Leading Article: A welcome new option for women

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The Independent Online
A NEW contraceptive, Norplant, arrives in Britain later this year trailing clouds of controversy from the United States. The method itself is not controversial. It involves a simple subcutaneous implant of capsules containing a hormone that has been widely used in contraceptive pills for 20 years. The capsules release the hormone gradually over five years, providing more effective contraception than the Pill, with the added advantage that there is no danger of forgetting to take it.

Removal is also simple, restoring fertility within 24 hours. As an improvement on the Pill this implant is good news. It has been licensed for use in Britain on prescription with the recommendation that it be used only by women between 18 and 40 - surprisingly, not for the younger age group that might benefit most.

The controversy it has aroused in the US is mainly the result of some state

authorities requiring mothers to accept the implant under threat of having their welfare payments cut. There has also been a case of a judge who threatened to impose a stiffer sentence on a mother unless she had the implant. The woman had been convicted of abusing her child. In other words, some authorities have latched on to Norplant in the hope that they can save money on welfare and cut down on crime by coercing poorer mothers into using it.

Could it happen here? Given the growing pressure on welfare costs it is possible to imagine some local authorities urging young mothers on welfare to use the method, and perhaps threatening to become less helpful in providing housing for those who refuse: 'Have another baby and you won't get any more space'. But there is little scope in the present system for any serious or formal discrimination against women who do not practise birth control. Nor is there any difference in principle between Norplant and other methods. The decision seems likely to remain with doctors and patients.

The danger in Britain is not so much that mothers will be coerced into accepting Norplant as that it will be taken off the NHS list for being too expensive. The British price has not yet been decided but the current US price of about pounds 230 would make it more costly than contraceptive pills over five years. To exclude it would, however, be a false economy. The cost to the state of unwanted pregnancies vastly exceeds the likely additional cost of Norplant. If Norplant is more effective than other methods it will more than pay for itself by cutting down the number of abortions and unwanted children in care.

Another possible danger is that the convenience of Norplant will make people more careless about HIV. It cannot replace condoms for protection against infection. Doctors, teachers and health workers must continue spreading that message, and the government must continue funding sex education in the broadest sense. That apart, any safe method of birth control that widens the choices available to women must be welcomed.

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