Shot in the arm for birth control

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The Independent Online
A CONTRACEPTIVE implant which works for up to five years will become available in Britain this autumn. Its use in the United States has caused controversy, with claims that it is targeted at an 'underclass' of teenage mothers and the poor from ethnic minorities.

Norplant, the most reliable contraceptive method to date, is also reversible within 24 hours of removal. Family planning experts said it is 'probably the perfect method of contraception' for young women. It will be available only on prescription, from family planning clinics and GPs who perform minor surgery.

But in America, where the implant has been available since 1990 and is used by 600,000 women, it is fast becoming a civil rights issue. Some judges appear to be adopting its use as a part of punishment for women who abuse their children. High schools in Los Angeles and Baltimore provide it for pupils.

Although Britain has one of the highest rates of young, single mothers in Europe, experts are confident that Norplant will not attract the same controversy. The Family Planning Association said: 'It will be very sad if women are put off it because of this. There are very different attitudes here, and it is an issue of consent.'

Ann Furedi, of the Birth Control Trust, said a more pressing issue was whether Norplant would be available on the NHS. The Government is expected to ban some more expensive contraceptives this year. No price has been set by Roussel, the company behind its launch, but it costs about dollars 350 ( pounds 230) in the US.

Norplant is placed under the skin of the upper arm where it cannot be seen, although it can be felt. It consists of six rubber capsules 34mm long and 2.4 mm wide, containing the hormone levonorgestrel, used in brands of the Pill for more than 20 years. (Norplant is unlikely to be suitable for older women who have stopped the Pill for medical reasons.)

A steady amount of hormone is released into the bloodstream each day. Insertion is carried out under local anaesthetic, with the capsules placed in a fan shape through a 2mm incision. The procedure takes less than 15 minutes, and Roussel says it can be done by any trained healthcare professional.

About 55,000 women from 50 countries have taken part in clinical trials since 1975, and it is approved for use 29 countries. Research suggests that in the first two years Norplant is more effective than the Pill and intra-uterine devices, and as effective as sterilisation: the pregnancy rate over five years is 3.9 per 100 users. The most common side effect is irregular bleeding .

Contraception for poor, page 3

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