More Women Using IUD's for Contraception
Posted by on November 12, 2015 - 1:47pm

Currently, 60% of women are using birth control (with over 99% of women having used it in their lifetime)--from the pill, hormone shots, and non-hormonal methods (like the diaphragm). But now, more and more women are turning to intrauterine devices (IUDs) as their choice of contraception. The Centers for Disease Control and Prevention recently released a survey that showed between 2002-2013, the number of women using the pill, condoms, and female sterilization has dropped and the number of women using long-acting contraceptives (IUDs or contraceptive implants) has more than quadrupled!

Once inserted, IUDs can be reliable for years without having to be replaced or tampered with. The convenience with IUDs is that there is little or no room for human error--no pill to remember, no contraception device to travel with--it just stays in your body to prevent pregnancy. The rise of IUD use is a little surprising, given that women in the United States have been slower to accept implants than women in other countries. This hesitancy was due in large part to misconceptions regarding IUDs being difficult to implant and causing infections. Despite these misconceptions (which have been around for over 30 years), women are starting to trust IUDs as the most effective form of birth control. It's important to remember that while IUDs are effective in reducing the risk of pregnancies, IUDs do not protect against sexually transmitted infections.

An IUD is a T-shaped device implanted into the uterus for the purpose of contraception by preventing sperm from reaching the egg. There are four different IUDs available in the United States. Three of them, Liletta, Mirena, and Skyla, release a small amount of progestin similarly to a birth control pill, which usually makes periods lighter. One of them, ParaGard, also known as 'the copper T IUD,' is hormone free and lasts longer than the hormonal options, but can cause heavier periods. IUDs are more than 99% effective, but, again, do not protect against STIs.

The growing trust of IUDs is good news for women! It's important to offer many birth control options so that women may choose the method that works best for them.

Teen pregnancy down but LARC use is too low
Posted by on April 11, 2015 - 9:37am

Teen childbearing can carry health, economic, and social costs for mothers and their children. Teen births in the US have declined, but still more than 273,000 infants were born to teens ages 15 to 19 in 2013. The good news is that more teens are waiting to have sex, and for sexually active teens, nearly 90% used birth control the last time they had sex. However, teens most often use condoms and birth control pills, which are less effective at preventing pregnancy when not used consistently and correctly.

Intrauterine devices (IUDs) and implants, known as Long-Acting Reversible Contraception (LARC), are the most effective types of birth control for teens. LARC is safe to use, does not require taking a pill each day or doing something each time before having sex, and can prevent pregnancy for 3 to 10 years, depending on the method. Less than 1% of LARC users would become pregnant during the first year of use.

Few teens (ages 15 to 19) on birth control use the most effective types.

  • Less than 5% of teens on birth control use LARC.
  • Most teens use birth control pills and condoms, methods which are less effective at preventing pregnancy when not used properly.
  • There are several barriers for teens who might consider LARC:
    • Many teens know very little about LARC.
    • Some teens mistakenly think they cannot use LARC because of their age.
  • Clinics also report barriers:
    • High upfront costs for supplies.
    • Providers may lack awareness about the safety and effectiveness of LARC for teens.
    • Providers may lack training on insertion and removal.

Providers can take steps to increase awareness and availability of LARC.

  • Title X is a federal grant program supporting confidential family planning and related preventive services with priority for low-income clients and teens.*
    • Title X-funded centers have used the latest clinical guidelines on LARC, trained providers on LARC insertion and removal, and secured low- or no-cost options for birth control.
    • Teen use of LARC has increased from less than 1% in 2005 to 7% in 2013.
  • Other state and local programs have made similar efforts.
    • More teens and young women chose LARC, resulting in fewer unplanned pregnancies.

Source:  CDC.

Review: The Supreme Court Contraception Mandate Cases
Posted by on July 25, 2014 - 3:13pm

On March 25, the Supreme Court heard arguments regarding challenges to the contraception mandate of the Affordable Care Act, with a decision expected to come down in late June. Here’s a rundown of the main aspects of this important case:

What is being challenged?

Under the contraception mandate in the Affordable Care Act, employers are required to provide employees with comprehensive health insurance, including a range of contraceptive methods for women. Organizations exempt from this mandate include small employers that are not required to provide any health insurance to employees, religious organizations and organizations with select insurance plans that were grandfathered in. Religiously-affiliated non-profit organizations may request exemptions as well. The main issue being decided is whether for-profit organizations can choose not to cover contraceptive care in health insurance plans based on religious objections. This comes down to the scope of the Religious Freedom Restoration Act of 1993 (RFRA), which currently does not apply to for-profit corporations.

Who is challenging the law?

The cases were brought by two for-profit corporations, that while not religious or religiously-affiliated, claim to operate based on religious principles. The corporations are Hobby Lobby, a craft store chain based in in Oklahoma City and owned by a Christian family, and Conestoga Wood Specialties, a Pennsylvania-based company that makes wood cabinets and is owned by a Mennonite family.

Why is the law being challenged?

The corporations challenging the contraception mandate believe that certain forms of birth control drugs and devices, including the morning after pill and IUDs, are equivalent to abortion because they may prevent embryos from implanting in the uterus. As such, they believe that covering the cost of these forms of contraception makes the them complicit with abortion. The corporations do not oppose all forms of birth control, including condoms, diaphragms, sponges, certain drugs and sterilization.

How is the administration defending the law?

Donald B. Verrilli, Jr., the current solicitor general who is representing the U.S. administration, has stated that the law offering comprehensive contraceptive care to women promotes public health and ensures equal access to healthcare for women. He also emphasized that it should be doctors, not employers, who should decide the best form of contraception for women. Additionally, a brief from the Guttmacher Institute points out that many women cannot afford highly effective forms of birth control, and so upholding the law will reduce unplanned pregnancy and abortions.

What are the potential outcomes and implications of the decision?

There are many ways the decision could go, each with varying repercussions. If the Supreme Court decides the RFRA does not cover for-profit organizations, it will end those organizations’ ability to challenge the contraception mandate based on religious beliefs. The Supreme Court could decide the RFRA does apply to for-profit organizations, but still rule on the side of the administration. This would be a less decisive win for the administration that would likely lead to more challenges. If the Supreme Court rules in favor of Hobby Lobby and Conestoga Wood Specialties, it will impact women’s access to affordable birth control, while opening the door to other religious objections raised by employers, such as hiring gay and lesbian individuals, or offering benefits to same sex spouses.

For more information, see the sources below:

Liptak, Adam. "Supreme Court Hears Cases on Contraception Rule."  The New York Times. 25 March 2014.
Totenberg, Nina. "Supreme Court Justices Divide by Gender in Hobby Lobby Contraception Case." NPR. 25 March 2014.
Fuller, Jaime.  "Here's What You Need to Know About the Hobby Lobby Case." The Washington Post. 24 March 2014.
"Health Care Law's 'Contraception Mandate' Reaches the Supreme Court."  Pew Research: Religion and Public Life Forum. 20 March 2014.

The Right to Contraception Coverage
Posted by on July 1, 2014 - 1:03pm

Yesterday, in a 5-4 decision, the Supreme Court ruled that “requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom.” Justice Samuel A. Alito Jr. conceded that the government does have a “compelling interest in making sure women have access to contraception,” but that there are ways of providing that access without “violating the companies’ religious rights.”

Justice Ginsburg’s dissent put into words what many onlookers felt. Justice Ginsburg stated that requiring contraception coverage is vital to women’s health and reproductive freedom. Furthermore, Justice Ginsburg stated this may invite “for-profit entities to seek religious-based exemptions from regulations they deem offensive to their faiths,” including some medical procedures and drugs, vaccinations, and even blood transfusions—procedures which certain religions denounce. While there is no evidence yet to support this claim that corporations will begin splitting hairs over other medical procedures, it does raise important questions about where the line is drawn between business and religion.

Those who disagree with the Supreme Court decision state that requiring all insurance plans to include coverage for contraception improves not only public health, but also ensures that “women have equal access to health care services.” Therefore, this blow was particularly shocking. If other family-owned corporations follow this ruling, the cost for contraception coverage will likely become a barrier for many women. IUD’s, for instance, can coast more than $1,000 once medical exams, insertion, and follow-up visits are added—and it is likely that this may cost too much for some women to pay without insurance coverage.

While the full repercussions of this decision are not yet clear, it is important to develop protective measures that defend women’s healthcare and their access to a range of contraception options.

Source: The New York Times

Women's Health Through the Ages
Posted by on January 24, 2014 - 4:44pm

This month marks the 41st anniversary of Roe v. Wade, the pivotal case where the United States Supreme Court legalized abortion. Many see this decision as both a political and religious issue, while others view this as the right for women to make private medical decisions without the interference of politics. Regardless of how you view abortion, it’s important to recognize the evolution of women’s health in America to see how far we’ve come in this field.

Here is a brief timeline outlining notable events in women’s health in the United States.

1800: This year, every American woman had an average of seven children over her lifespan. The birthrate reached an all-time high of 55 births per thousand residents—today the rate is 13 births per thousand.

1849: Elizabeth Blackwell ranked first in her class at New York’s Geneva Medical College, making her our country’s first female doctor. Battling sexism and prejudice, Blackwell founded a small clinic that eventually grew into the New York Infirmary for Women and Children and even opened the Women’s Medical College in 1868 to train more female physicians.

1896: The first commercial menstrual care product in America came on the market from a “little known” company called Johnson & Johnson. Unfortunately, this model was a commercial failure and it wasn't until 1921, with the invention of Kotex, that menstrual care products found their market success.

1916: Margaret Sanger opened America’s first birth control clinic in Brooklyn, New York. Later, in 1921, she founded the American Birth Control League, which was eventually called Planned Parenthood.

1931: Robert Tilden Frank, a New York gynecologist, became the first researcher to give medical credence to premenstrual syndrome.

1960: The FDA approved the sale of the birth control pill, the first oral contraceptive manufactured by Searle.

1969: The low-radiation mammogram was invented, minimizing the risk of high doses of radiation on earlier models.

1970: The publishing of Our Bodies, Ourselves revolutionized views about the female body and sexuality. It is a book written by women, for women, and has sold more than 4 million copies since its publication.

1973: Roe v. Wade decision made by the United States Supreme Court.

2006: The FDA approved the emergency contraceptive pill Plan B for prescription use. It is now sold over-the-counter for women 18 and older.

2007: Dr. Teresa Woodruff edits the first book on oncofertility, a new field that studies how to preserve fertility in patients whose fertility has been compromised due to cancer treatment.

Of course we know that women's health extends well beyond these notable triumphs, and we're looking forward to a future where innovative advances in women's health continue to become more frequent and groundbreaking.

Source: Everyday Health

Updated practice guidelines for contraceptive use available
Posted by on December 4, 2013 - 9:12am

About 50% of pregnancies in the U.S. are unintended and are higher among adolescents and young women, minorities and women with less educational and financial resources.  Thus strategies to prevent unintended pregnancies include assisting women at risk in choosing appropriate contraceptive methods and helping women use those methods properly and consistently.  A new report prepared by the National Center for Chronic Disease Prevention and Health Promotion is now available and addresses sometimes controversial or complex issues regarding specific contraceptive methods.    They utilize recommendations originally made by the World Health Organization but they have been tailored more specifically to the U.S.

U.S. Supreme Court to review mandate to insure contraception
Posted by on November 26, 2013 - 12:33pm

The Supreme Court on Tuesday, November 26,  agreed to hear cases on whether corporations may refuse to provide insurance coverage for contraception to their workers based on the religious beliefs of the corporations’ owners.   President Obama’s health care law has exempted many religious groups from the law but did not exempt for-profit corporations because of owners' religious objections.

The National Women’s Law Center (NWLC) will be submitting a “friend of the court” brief to the Supreme Court that lays out how birth control advances the health and rights of women. Nearly 99 percent of women use contraception at some point during their reproductive years who come from a variety of religious faiths.  And currently nearly 27 million women can get free birth control without copays — a number that will increase as the health care law continues to go into effect.

Most women's organizations believe that allowing bosses to make women’s health care decisions is a dangerous precedent that could lead to companies refusing to abide by other laws that protect their employees, such as employment protections like minimum wage or equal pay. 
Sign the pledge to say all women deserve to make their own birth control decisions — no matter where they work.

 

 

 

Who should decide what birth control you use?
Posted by on November 5, 2013 - 10:30am

According to the National Women's Law Center,  "During the debate over the government shutdown, leaders in the House of Representatives passed legislation to exempt bosses from complying with the part of the Affordable Care Act, that gives women access to preventive services like birth control and well-woman visits with no co-pays or deductibles — if those employers oppose it for "religious or moral" reasons.    This means bosses could impose their religious beliefs on their employees or even block their employees' access to needed health care for vague and undefined "moral" reasons. The Senate rejected the House's plan — but this isn't the first time lawmakers have tried this trick, and it likely won't be the last."

Should your boss decide if and what birth control should be available to you through your plan???  Women need to remain vigilant as this debate continues!

Preventing repeat births for teens
Posted by on May 2, 2013 - 12:30pm

Nearly 1 in 5 teen births are repeat births, about 183 a day.  Many repeat births could be prevented through postpartum use of long-acting reversible contraception (LARC) such as IUDs and implants. Counseling women during prenatal visits about postpartum contraception, and offering women LARC in the hospital after delivery makes it easier for women to avoid unintended pregnancy.

South Carolina’s Medicaid*  [PDF - 27KB] program reimburses for LARC insertion in the hospital before women who have just given birth leave the hospital.

The Truth About Emergency Contraceptives
Posted by on March 28, 2013 - 10:43am

Recently, emergency contraceptives have been at the center of the debate as to whether employers must cover contraception under their health insurance plans. Under the Affordable Care Act, which covers preventive care, non-exempt employers must cover the morning-after pill (Plan B) and the week-after pill (ella) for their employees. Some companies don’t want to follow this requirement because they claim that these drugs cause abortions. However, it seems that these claims are based on outdated information, because recent research now definitively proves that Plan B doesn't cause abortions, and that ella most likely doesn’t impact established pregnancies.

In the past, researchers knew that Plan B prevented pregnancy primarily by stopping ovulation, and therefore, fertilization. However, they were not certain whether it prevented fertilized eggs from implanting in the uterus. An abortifacient (abortion-causing drug) is something that interrupts an established pregnancy, which is typically considered to be when a fertilized egg implants in a woman’s uterus. By this definition, a drug that causes an unimplanted fertilized egg to leave a woman’s body is not considered an abortion, but it is still objectionable by some parties.

Recent studies, including one led by the International Federation of Gynecology and Obstetrics, have proven that these objections are unfounded by showing that Plan B only prevents ovulation and fertilization. It in no way stops a fertilized egg from implanting in a woman’s uterus, and does not cause abortions. This is also most likely the case with the week-after pill, known as ella, although the research is not as definitive. Ella is related to the abortion drug, RU-486 (Mifeprex), but unlike that drug which predominantly affects a woman’s endometrium, ella more strongly affects a woman’s ovaries, preventing ovulation. One study found that the rate of women who took ella after ovulation experienced pregnancy at the same rate as women who did not take it, indicating that the drug most likely does not prevent implantation.

While there is still stronger controversy when it comes to ella, individuals in the medical field opposed to abortion are starting to accept the fact that Plan B doesn't cause abortions, which is an important step in its increased acceptance as a contraceptive.

Source: Rovner, Julie. “Morning-After Pills Don’t Cause Abortion, Studies Say.” NPR. 4 February 2013.

For more information on the preventive services covered for women under the Affordable Care Act, click here.

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