PIP: This is an outline of the therapeutic uses of RU-486, followed by clarification of the term “contragestion”, and analyses of the theological, legal, and corporate-political issues confronting acceptance of this drug. RU-486 is a computer-designed progesterone antagonist with no known side effects other than those predicted by its endocrinological action. It has been used to terminate pregnancy (with prostaglandin) up to 41 days amenorrhea, and has been shown to terminate pregnancy with fetal demise, to cause luteolysis in the late menstrual cycle, to facilitate management of ectopic...
Each year, an estimated half million women die from complications related to child birth either during pregnancy, delivery or within 42 days afterwards. When pregnant women have complications, their infants are at greater risk of becoming ill, permanently disabled or dying. For every maternal death, there are at least 20 infant deaths: stillbirths, neonatal or postneonatal deaths. Altogether, an estimated 7 million infants each year die perinatally (stillborn or deaths within the first week of life). Low cost, feasible, and effective intervention strategies include: a) improved family...
The idea of making oral contraceptives available without prescription has a long history, and has been recently revived in the US and the UK. High dose oral contraceptives have generally been replaced by low dose formulations and, subsequently, most cardiovascular risks have been reduced and a protection against ovarian and uterine cancers has been consistently demonstrated. Oral contraceptive compliance, however, continues to be a problem, but there is no reason to assume that wise practice would be any more or less if oral contraceptives were available over-the-counter (OTC). Some...
A vaginal microbicide could slow the spread of HIV. To date, volunteers in placebo-controlled trials of candidate microbicides have been counseled to use condoms. This does not reduce the number of volunteers exposed to possible risk, but it shifts the allotment of risk from those conducting the trial to those women who may be least able to make autonomous decisions. Alternative ways of meeting the obligation to offer volunteers active benefits are explored. Counseling the use of condoms prolongs clinical trials and could cause tens of thousands of otherwise avoidable deaths.
The new millennium sees the largest cohort of young people in history entering its fertile years. Many of these people are too poor to pay the full cost of modern contraception, but the money available for subsidizing their needs is exceedingly limited. The AIDS pandemic is placing additional, unprecedented demand on already overstretched resources. Existing methods of contraception that are well established and off-patent can be produced in bulk at low cost, and will remain the backbone of future programmes. The use of misoprostol as an abortifacient is likely to spread rapidly. New...
Women suffered differentially in the tsunami disaster. While the total death toll will never be known accurately, it is known that more women and children died than men. Among the survivors it is the special needs of women that are being overlooked.
Given the rapid growth in the number of young fertile women, it is possible that more women will die from pregnancy, childbirth and abortion in the current decade than in any other in human history. With steps that we know how to take, we should be able now to roll back the silent tide of maternal death.
OBJECTIVE: To validate anecdotal reports that abortion-related complications decreased in the Dominican Republic after the introduction of misoprostol into the country.
DESIGN: Retrospective records reviews and cross-sectional surveys, interviews and focus groups.
SETTING: Family planning clinics, pharmacies, door-to-door canvassing and a tertiary care maternity hospital in Santo Domingo, Dominican Republic.
POPULATION: Women of reproductive age in Santo Domingo, Dominican Republic.
METHODS: Qualitative and quantitative methods were used. Individual interviews...