“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

Will St. John’s Wort Affect Birth Control?

Herbal remedies are very popular around the world. Many people prefer them to pharmaceuticals because they believe herbs can elicit positive results without serious side effects. However, plants produce a wide variety of chemicals at varying concentrations, and might have a number of effects on your body, both good and bad. Furthermore, since herbal supplements are not evaluated by the FDA for safety or effectiveness, consumers often don’t have ready access to evidence about herbal products. We can’t even be sure that they contain the ingredients that are listed on the label!


St. John’s wort might decrease the effectiveness of birth control pills, and might be unsafe during pregnancy.


One popular herb is St. John’s wort, or Hypericum perforatum. While the scientific evidence is mixed at best, many people believe that St. John’s wort can be used as an antidepressant. However, people often treat themselves with herbal supplements without guidance from a medical doctor or pharmacist — and without knowing whether or not these herbs are safe to use with any medications they might be taking.

Over the millennia, plants have evolved all sorts of powerful chemicals, such as toxins, to defend themselves against insects and other predators. For this reason, we can’t assume that plants only contain inert chemicals that won’t affect us or interact with the chemicals in other drugs and supplements we use. St. John’s wort, in fact, contains chemicals that interfere with other medications. It has been banned in France, and other countries require or are considering warning labels on St. John’s wort products so consumers can be aware of possible drug interactions. Continue reading

Let’s Talk Contraception: Dispelling Myths About Emergency Contraception

EmergencyContraceptionSince 1998, when the Food and Drug Administration first approved the morning-after pill, there have been controversies about its sale and use. Initially, age restrictions were enforced to regulate its sale, and some hospitals and pharmacies refused to provide it to their patients. After considerable pressure from public and medical groups, emergency contraception (EC) is available for sale to anyone at their local pharmacy, with the exception of ella and the copper IUD, both of which require prescriptions.


Emergency contraception is widely available, easy to use, and safe!


And yet, after almost 20 years of remarkably safe use, there are still myths regarding its safety, actions and use. Let’s look at some of those myths right now!

First, there are misunderstandings regarding EC’s availability:

Myth: EC is hard to get and you need a prescription.

Since 2013, most ECs are available to buy in pharmacies over the counter to anyone, regardless of age or gender. There are two exceptions: If you need ella, another morning-after pill, you do need a prescription, and the copper IUD requires placement by a health care provider.

Myth: There is only one type of EC available.

There are several different pills available, such as Plan B One-Step or generic equivalents. These all contain levonorgestrol, a progesterone hormone that is also in many other contraceptives. Ella contains ulipristal acetate and works effectively and evenly up to five days after unprotected sex. Ella is dispensed with a prescription. The copper IUD also needs a prescription but is the most effective EC when placed within five days of unprotected sex. It is recommended for obese women or women who have had several episodes of unprotected sex, and its contraceptive effect lasts 10 years. Continue reading

Pro-Choice Friday News Rundown

  • cigaretteSome Republicans are trying to circumvent the Affordable Care Act’s mandate for co-pay-free birth control by pushing for over-the-counter availability of the Pill. Even the American Congress of Obstetricians and Gynecologists thinks this is a horrible idea. Its president states, “Unfortunately, instead of improving access, this bill would actually make more women have to pay for their birth control, and for some women, the cost would be prohibitive.” (Care2)
  • Smoking is damaging, hazardous, and deadly enough on its own. Smoking while on the Pill? Not a good idea. If you’re doing this, please stop. (The Root)
  • Arizona congressional tool Trent Franks says all Democrats who refuse to enact legislation to force women to give birth against their will are doomed to have regrets in their golden years. Insert world’s biggest eye roll here. (Right Wing Watch)
  • Students at one Seattle high school can get IUDs inserted for free! (Grist)
  • A harsh 12-week abortion ban in Arkansas has been blocked by the 8th U.S. Circuit Court of Appeals! Considering 12 weeks is well before a fetus is viable outside the womb, it would have been the strictest in the country. (Think Progress)
  • Are “hookup apps” like Tinder and Grindr behind an increase in sexually transmitted infections? (Time)
  • Race-baiting abortion opponents continue to be disingenuous, tone deaf, ignorant, and just plain The Worst. (RH Reality Check)
  • California is cracking the whip on the lying liars at “crisis pregnancy centers” who intentionally deceive women about abortion. Now if only we could get some federal legislation. (HuffPo)
  • Forced vaginal exams on students? Excuse me??? What the hell kind of shenanigans are going on at Valencia College in Florida? (CNN)
  • Five states worked on abortion restrictions over Memorial Day weekend and no one seemed to notice. (Fusion)
  • Wisconsin Gov. Scott Walker is so embarrassingly stupid I can’t even take it. He referred to mandatory ultrasounds for women seeking abortions (some of which are transvaginal) “a cool thing” and said, “We just knew if we signed that law (requiring ultrasounds), if we provided the information, that more people if they saw that unborn child would make a decision to protect and keep the life of that unborn child.” What? Uh, NO. All available evidence shows that these ultrasounds do nothing to change women’s minds when they do not wish to continue a pregnancy. Women aren’t fools who need to physically see something to realize its significance. You can show them all the fetuses in the universe — if they’re confident in their choice not to give birth, it won’t make a difference. Stop forcing images upon women because you think it’s “cool.” It isn’t. (Talking Points Memo)

Let’s Talk Contraception: What Contraception Does Your Doctor Choose?

IUD in hand croppedHave you ever wondered what birth control method your health provider has chosen to use for her contraceptive? Though it is usually not relevant or ethical for your provider to disclose something so personal, you might find it helpful and reassuring to know this information when you are deciding which contraceptive is a good choice for you.


Thanks to the Affordable Care Act, you might not have to worry about footing the bill for an IUD or implant yourself.


New research by Planned Parenthood has some answers to this question. In a recent study published in Contraception, the official journal of the Association of Reproductive Health Professionals and the Society of Family Planning, Planned Parenthood researchers found that women’s health care providers are three-and-a-half times more likely to choose long-acting reversible contraceptives (LARCs) such as IUDs (intrauterine devices) and implants as their contraceptive of choice. Forty-two percent of providers use LARCs, compared to just 12 percent of women in the general population. The birth control pill is used far less often, by only 16 percent of providers surveyed. Earlier studies have also shown these differences, but the Planned Parenthood study shows an increasing trend of women health care providers choosing LARCs.

The Centers for Disease Control and Prevention also conducts surveys and studies to look at contraceptive usage across the general population. Their surveys have shown an upward trend in LARC use — a five-fold increase in the last 10 years. Most of the women using these methods are 25 to 34 years old. But women in general use LARCs far less often than the percentage of health care providers reporting they use LARCs in the Planned Parenthood study. Continue reading

Let’s Talk Contraception: How Effective Is My Birth Control?

According to the Guttmacher Institute, 62 percent of women of child-bearing age (roughly 15 to 44 years of age) currently use a contraceptive method. Most contraceptive users are married and on average would like to have two children. This means that a woman might be using a contraceptive method for more than 30 years.

Studies have calculated that if a sexually active woman is not using any contraceptive method, over the course of a year she has an 85 percent chance of becoming pregnant. Using contraceptives greatly decreases this chance, but there are still some possibilities that her contraceptive method could fail to prevent pregnancy.


To maximize your contraception’s effectiveness, use it as correctly and consistently as possible.


When choosing a contraceptive method, you might want to use the safest and most reliable method available. How likely is it that your choice could fail? With the many types of birth control at your disposal, how do you know which is most effective? And why, with even the most effective contraception around, do women still have unintended pregnancies?

If we rank birth control methods according to most effective to the least effective, how do they compare? How is effectiveness measured?  Continue reading

Contraception in the Zombie Apocalypse

The zombie hoard approaches. Photo: Caio Schiavo

The zombie horde approaches. Photo: Caio Schiavo

If you’ve watched a zombie movie with your friends, you’ve probably talked about what kinds of weapons you’d be packing in case of a zombie apocalypse. The Centers for Disease Control and Prevention even has a list of supplies you’ll need for a zombie preparedness kit, which includes smart choices like water, duct tape, and bleach. (I would add toilet paper to that list. How you’ll miss it when you’re on the run!) But how many of you have discussed birth control?


You’ve probably picked out which weapons to use during the zombie apocalypse. But have you chosen a birth control method?


Even if your greatest dream is to have a baby, you must admit that the zombie apocalypse is the worst time to be pregnant, give birth, and raise a child. Fleeing and hand-to-hand combat can be a drag while pregnant, and childbirth can kill you, especially without access to trained personnel or hygienic supplies. And if you do manage to birth a baby into this cruel new world, diapers can distract from more pressing duties, and the infant’s cries can attract undead attention.

When you’re in hardcore fight-or-flight mode, taking a pill at the same time every day might be difficult, and besides, a supply of pills can take up valuable backpack real estate. Plus, even if you find an abandoned pharmacy to raid, birth control pills and condoms come with expiration dates and can be affected by high temperatures. The same goes for contraceptive patches and rings. For these reasons, you need a contraceptive method that’s well suited to the zombie apocalypse. Besides abstinence, what are your options? Continue reading