contraception

Note to Central Illinois Readers: Kate Clancy's Researching Hormonal Contraception Use in the U.S., You Can Help

Professor Kate Clancy, who's doing research about attitudes towards hormonal contraceptives in the U.S., is looking for focus-group participants in central Illinois.

Women in the United States use hormonal contraceptives more than any other nation in the world. Doctors and patients in other countries report a hesitance to prescribe hormonal contraceptives for off-label use (to improve the skin, or regulate the cycle) where most pharmaceutical advertisements in the US celebrate exactly those uses.

Why do women in the US use hormonal contraceptives more frequently? How did you and your doctor decide that this prescription was right for you?

If you live in or near Champaign-Urbana, we would like to have you come participate in a focus group on exactly this topic! We would like to validate a survey that will be used online, but also get freeform responses from real women about their real experiences.

Source: Context and variation

I think this is a great idea!

What I was taught by sex educators, who often still remembered when The Pill first came out, was assumed (probably with justification) that it was easier for conservative parents to accept hormonal contraception for their daughters when the "official" reason was to moderate acne or even out periods.  Same for some more progressive but still-traditional Catholic healthcare providers.  And so that was the line a lot of us learned and were encouraged to pass along back in the day.

But!

That's an awful long time to let an assumption like that go unchallenged.  Which is why I think it's a very good idea to stop assuming and actually inquire.

Details of the study including contact information can be found by following this link.


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Moderate, Independent Voters Likely Unimpressed by Republican Culture War Against Women, Contraception, Climate

Photo of Bamiyan Buddas destroyed by the Taliban from TurkicPress.com. Cached as a bandwidth-conserving courtesy
Photo of Bamiyan Buddas destroyed by the Taliban from TurkicPress.com.

Via Daily Kos Alexander Burns says

The Center for American Progress Action Fund and Planned Parenthood Action Fund will argue at a briefing this morning that Republicans are "pushing an extreme ideological agenda" on social issues that’s likely to alienate female swing voters at the start of the 2012 cycle. In a memo that will be shared with reporters, the Planned Parenthood Action Fund takes aim at several specific bills – backed by GOP Reps. Chris Smith of New Jersey, Mike Pence of Indiana and Joe Pitts of Pennsylvania – that aim to restrict federal funding for abortion services and groups that provide them, including Planned Parenthood. From the memo: "House leadership is already risking a political backlash ... [T]hey have introduced a number of anti-women’s health bills that will alienate a key voting demographic, independent women voters.... they risk being out of step with the American public by pushing an extreme ideological agenda that takes away women’s health benefits and rights, instead of focusing on jobs and the economy."

Source: The very-poorly permalinked Politico Morningscore for 2/2/2011

I'd just add that another rather useful component of that backlash might be the just how little money all this ideology-driven women-bashing, hippie-punching, windmill-defunding, polar-bear-killing will actually save from the federal budget.

All cuts they're talking about will save on the order of only dozens of millions of dollars. Not the billions the wingers and maybe too many normal conservatives and moderates imagine. Let alone the trillions one would actually need to cut if Republicans were serious about deficits. Which of course they're not. Nor have they ever been.

Now. Will teahaddists and other extremists be taken aback by relatively minuscule amount of money the Federal government actually spends on protecting women, or children, or the environment, or promoting conservation or climate protection from what... well... men like Chris Smith or Mike Pence or Joe Pitts evidently want to be able to do to them? No, because for the most part teahaddists and their allies also want the same things.

But centrist, moderate, independent, and swing voters, as well as the majority of ordinary conservatives who aren't as... singleminded about culture warfare aren't going to like it.


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Know Any Pro-Choice Activists Who'd Prefer Abortion to Contraception? DIdn't think so.

Amanda Marcotte says

I know I sound like a broken record on this, but it’s important never to forget that anti-abortion activists also object to the means to prevent unintended pregnancy, and hence the need for abortion, and are better understood as forced-pregnancy activists than anti-abortion in any meaningful sense.

Source: RHRealityCheck.org

Yup.  Raise a hand if you know anyone on the pro-choice side who prefers abortion to unplanned, unwanted pregnancy.  The main activists on the anti-choice side tend to be anti-choice as opposed to merely anti-abortion, productive ways of preventing unplanned, unwanted pregnancies have never been much of a priority for them.

(And yes, I still think the pro-choice side could do more to drive a reasonableness wedge between the genuinely anti-choice hard core and the vast majority of folks who are uncomfortable with abortion but totally fine about contraception and sex ed.)


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One of These Things Is Not Like the Other: Candada Has Fewer Restrictions on Abortion Yet Also Fewer Late-Term Abortions

Scott Lemieux, piling on to his colleague Pema Levy's "excellent response to William Saletan" on whether we should restrict late-term abortion in order to protect what he seems to think are, I dunno, more "legitimate" ones says

In Canada, late-term abortions are not legally restricted, and Canada also doesn't have the other kinds of restrictions found in many American states and doesn't exclude abortion from guarantees of health care. As far as I can tell, there's no evidence that Canadian women get late-term abortions at significantly higher rates (and historically overall abortion rates in Canada have actually been lower). Essentially, absent evidence to the contrary, I think the presumption in favor of a woman's decision-making capacity is justified, and further restrictions are likely to do more harm than good.

Source: TAPPED

Levy and Lemieux both note that, gee, maybe the reason for Saletan's hand-wringy concern that many women seeking 2nd- and 3rd-trimester abortions waited so long, compared to our generally demographically similar Canadian cousins, might be that getting an abortion in the U.S. is already pretty frickin' hard.  So Saletan's right on one count:

Contraception or abstinence is best, emergency contraception is next best, early abortion is next best, and we should make these options more accessible, not less.

Source: Slate.com

What he doesn't add, of course, is that by and large the same core group of extremists who go around cooking up the most egregiously intrusive restrictions on abortion are the same ones who also are most bitterly opposed to any and all forms of contraception as well.  So as far as they're concerned making it as hard to avoid unplanned, unwanted pregnancies as it is to terminate them is a win-win situation.

For that reason I wish Saletan would spend more of his time really digging into that and less time hand-wringing about "circumstances," as if those circumstances weren't the result of calculated political activism.  He's a professional, well-inside-the-mainstream journalist so he knows all the parties involved, he knows the history, and I think he's really, genuinely committed to reproductive rights.  I just disagree with his tactics of "maybe if we stop the lastest of late-term abortions they'll stop agitating to restrict condom sales."  Good faith efforts work only with those who are acting in good faith.


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Will Anti-Choice Activists Be as Frantic About Hormonal Contraception for Men? We Might (Finally) Find Out Soon

Speaking of emergency contraception, and the tendency to blame women for using it, and the tendency to blame women, for that matter, for just about any choice they make regarding their reproductive choices and/or opportunities, and especially for anti-choicers to blame them for all of the above because they're convinced that hormonal contraception is really a closet abortion conspiracy, Jenna of My Sex Professor brings a little potentially welcome news

Many men are disappointed with their lack of contraception options: between the barrier method and vasectomy lie few other choices. A new method (RISUG) is being tested, which entail a one-time reversible injection that prevents sperm from penetrating the egg. The procedure would take five minutes and be effective for at least ten years

Source: My Sex Professor

While for years we've heard stories about how male contraceptives are just around the corner, and are thus justified in feeling a little wary, it's worth pointing out that at least the stories are coming closer and closer together.  And this one actually sounds fairly promising!

It's great news, obviously, for at least the following reasons

1) There really aren't a lot of contraception options available for men.  Worse, of the three available -- condoms, vasectomy, and withdrawal, the most recently developed, vasectomies, were introduced nearly 200 years ago! Since then?  Nothing.  And say what you will about condoms (I say they're pretty good at preventing disease and pregnancy if they don't break and if you use them correctly) they're kind of hard to use correctly until you've really gotten the hand of it, by which point... but I digress.  What I was going to say is this sounds promising because it would be really, really nice to have something intermediate to the permanence of vasectomies and the uncertainties of condoms

2) The introduction of reliable, realistic, reversible and hard to screw up contraception for men will change the blame-women-first-and-always dynamic.  Because once solutions become available for men there won't be that sort of shoulder-shrugging "what can ya do, man" resignation men who fuck up are able to rely on from their peers.  Because, in part, the obvious answer to "what can ya do, man" would then be "what you can do, asshole, is get a shot once every ten years.  You're not getting any sympathy from us."  So that's a big deal.

3) When it comes to the situations where emergency contraception is most likely used (condom breaking, or not using a condom for first-time sex after a long drought, or when functionally incapacitated by drugs or alcohol) the odds of neither party being on some form of contraception can be way lower.

4) Taking items 1-3, above, into account, the focus of responsibility for contraception can shift away from 100% women to more like 50/50 men and women.  (If the product Jenna mentions is as effective and non-intrusive as promised responsibility could shift further onto men.  Although, obviously, an easily used saliva- or semen-based test to quickly confirm effectiveness would be welcome as well.)

But then there's

5) The beauty of the proposed method is that by robbing sperm of the ability to merge with eggs it'll make "conception" impossible! Which ought to shut the ugly pie holes of the "contraception is really abortion" covens.

And, if I can put on my speculative psychopathology-of-the-anti-choice crowd had for a moment, it could even be that...

6) If contraception happens inside men's bodies the anti-choice crowd won't actually care.  Or at least if they do they'll have to start basically from scratch.  And while yes, as a matter of fact it would be better if the anti-choicers were really anti-choice and not just anti-women-as-autonomous-agents, as most evidence suggests. But even then...

7) If the anti-choicers did turn on men and start running the same ill-willed intrusions at least it would put men squarely on the front lines  with women, as opposed to the status quo where most men have basically been confined at best to the sidelines.


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The Story Behind the Story Behind the 20% of Brit Women Use EC Story... Plus an EC Product Packaging Suggestion

Ever notice how sometimes the deeper one digs the more interesting some news tidbits become?

In a news-roundup post, Beth Saunders of RHRealityCheck.org passes along with insufficient comment a tidbit from an anti-choice website that...

Twenty percent of British women used emergency contraception in the past year, according to a survey by the Co-Operative Pharmacy.

Source: RHRealityCheck.org

If you go to the site itself (LifeSiteNews) you get a little more background... but obviously you also get more anti-choice slant (emphasis mine)

A Co-Operative Pharmacy survey of 3000 people found that 20 percent of women aged 18 to 35 took the “emergency contraceptive” pill last year. The same group said they had typically used the drug, which only acts as a genuine contraceptive in some cases, when they had had sex after using drugs and/or alcohol.

The poll further found that up to 250,000 women had used the drug two or more times during the year. One in fifty 18-21 year-olds said they used the MAP as their normal form of contraception. One sixth of the women surveyed said they had contracted a sexually transmitted disease.

Source: LifeSiteNews

And if you go to the actual Co-Operative Pharmacy press release you get the same core information minus (shock, gasp, surprise!) mention of "only acts as a genuine contraceptive in some cases."  Which is good because, of course, that would be factually incorrect.  Here's the straight story from the source.

Thousands of women risk waking up on New Years Day with more than a hangover as over one in five blame partying with drink or drugs for not using contraception with a new partner, figures* reveal today (1 January 2011).

The Co-operative Pharmacy, part of The Co-operative Group, questioned 3,000 people about contraception and found that one in five women aged 18 to 35 years old have used the morning after pill in the last 12 months. One in six women admitted to having had a sexual disease.

The research also revealed that the preferred method of contraception for almost half of all women was the pill and two out of five favoured condoms. 250,000** women have used the emergency contraceptive three times or more and more than one in 50 of those aged 18 to 21 said they preferred to use the morning after pill as a regular form of contraception.

Source Co-Operative Pharmacy

I don't feel qualified to comment on on-the-ground experiences (feel free to chime if you know otherwise) but it sounds like most pharmacists don't agree that EC is all that great on one's system.  From the Co-Operative press release:

Mandeep Mudhar, Head of NHS Development at The Co-operative Pharmacy, said: “Our research shows that some women are taking unnecessary risks with their health. The morning after pill should be a last resort to prevent an unwanted pregnancy after having unprotected sex or if another method of contraception has failed, such as if you have forgotten to take one of your contraceptive pills.

“However, the emergency contraceptive pill does not protect against sexually transmitted infections. Pharmacists provide free accessible advice about contraception but we would always urge people to use a condom, particularly with a new partner, as it offers the greatest protection.”

That sounds about right.  I'd just add, though, that the key word above would be "particularly with a new partner."

Few young single people have "Jersey Shore" style lifestyles where they're prepared at every moment to be ready to fall into bed with someone new.  Instead, most young single people, women as much as men, tend to go through sexual "boom and bust" relationships.  And for people for whom hormonal contraception is an option (obviously only women so far, darn it) it often doesn't feel worth the hassle and often the discomfort of staying on a medication you may expect to need only a few times a year.

To that extent that most women who report using emergency contraception as their "primary contraceptive" are almost all still using it only once a year we're not necessarily talking about a giant epidemic of "irresponsibility" here.  Nor, I would add, does that suggest epidemics of "promiscuity" either.  Unless by promiscuity you mean "once last year."

The EC/STI connection is a little more problematic.  First of the STI question seems to have been about lifetime experience with STIs whereas the rest of the survey reports about annual experience with contraception.  I mention this only to tidy up the numbers, not to minimize the actual risk.  Second, by focusing on the EC angle the story almost necessarily underplays the story of very large numbers of people using no protection for first-time sex.

Proposal: I know it sounds counterintuitive but I think it occurs to  me it might be a very good idea to encourage manufacturers and/or pharmacists to include a condom in every package of EC.  It's counterintuitive because one tends to view EC as something you take after the fact.  And indeed it is.

EC is not, however, always purchased after the fact.  I expect it's a lot easier to remember that if you've already Backed Up Your Birth Control it might be easier to remember you've also got at least one backup condom.  And even if not?  Well, you've still got a condom for next time.  Even if, as those survey numbers suggest, next time also happens to be next year.  And one way or other, knowing there's a condom in the box "puts the idea into consciousness" as the new-agers say.

Extra credit if the condoms have the retro-20th-Century "for prevention of disease only" motif!


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If Abortion is Murder Then Do You Think Anyone Believes Blowjobs are Cannibalism?

Via Jennifer of Libido Events

From Jennifer at LibidoEvents.com Cached as a bandwidth-conserving courtesy
Image via Jennifer at Libido Events, source unknown.

Source: Libido Events

It sounds whacky but for the every-sperm-is-sacred, conception-begins-with-ejaculation bunch it sort of makes sense.

I don’t think it actually stops very many of them from demanding, or even delivering blowjobs. (Heck, for that matter it doesn’t stop that many of them from having abortions!)


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George W. Bush's Mom, Dad (George H.W. "Rubbers" Bush), and Grandparents Have Always Strongly Supported Reproductive Choice

Jodi Jacobson of RHRealityCheck.org pulls together some fairly binding evidence that George W. Bush wouldn’t know the truth if it bit him on the ass the staunchly Republican Bush family has always been strongly pro-choice.

The Bush family has a long history of support for Planned Parenthood.  Prescott Bush, father of George H. W. Bush (Bush 1) and grandfather of Bush 2 was the treasurer of Planned Parenthood when it launched its first national fundraising campaign in 1947. Birth control being controversial in the period pre- Griswold v. Connecticut (and yes, history obviously repeats itself), Prescott Bush was attacked for his pro-choice position and knocked out of the running for a Senate seat in Connecticut.

Writing at SFGate.com in 2005, Vicki Haddock recounts the history:

Prescott Bush won a Senate seat two years later, and his son George and daughter-in-law Barbara continued to support Planned Parenthood even after George’s election to Congress from Texas.

“In fact,” writes Haddock, “he was such an advocate for family planning that some House colleagues gave him the nickname “Rubbers.”“ 

Source: RHRealityCheck.org.

That sounds about right. It’s still very possible that when presented with a jar containing the remains of his mother’s miscarriages he decided to become anti-abortion. But it’s not likely that then or now his mother has ever opposed choice, and there’s no reason to believe at all that she intended for her son to oppose it.

That shouldn’t even be controversial! Not all that long ago Republicans were at least as likely as Democrats to support family planning. And of course somewhere between many and most Republicans, like most Americans, period, still do. It’s just now political suicide rather than a minor setback for them to admit it.


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UK Researchers Looking for Pregnancy-Test Style On the Spot Detection of Sexually Transmitted Diseases

Speaking of the intersection of technology, STIs, contraception,

Jennifer Welsh of Discover Magazine’s Discoblog says UK researchers are working on inexpensive, disposable pee-on-a-stick type tests for sexually transmitted diseases. She says they’d be used in combination with cell phones (presumably to transmit results for analysis?)

Diagnostic sticks for chlamydia, gonorrhea, and herpes are estimated to cost a little over a dollar, and could be sold in pharmacies and vending machines in night clubs. A worried person would take the test by peeing or spitting on the computer chip-enabled diagnostic stick, connecting it to their phone or computer, and would get the results in minutes. (This microfluidic device sounds similar to other “lab-on-a-chip” devices under development.) The mobile or computer app could also recommend doctors.

Source: Discover Blogs

This is pretty cool. As with a lot of immediate-situation testing the key will be the rate of false negatives — situations where the test fails to detect existing disease. False positive STI tests are obviously annoying but nowhere as consequential(!!!) in the long run.

Along the same lines, as I’ve mentioned elsewhere, when hormonal contraception for men becomes available I think it would be very good if on-the-spot confirmation of effectiveness was available as well. It would be very nice if the proposed pee-on-a-stick sort of testing for STIs can be extended to include that.


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Rabbit White on the History and Future of Condoms

Rabbit Write has a great writeup of the history and future of condoms. She covers the bases very nicely — everything from the way otherwise different ads for condoms have different copy text in different magazines (Playboy vs. Ms for instance) to changes in the arguments moralizers have used to oppose them.

If you’re at all interested you should just go read the whole thing. I would like to put some emphasis on one element of her post, though.

What makes the condom different from other methods of contraception is that it’s both birth control and disease prevention. You can’t separate them, and it’s historically made condoms easy to demonize, they were associated with prostitutes, promiscuity.

...

There was this bio physiologist, maybe 25 years ago, who decided to change the nature of his research do something to help women. This was at his daughters death bed, something very dramatic like that. He began to develop a product that did birth control and disease prevention. But he couldn’t get funding for it. The birth control people said “we don’t know anything about disease prevention” and the disease prevention people said, “well we don’t have any interest in birth control.”

Source: Rabbit Write.

It’s true that while virtually everyone needs to worry about sexually transmitted diseases not everyone has to worry about pregnancy. And even for heterosexuals there are plenty of ways to have sex that don’t risk pregnancy but do risk STI transmission. But with the world population approaching 7,000,000,000 people it’s a good idea to continue (start?) looking for more solutions that reduce the risk for both STIs and pregnancy.


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