|
February 8, 2000 TRAPPES, France -- The students stopping in at the high school infirmary on a recent morning here were making their usual requests: Some wanted aspirin. Others cold medicine. One just wanted a place to cry because she had flunked a math test. Soon, however -- as soon as the nurse here gets her supply -- students will also be able to pick up morning-after pills. Last month, France became the first country in the world to give its school nurses the right to dispense emergency contraception pills. The pills are to be available in both high schools and junior high schools, where students are as young as 12. Although the nurses are advised to make efforts to inform the child's parents, they do not have to. French health and education officials hope the policy will help lower unwanted pregnancies among teenagers and reduce the country's abortion rate, among the highest in the European Union, and stubbornly so, as it has not dropped despite the easier availability of contraception in the past decade. The measure has found wide support here. Women's groups and abortion rights activists and even some parents groups see it as a major step toward making contraception more accessible to young people, even those who live a long way from family-planning clinics, those who can not afford to buy the pills and those who are too shy to go to the local pharmacist, who may know everyone in the village. The school nurse's union has also hailed the measure as a positive step. Many nurses, like Chantal Broal, who runs the infirmary at the high school here, believe they will be able to ease the burden on terrified young girls who made a mistake. In this working-class city on the outskirts of Paris where many of the students come from North African immigrant families who rarely discuss sex with their children, Ms. Broal says there are unwanted pregnancies every year. "Having a pill that can help is a lot better than standing around with my arms at my side," Mrs. Broal said recently between tending to students. Despite days of banner headlines on the subject, few youngsters who stopped by the infirmary even knew about the new policy. But even in a country that has often been a leader in contraception issues, some parents and family rights groups are saying the government has gone too far this time. Some say the it is usurping the role of the parent and is encouraging casual sex. Worse still, some say, it may be inadvertently promoting the use of the morning-after pill when the need for condoms to prevent sexually transmitted diseases, including AIDS, should be emphasized. "It is a complex issue," said Christian Ganet, the president of Parents of Public School Students, the more conservative of the two federations of parent associations in France, which has denounced the school distribution program. "There are a lot of facets to this thing. On the one side there are advantages. If you did a survey there is an advantage to a number of children, but from the other side how many will begin to rely on this and become H.I.V.-positive?" The decision to make the morning- after pill available to schoolgirls follows a decision last June by the French government to allow pharmacists to sell the medicine over the counter without a prescription. France is also the only country to do that. To be effective, the pill, marketed here under the brand name Norvelo, must be taken within 72 hours of having sex. It works by preventing a fertilized egg from implanting itself in the womb. Similar pills are available in the United States and about 15 countries in Europe but only with a prescription. England alone is currently testing a program that would allow specially trained pharmacists to sell such a pill without a doctor's approval. The Norvelo pill is not the same as RU-486, or methapristone, which can terminate pregnancies up to 12 weeks after conception. In its literature, the French government describes Norvelo as a "late contraception" pill, though Catholic groups take offense at this. "They are kidding themselves," said Françoise Meauzé, the vice president of the National Confederation of Catholic Family Associations. "This is an abortion pill, too, and distributing it like this is not right. There is a banalization of sex going on. And of course the big danger is that the kids will just keep going back and back again for another pill." Ms. Meauzé, like others who have come out against the program, says she is shocked at the way that French government decided on distributing the pill, after hardly consulting anyone involved. Mr. Ganet, the leader of one parent group. said he was not informed of the decision before it was announced. But French officials say the decision was carefully thought out, if not widely discussed. "No decision like this is wholly without flaws," said Ségolène Royal, the deputy minister of education who announced the decision at a conference for school nurses on Nov. 26. "But at the same time there exists a universal morality that demands that we relieve human suffering when we can." School nurses could begin dispensing the pills on Jan. 8, but nurses were on their own to order the pills, and nothing was in place by then in most schools. The decision was touched off in part by a government-commissioned report looking into abortion practices, 25 years after abortion was legalized here. The author of the report, Dr. Israël Nisand, a professor of obstetrics and gynecology at Strasbourg University, recommended the measure and the institution of sex education after discovering that French adolescents, who receive virtually no sex education, were horribly misinformed. Dr. Nisand found that many youngsters believe they could not get pregnant until they have had sex several times. They also believe that having sex when they are menstruating is risk-free. And, he said, they often do not use condoms correctly. "The people who mix up a discussion about the morning-after pill with AIDS are really masking other motives," Dr. Nisand said. "Right now, the youngsters have a far greater risk of getting pregnant and an abortion at the age of 14 is very traumatic. If you can prevent only a few hundred of those it is a good thing." Though a largely Catholic country, France has for a long time given students confidentiality when they sought advice on contraception and condoms have been available in French schools for years. But abortions have failed to decline in the last decade. Each year, about 220,000 abortions are performed in France, about 6,700 on adolescents under the age of 18. In 1995, the most recent figures available for France, 10.5 out of every 1,000 girls under the age of 20 had an abortion, according to the World Health Organization. By comparison, the rate of abortion in 1995 in Germany was 6.8, in Italy 6.3, in Spain 4.5. The United Kingdom has a higher rate at 18.5. Former eastern bloc countries, where other forms of birth control used to be very difficult to obtain, continue to have far higher abortion rates, in many cases more than 30 per 1,000. In 1996, the rate of abortion among girls between the ages of 15 and 19, was 29.9 per 1,000 girls, according to the Centers for Disease Control and Prevention in the United States. Some of the students at the Lycée La Plaine de Neauphle, the high school in Trappes, squirmed with embarrassment at the idea of going to the infirmary to get either condoms or the morning-after pill. "Maybe," said Isabelle Sohet, 17, looking doubtful. "If you were in real trouble." But like several other students, she wondered whether the easy availability of the pill would make it that much harder to convince the boys to use a condom. "It's hard to know what is good policy," she said. "I can see, too, that having that pill could really save your life some time, so this is a hard question." Ms. Broal, who runs the infirmary, says she can not begin to guess whether there will be a lot of demand for the pill. Until now, she pointed out, girls who needed it had no reason to come see her. "But if they know it's here," she said, "they may come." http://nytimes.com/library/world/europe/020800hth-france-birthcontrol.html
Wednesday,
2 February, 2000, 01:53 GMT
A new version of the "morning-after" pill is launched in the UK on Wednesday. The Levonelle-2 pill is said to have a higher success rate with reduced side-effects and costs just £5. But family values campaigners have said it will promote promiscuity. The pill
contains the female pregnancy hormone progesterone.
Other products, such as the PC4 pill, combine two hormones, progesterone and oestrogen. Schering Health Care Ltd, which manufactures Levonelle-2, claims that because it contains only one hormone it produces fewer side effects like vomiting and sickness. In addition, women who use Levonelle-2 will only have to take two pills - one as soon as possible after sex and the other 12 hours later. Other types of emergency contraception require the woman to take a course of four pills. Dr Diana Mansour, consultant in community gynaecology and reproductive healthcare at Newcastle General Hospital said: "Today's launch is a very welcome one as we can now offer women a more reliable emergency contraceptive that causes less nausea and vomiting and is much simpler to take than the existing oral method." Lack of meaningful relationships But the new pill was condemned
by Valerie Riches of Family and Youth Concern. Friday,
14 January, 2000, 13:55 GMT
Women are being given free morning after pills without prescriptions over the counter at UK chemists in an attempt to cut the number of unwanted pregnancies. Those backing the pilot scheme - including the Department of Health - says it offers effective action and expert advice, including proper consultation. But opponents say it encourages casual sex. "Girls will get used and hurt because boys know there is no need to worry about the risk of pregnancy," said pressure group Family and Youth Concern. What do you think? Is this a sensible response to a growing social problem, or does it encourage casual attitudes to sex and pregnancy? Your Reaction: Well having been in this
situation myself and sat in a room being questioned about the situation,
I am in favour of purchasing the Morning after Pill over the counter.
I do not think it will increase casual sex as I always say it is down
to the amount of education that a person has had as to where they
want there life to go. I think it will reduce pregnancies. I think this is the most
stupidest idea. No doubt the people behind it have good intentions,
but LOOK AT THE WHOLE PICTURE!!! By giving free morning-after contraceptives,
the public is saying that it is O-KAY with a girl conceiving a baby
and then KILLING it the next morning. Where have our morals gone?!!
I do not feel that giving
women easier access to the morning after pill is irresponsible. There
have been improvements in sex education in school and the message
that a sexual relationship should not be entered into lightly has
been spread. At the age of 32 I had
the misfortune to have to take the morning after pill when a condom
broke. It doesn't just happen to teenagers. The relationship was far
too new to consider children. Being an average wage-earner and not
a high-flying career woman I would never consider bringing up a child
alone. A free morning after pill
is cheaper than an abortion or an unwanted baby and people are going
to continue to 'take risks' whether it is available or not. My concern
is the side effects of a drug that may not actually work. If you take
the pill and don't get pregnant how do you know it has prevented a
pregnancy? A close friend took it exactly as prescribed within the
time limit and still ended up pregnant. I wish that chemists had
been freely giving out the morning-after pill two years ago. It would
save the anguish of unwanted pregnancies due to faulty condoms. I took the morning after
pill last year at the ripe old age of 31. I knew little about it and
its side effects. Fortunately, through my GP I had the support of
a very understanding nurse who explained how it worked and how I was
likely to feel. Sex makes people pregnant.
How inconvenient. What gives us the right to spontaneity? Modern women
should be more organised than to need such unnatural and future-changing
aids. Why don't we start demanding real love? We're selling ourselves
short. We are not discussing any
form of contraception: this pill does not prevent it, (morning-AFTER
pill): it prevents the implantation of the human embryo in its mother's
womb. So we are discussing abortion. How are we to help those who
realise this fact only after the event? Yes, the morning after
pill is a form of abortion, yes this is better than bringing unwanted
kids into the world, yes, it should be available as easily as possible
- this bears no relevance to the question of a more responsible attitude
to sex and reproduction though. That will only come from providing
full information on all the issues to young people and allowing them
to develop their own moral system based on the current technological
situation - remember, there is no longer an automatic connection between
sex and pregnancy. Overall this is a welcome
development as many women across the world have expressed with their
insightful comments. What I find disturbing is the negativity and
moralising from my fellow men. In particular from our North American
cousins who harbour conservative Victorian-esque values and who seem
to both undervalue and underestimate the women of this world. I am horrified to read
some of the previous messages. Especially those from people who think
that making the morning after more available leads to teenagers being
more sexually active. Wake up! People, whatever age, are having sex.
This is not just an easy way out for teenagers, it is a secondary
precaution against pregnancy for women. It is not always unprotected
sex that calls for the use of the morning after pill. Broken condoms
do happen as well. People who are against this need to see it from
a scared woman's point of view. Why should women have to panic and
wait hours to receive the pill. And all of you who are worried about
your taxes being spent on this, would you rather spend a small amount,
or a larger amount on abortions every year? Stop thinking about you
own personal expenses, and think about those who may have no other
means of preventing an unplanned pregnancy within a 72 hour period.
I do support this idea
but with misgivings. I am under no doubt that it will make people
less inclined to take better precautions in the 'heat of the moment'
as its often the embarrassment of questioning by doctors and wasting
precious time in casualty, that is most off-putting. But also having
taken it myself and being aware of highly unpleasant illness that
can accompany it, a few experiences like that and I think the woman
will think twice. It does worry me that men will be more inclined
to pressurise women into unprotected sex as a result, not having to
suffer such effects themselves, so I'm encouraged by the negative
responses from men here.. Not only should it NOT
be so easily available; it should be taken off the shelves completely
until it has undergone proper investigation as to safety/side-effects;
or better still our attitude as a society should grow away from selfishness
- open up to the truth of the value of human life at all stages -
and make a place for all infants - no matter how they were conceived.
Last time I checked, birth
control, abortions and sex before marriage are still legal in the
UK. As such if a female decides that she needs the morning after pill
it should be her decision. I think it is wonderful
that the UK can lead the way in this important move toward improving
women's health and options. According to the World Health Organisation,
there are NO contradictions to the use of morning after pills. Studies
also show clearly that the pill works better the sooner they are taken.
Therefore it seems ridiculous to limit access to those women who can
scramble to get themselves to a doctor within the short time frame
possible, when well qualified pharmacists can do the job perfectly
well. Being male I cannot comment
on the consumption of the morning after pill, but the reported experiences
sound like it is an extremely unpleasant experience (although perhaps
less unpleasant than later treatment of an unwanted pregnancy). Another
observation is that the objections stem from some fanciful concept
that this will enable evil men to force unwilling females not to take
contraceptives. If the female does not consent, it is rape. If the
female does consent then she is presumably happy with the precautions
taken. 'Emergency contraception'
involves the use of an abortifaecent, which means the already conceived
embryo may be destroyed. We are not animals who need to be protected
from pregnancy in this way. We can say no. To take the morning-after
pill, which can only be a few times per life, a woman needs expert
medical advice because of serious side-effects, like any abortion
she needs to have proper counselling about the step she is about to
take. It is not a form of contraception, or a neutral easy-to-pop
pill. I hope you register my pro-life and pro-human view, for a balanced
output on the topic. Surely it is better not
to conceive than to have to take four harmful pills that may or may
not work and which ultimately facilitate an abortion of a foetus from
the mother. This pill will merely encourage more irresponsibility
(if that is possible). Other countries manage to keep unwanted pregnancies
under control without resorting to these methods, why can't we? I do not think the morning
after pill will encourage casual sex any more than what society already
does. This pill has been around for a while, the only problem is females
feel belittled when asking for it from their GPs. This then causes
unwanted pregnancies. Also if there is a split in the condom on the
Friday night, it will be too late to wait for the Monday to contact
the GP. As for the danger of males thinking they don't need to use
a condom it is up to the independent sensible women/girl to make them
wear one. I have never had cause
to use the Morning after Pill myself but I understand that it can
make you feel very sick afterwards and hopefully this will deter people
from using it instead of regular contraception. An earlier comment
said that tax-payers would not want to shoulder the costs of this.
However, I'm quite sure that the cost on the tax-payer of teenage
and other unwanted pregnancies would far outweigh the costs of this
pill being OTC. Wouldn't it be great if
the human race was perfect? Or would it? Life doesn't always go to
plan - people and products make mistakes and fail - The day after
pill helps to patch up those failings. Nobody in their right mind
is going to use this method as a sure way of contraception - it is
a worrying time waiting for your next period and trying not to vomit
after taking the tablets. It is ridiculous that we as women who are
old enough to have a child or abortion are not allowed to receive
the pill OTC. Chasing round surgeries and casualties just puts more
pressure on the NHS and can cause delay outside the 72-hour deadline
resulting in a unwanted baby or abortion! I am in favour of the
idea, as long as expert consultation is available from the chemist.
Better that than the cost and misery of abortion or unwanted children.
As for encouraging casual sex, young people will want to live out
their sexuality whether the "morning after pill" is available over
the counter or not. Having had the misfortune
to need the Morning After Pill once, after a condom accident, I can
identify with the panic of trying to get to a clinic within the shortest
time possible! Luckily my accident happened on a weekday, but I spent
a good 12 hours or more in panic before taking the first dose. It
made me feel absolutely terrible, I had to get up 12 hours later to
take another dose (2 am!) and I wouldn't choose to do it again - unless
I had to! People whittling on about irresponsible use are blind to
the facts - there will always be people who use abortion and/or emergency
contraception as their only contraception. Most of use are sensible,
and deserve the chance to reduce the panic at failed condoms as much
as possible! It may be less costly
to issue the pill in this manner but the problem doesn't go away.
What's wrong with teaching a little abstinence? I mean, the best way
to avoid unwanted pregnancy or STDs is NOT to do it. What's wrong
with a little discipline and self-control. Such ideas are not here
to kill our joy but to enhance it. If only it was "in fashion" to
say NO instead of being made to feel "abnormal" because you don't
indulge. As for the cost of freely dispensing this pill - I don't
want to bear the cost. Why should I? This seems like a VERY
bad idea. I am a medical student - all my textbooks say that the morning
after pill has significant side. I guess the first chemist to give
it out to someone who has a stroke or pulmonary embolus will discover
this. I reluctantly support
the distribution of morning-after pills. I say reluctantly because
I believe that sex belongs in marriage and nowhere else. However,
it is better to prevent unwanted pregnancies than to have abortions.
Some people will engage in casual sex no matter what and the availability
or unavailability of birth control will have no impact on their behaviour.
Since it is a morning-after
pill it is no longer contraception it is abortion. So no, it should
not be so easy to come by. Although many people use the world population
problem as an argument for abortions I feel this argument is weak.
Going into the streets and murdering older people would also reduce
the population that doesn't make it morally acceptable though. It seems incredible that
the Morning After Pill is being so frivolously promoted and distributed
when the contraceptive pill is still restricted to prescription only
distribution. Morning After Pill distribution has risen tremendously
over the last years and the abortion rate is still rising. There is
no evidence to support the theory that these pills will prevent 'unwanted
pregnancies'. Once again women are being used as guinea pigs for an
experiment that is likely to be illegal. We have entered a permissive
society and it is too late to return to 'old fashioned values'. Therefore,
we have to accept that girls will be promiscuous, and preventing unwanted
pregnancies is a good idea. Surely it is far better to prevent a pregnancy
at an early stage than have to go through a later termination? It is far less costly
to society to offer 'morning after' pills than to allow unwanted pregnancies
to become unwanted children. I fail to understand why
so many think that it is only teenagers involved. Also PCC (the morning
after pill) is so much more effective if given early, it makes sense
that an enlarged supply chain is instigated! The lapse in any morals,
comes well before the seeking of the morning after pill! I am a woman locum chemist
working mainly on Saturdays when surgeries are closed. Many times
I have been asked about the availability of this pill by women who
have been exposed to unprotected sex. The only answer has been to
direct them to their GP or the local casualty dept. Either way, the
woman almost certainly ends up taking this pill having consulted someone
who knows only as much of the medical history as the woman volunteers.
It seems therefore nonsensical to have to send anyone on an emergency
circuit when a careful consultation between us would be as effective,
quicker, cheaper, more dignified and equally safe. The morning after pill
should perhaps not be available so easily to those under 21 years
of age. If they think they can get it easily then they are more likely
to behave recklessly. There should also be a track record kept of
every woman who is receiving the pill and nobody should be allowed
more than two pills per year. Certainly the concept is far preferable
to surgical abortions in a more advanced stage of pregnancy which
become more barbaric and distasteful as each day passes toward full
term. Anyone who assumes that
just because this pill is more freely available, that it will lead
to more reckless behaviour by women, has a very low opinion of women.
I took this pill at age 16. I didn't have sex thinking "Oh it's okay,
I can get a pill tomorrow". Since then I have gained a degree and
am now working. I hope to raise children within marriage when I have
enough money. Of course people need to take personal responsibility
for their actions, and allowing women this pill helps that. These
"moral guardians" shold stop assuming that everybody else has sex
willy-nilly with anyone. Most people, including teenagers, don't.
I think it's a brilliant
idea. Yes, it will be used by teenagers, but they'll have sex whether
they can get the morning after pill or not. Plus, it will be used
by a lot of women in stable relationships that have been unlucky.
Has anyone out there ever spent a bank holiday trying to get hold
of the pill and ended up waiting in A&E, knowing that the longer you
sit there, the less chance there is of it working? This pill is available
free worldwide! The current world birth rate and population are putting
the greatest of strains on the resources of this planet. Given the
current direction of growth, catastrophe is unavoidable. The prevention
of overpopulation is the only way forward for society, otherwise we
will experience an even greater loss of quality of life, and in the
end another world war or perhaps nature culling the excess population
with a new plague or disease. I have had the morning
after pill, three times in the last 4 years. On one occasion I had
to wait till the third day to get it as the GP surgery was closed
(bank holiday) and my local hospital does not hand them out. I think
that this is therefore a godd idea, as long as it is used correctly,
and it should be monitored regulary. Any sort of help that
might control population explosion is to be encouraged - it is no
longer a moral issue.
I've had to take the morning-after
pill twice as a result of condoms breaking. Both times it made me
feel extremely ill. Consequently, I can't imagine anyone wanting to
take the morning-after pill instead of using other forms of contraception.
This action is rewarding
the behavior you are condemning and trying to stop. Try some other
method. I cannot understand why
the NHS is putting the morning after pill up for prescription free
sale! Three years ago I was refused it because due to problems during
pregnancy I was diagnosed as being a "high stroke risk". So how will
they know who is and who is not? It seems like a "get rid of it" problem
to me. If I had to go to the chemist rather than the doctor, this
factor would not have been pointed out to me. It seems dangerous to
put women in that situation. A good idea. Even with
careful planning things can go wrong such as condoms splitting and
this is a way of helping people in those circumstances. The morning after pill
would only be a bandaid instead of a solution just like the condom
was to HIV infection. If you dont want an unplanned pregnancy, abstain
or go on the birth control pill. This pill will reduce the use of
condoms and STD's will be on the rise. I believe that a person
has the right to do what they want. Making a pill that is important
in the rights of women available will not give the impression that
they have free reign to go crazy. It will give them the understanding
that they have choices and a country that respects that. I do not agree with rewarding
carelessness and irresponsibility by offering a free walk to your
chemist as a solution. While I understand the government's desire
to lower the teen pregnancy rate, this latest "free giveaway" is attacking
the problem from the wrong end. No pill will help. The
media is advertising teenage sex in full force. We do not talk about
"making love", we talk about sex by which we actually mean animal-like
copulation. The attitude towards such an intimate and personal interrelation
should be changed dramatically. This pill will only encourage
inappropriate behavior. I agree with Linda in Latvia. The movies,
TV, magazines, etc, etc., continually bombard us with sex and violence.
Society needs a dramatic change in attitude. People have sex. Period.
There is no question about "reward" or "punishment" and I am shocked
and dismayed to see it put in these terms of morality and judgement.
If we can help women (not just teens) have control over their bodies
and fertility then it should be made available as easily and ubiquitously
as possible. New attempts at lowering
teenage birth rates should be welcomed. Easier availability of the
morning after pill will not only benefit teenagers but all people
who wish to control if and when they have children. This scheme will
also save GPs time, it is they who at present have to give prescriptions
for the morning-after pill. As with any attempt to help reduce teenage
pregnancy the religious right will object, but that should not be
allowed to stop such measures. The government should be applauded
for taking the step and encouraged to take more. This seems a practical
initiative to me. What would those who oppose this measure prefer?
Messy abortions, uncared for children, young women denied their potential
for one mistake? I still think that men should take more responsibility.
You Europeans' birth rate
is to low as it is. You better get busy and produce your own children
unless you want to get over run by another culture. In the short term this
scheme may cut the number of teenage pregnancies. But it gives a big
thumbs up message to sexual experimentation by teenagers and so will
further the problem in the future. But the government only ever thinks
of the short term, and where the next votes will come from. Democracy implies choice.
Together with an adequate education both at school and at home, it
should result in mature individuals who can take advantage of choices
like the morning-after pill. What needs be questioned is the adequacy
of education or the understanding of democracy. It is an unfair burden
on the taxpayers. This pill should be available
free worldwide! The current world birth rate and population are putting
the greatest of strains on the resources of this planet. Given the
current direction of growth, catastrophe is unavoidable. The prevention
of overpopulation is the only way forward for society, otherwise we
will experience an even greater loss of quality of life, and in the
end another world war or perhaps nature culling the excess population
with a new plague or disease. If this helps cut down
on unwanted pregnancies: brilliant. It can be incredibly difficult
to get hold of emergency contraception in the necessary timeframe.
And it isn't just for teenagers: I'm sure few people in stable relationships
can honestly say they've never had a broken condom or got their dates
wrong. Of course women and girls won't start taking it like sweeties.
Do the critics know that it is taken along with anti-emetic (sickness)
tablets? I do not know any women who take it out of choice. Let's
not forget that there are still dinosaurs around who oppose all forms
of artificial contraception and presumably believe a woman's place
is banged up every year. What is the fuss about?
Seeing that there are hardly any restriction in people copulating
at will with anybody and as many people as possible, why should one
miserable inanimate pill hold them back. Under what scruplous or social
order are we questioning the need? The experiment sounds like
a good idea and should be tried. Will the pills cause additional problems
for people? Perhaps. Will the "curse" of an unwanted pregnancy be
dealt with in a responsible way? Yes. Will people "take advantage"
of the new technology? Yes. Will it benefit society? I believe so.
If it works better than anything else does by March, the experiment
has to seen as a success. It is interesting that
so far the only negative opinions expressed above have been by men.
Kaiser Daily
Reproductive Health Report. The FDA yesterday gave marketing approval to "Plan B," a progestin-only emergency contraceptive manufactured by Women's Capital Corporation that has the same effectiveness but fewer side effects than EC based on the Yuzpe regimen. The approval makes Plan B the second emergency contraceptive regimen on the market, following last fall's approval of Preven, which is based on the Yuzpe regimen. Studies have found that progestin-only EC causes "less nausea and vomiting" than the other method ( AP/Baltimore Sun, 7/30). The package consists of two .75 mg tablets of levonorgestral; the first pill needs to be taken within 72 hours of unprotected sex, the second 12 hours later. The method works by halting ovulation or implantation and will not terminate an already-established pregnancy. Dr. Edith Guilbert, who participated in a large-scale World Health Organization study of the method, said, "Plan B will be much easier to administer and use than the older regimens. A new and better product will also help increase awareness of emergency contraception and this should help reduce high rates of unintended pregnancy." Plan B initially will be available though Planned Parenthood Clinics and other providers listed on the Emergency Contraception Hotline (1-888-NOT-2-LATE) and the Emergency Contraception Web site (http://www.princeton.edu/ec). It will also be distributed by pharmacists in Washington State as part of a pilot program testing direct-pharmacist distribution of EC. Plan B will be available on the general market later in the year (Women's Capital Corporation release, 7/28). Gloria Feldt, president of Planned Parenthood Federation of America, said, "Plan B provides women with an important means of preventing unintended pregnancy. We hope the arrival of a new progestin-only emergency contraceptive product will lead more physicians and more pharmacists to prescribe and to offer emergency contraception to their patients" (Planned Parenthood release, 7/29). Sábado 26
junio 1999 - N¼ 1149 Francia
permite la venta sin receta de la 'píldora del día siguiente'
sin estrógenos El levonorgestrel, principio activo de la píldora comercializada en Francia bajo el nombre de NorLevo, se conoce en España desde los años 70 y se prescribe, siempre con receta, como terapia hormonal sustitutiva o como parte de un tratamiento anticanceroso. En ningœn caso como un método contraceptivo de urgencia, explicaron ayer fuentes del Ministerio de Sanidad y Consumo. Pero en Francia, pese a la tibieza inicial de la Academia Nacional Farmacéutica, partidaria de exigir la prescripción médica durante un per’odo transitorio, la Agenda del Medicamento ha optado por la libre comercialización de este principio, considerando su inocuidad. Mientras las ministras Martine Aubry (Empleo), Nicole Péry (Derechos de la Mujer), Ségoléne Royal (Enseñanza Escolar) se felicitan públicamente por este hecho, la Confederación Nacional de Familias Católicas (AFC) expresa su disgusto, porque "se trivializa", dice, "un acto que compromete, sin embargo, a una persona en lo más profundo de sí misma". La eficacia del NorLevo, que se presenta en forma de dos comprimidos de 0,75 miligramos de levonorgestrel cada uno, asciende al 99% durante la primeras 24 horas y se mantiene posteriormente entre el 85% y el 95%. El primer comprimido debe ser ingerido lo antes posible, siempre dentro de los tres días posteriores al acto sexual, y el segundo, entre las 12 y 24 horas siguientes. Su precio dobla el de otras píldoras de urgencia, y la Seguridad Social francesa no parece estar en condiciones de sufragar su consumo. "Las discusiones iniciadas con los laboratorios no han permitido hasta ahora llegar a una tarifa abordable para la Administración", indicó ayer Nicole Péry. Un estudio de la Organización Mundial de la Salud de 1998 mostraba que el levonorgestrel es mucho mejor tolerado e igual de eficaz que los tratamientos combinados de estrógenos y progestativos. Estos son los más utilizados por los ginecológos españoles para evitar un embarazo no deseado en los tres días siguientes al acto sexual. Lo consiguen en el 99% de los casos, pero a cambio de sufrir vómitos, mareos, malestar general por unos días y trastornos menstruales en muchas ocasiones. Acceder a estos combinados a través de la red de hospitales públicos es difícil, según Justa Montero, de la Federación de Planificación Familiar de España. Montero asegura que hay dos razones para ello: la objeción de conciencia y que "no es considerado una urgencia hospitalaria". A falta de estudios que avalen las expectativas de la nueva píldora y fiándose de experiencias como la de Finlandia, donde se usa desde 1987, las autoridades sanitarias francesas confían en que su comercialización permita reducir notablemente el número de interrupcioines de embarazos ya establecidos. Se calcula que los embarazos no deseados entre las adolescentes francesas supera cada año los 10.000. Ese grupo de riesgo, junto al de las jóvenes solteras que mantienen relaciones sexuales ocasionales, son los destinatarios principales de la píldora. A la ignorancia sobre los recursos anticonceptivos de que hace gala una parte de los adolescentes franceses, se sumaba hasta ahora la dificultad de acceder de forma inmediata a los tratamientos de urgencia. Los ginecólogos no creen, sin embargo, que la nueva píldora vaya a ser utilizada abusivamente. "Por regla general, las mujeres comprenden perfectamente que una cosa es la contracepción ocasional y otra, la regular", afirma Elisabeth Aubeny, del hospital Broussais de París. El hecho de que NorLevo vaya a venderse en las farmacias vuelca sobre los farmacéuticos buena parte de la responsabilidad de informar sobre el producto y las condiciones en que debe ser suministrado. Algunos de ellos adelantan, invocando l a cláusula de conciencia, su negativa a distribuirlo. La Orden Nacional de los Farmacéuticos va a enviarles una ficha con las características del medicamento y del conjunto de anticonceptivos de urgencia, junto al recordatorio de que deben escuchar respetuosamente al cliente y enviarle a la farmacia más próxima en la que puede encontrar la píldora. © Copyright DIARIO EL PAIS, S.A. - Miguel Yuste 40, 28037 Madrid digital@elpais.es | publicidad@elpais.es |
|
La Ampliación de Acceso a las Píldoras Anticonceptivas de Emergencia en Washington: La Promoción de Acuerdos Cooperativos para Autorizar a los Farmacistas a dar Recetas El modelo de entrega de servicio de píldoras anticonceptivas de emergencia (PAE) -- ir a una clínica o llamar a un médico para pedir una receta después de tener relaciones sexuales sin protección -- puede presentar obstáculos para las mujeres. Dado que el tratamiento se debe iniciar dentro de las primeras 72 horas después de tener relaciones sexuales sin protección, el aumiento de acceso a las PAE sigue siendo un componente crítico en la ampliación de la disponibilidad de esta opción anticonceptiva única. Un método de aumentar la disponibilidad consiste en que los proveedores de salud proporcionen las PAE a las mujeres por adelantado para usar después. Otro método para aumentar el acceso consiste en eliminar totalmente la necesidad de ver a un proveedor de salud. Un proyecto innovador en el estado de Washington propone hacer las PAE más disponibles a las mujeres a través de acuerdos que autorizan a los farmacistas a dar recetas. Estos acuerdos entre farmacistas y médicos u otros proveedores de salud con autoridad independiente para dar recetas harán posible que los farmacistas receten las PAE directamente. El hecho que los farmacistas puedan dar recetas elimina la necesidad de ir a una clínica y, además, las farmacias se encuentran en lugares convenientes y normalmente estan abiertas durante la tarde, los fines de semanas y los días de fiesta. A las mujeres que llaman al Servicio Telefónico Gratuito de Anticoncepción de Emergencia o visitan la página del World Wide Web, se les avisara que, en el estado de Washington, pueden recibir las PAE sin una receta de un médico en farmacias participantes. Este proyecto es un colaboración entre el Program for Appropriate Technology in Health (Programa para el Uso Apropiado de Tecnología en la Salud), el Washington State Pharmacists Association (la Asociación de Farmacistas del Estado de Washington), el Washington State Board of Pharmacy (El Consejo de Farmacia del Estado de Washington), el University of Washington Department of Pharmacy (la facultad de farmacia de la Universidad de Washington), el Reproductive Health Technologies Project (el Projecto de Tecnologías en Salud Reproductiva), y el Office of Population Research (el Departamento de Investigación sobre Población de la Universidad de Princeton). El proyecto fomenta y promueve de modo activo estos acuerdos que autorizan a los farmacistas a dar recetas e instruye a los farmacistas acerca de cómo proveer las PAE. La instrucción de los farmacistas cubre, por ejemplo, información terapeútica sobre las PAE, cuidado de pacientes y aconsejamiento, empaquetadura y rotulación, y referimentos para cuidados continuados de anticoncepción y de salud reproductiva. El impacto de este método nuevo de dispensar las PAE se evaluará a través de encuestas y entrevistas con usuarias de las PAE y farmacistas y proveedores de salud participantes. Los colaboradores en este proyecto anticipan que habrá interés en replicar este método de aumentar el acceso a las PAE y reducir los embarazos no deseados en otros estados. Actualmente, 18 estados permiten que los farmacistas den recetas, aunque el nivel de autoridad varía mucho de estado a estado.
|
|
For Immediate
Release: CAMPAIGN EDUCATES PUBLIC ABOUT EMERGENCY CONTRACEPTION Washington, D.C.-A non-profit
group called the Reproductive Health Technologies Project
is launching a year-long media campaign this summer to educate women
about Emergency Contraception. Emergency Contraception
can prevent pregnancy after unprotected sexual intercourse.
Emergency contraceptives include emergency contraceptive pills, minipills,
and the copper-T IUD. Each requires a prescription from a health care
provider, and each is at least 75 percent effective at preventing pregnancy.
Every night in the United
States, about 10 million couples at risk of unintended pregnancy
have intercourse; among these, about 36,000 experience a condom break
or slip, and more than 700,000 do not use any protection at all. "There are more than
3.5 million unintended pregnancies reported each year in the United
States. Half of these are the result of contraceptive failure,"
said Marie Bass, project director, Reproductive Health Technologies
Project. "This campaign is meant to inform women that they have
another contraceptive option after sex." Recently, Emergency Contraception has received a great deal of media attention, due mainly to an FDA notice published in the Federal Register. The FDA announced its support for Emergency Contraceptive Pills (ECPs), calling the drugs, "safe and effective" for use as 'after the fact' birth control. ECPs were also featured on a recent episode of the television show ER. "It's amazing that
Emergency Contraception has been available in the United States for
more than 20 years, but only one percent of women of reproductive age
have ever used it," said James Trussell, director, Office of Population
Research, Princeton University. "By making women aware of this
contraceptive alternative we can literally prevent millions of unintended
pregnancies each year." The campaign is nationwide,
with a special emphasis being applied to five target markets: Seattle,
Los Angeles, San Diego, Chicago and Miami. The Emergency Contraception
campaign consists of television public service announcements
(PSAs), radio PSAs, print PSAs, and a variety of outdoor
media PSAs. There will also be extensive community and university
outreach components for each market, with additional support provided
by key partnerships with local community organizations and networks
of health care providers. For more information, women can call the Emergency Contraception Hotline at 1-888-NOT-2-LATE and the Emergency Contraception Website can be found at http://opr.princeton.edu/ec/. |
Información
General | Información
por País | Consorcio Internacional EC. |
Noticias
Boletín |
Biblioteca |
Otros Sitios de
Interés | Inicio | Mapa
| Ayuda | Email
New morning-after pill has less
side effects 