goldenbach writes (Goldenbach, Washington Post, 7/6). Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women"s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women"s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company. © 2009 The Advisory Board Company. All rights reserved.


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