THE LEDGER-STAR
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Thursday, December 15, 1994 TAG: 9412150652
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY LAURAN NEERGAARD, ASSOCIATED PRESS
DATELINE: WASHINGTON LENGTH: Long : 111 lines
European women whose birth control fails or who just forget in the heat of the moment can simply dash to the pharmacy for a few pills to try to prevent pregnancy.
But few Americans are aware that popular birth control pills can double as ``morning after'' contraception. Now women's health advocates are out to change that, selling ``emergency contraception kits'' and battling for government approval of the method.
``A lot of abortions could be avoided and a lot of unplanned pregnancies could be avoided if people knew to use this method,'' said Dr. June Hodgson, a founder of the American College of Obstetrics and Gynecology.
But the campaign has opened a new political front on the abortion issue.
``Pro-abortionists have tacitly acknowledged that the birth control pill can cause early abortion,'' said Judie Brown of the anti-abortion group American Life League.
Studies show high doses of six brands of birth control pill taken within 72 hours of unprotected intercourse lower a woman's chances of becoming pregnant about 75 percent.
The reason: High levels of the pills' hormone estrogen, or estrogen plus progestin, can prevent a fertilized egg from traveling through the fallopian tubes and attaching to the uterus, proponents explain.
Today, birth control is sold especially as post-coital contraception everywhere from Switzerland to China, but the Food and Drug Administration doesn't allow packaging on pills sold here to mention emergency use.
Now health providers are petitioning the FDA to change that, saying the method could lower the country's 3.5 million annual unintended pregnancies.
``Millions of women are being hurt,'' said Janet Benshoof of the Center for Reproductive Law and Policy, which joined the American Public Health Association, the American Medical Women's Association and Planned Parenthood of New York in the petition.
Estrogen's effect was known here in the 1940s, even before birth control pills themselves debuted in the 1960s. Despite that history and studies dating to 1976, few doctors offer the method, experts say. A survey of 294 doctors, to be published next week, found 90 percent never or rarely mention the method. Only rape victims or college students are likely to be offered the treatment, it found.
The issue is touchy for FDA, which insists it can't force companies to add a controversial use to their drugs' labels, yet acknowledges doctors may dose drugs improperly if that's not done.
``If it's safe and effective, it would be one more alternative for women and so we think it's a use that is worth taking a look at,'' said FDA Deputy Commissioner Mary Pendergast, who began studying emergency contraception earlier this year.
Pendergast urged that a company apply for post-coital contraceptive approval. Manufacturers Wyeth-Ayerst and Berlex Laboratories haven't done so and declined comment, although Wyeth-Ayerst said in a statement that it ``looked forward to'' FDA discussions.
An Atlanta company isn't waiting for the FDA. Bridging the Gap sells ``emergency contraceptive kits'' for doctors to give women who either had unprotected sex or want emergency aid on hand just in case.
The kits say how many pills to take and how, warn that they're for one-time emergencies only and include condoms for the next encounter, said vice president John Stanley. Doctors just add the pills and pass on the packets. Stanley has sold 100,000 kits since spring, 10,000 to Hawaiian officials alone.
And some doctors are lobbying colleagues for the method. It's ``one of America's best-kept secrets,'' Dr. David Grimes of the University of California, San Francisco, told the American College of Obstetrics and Gynecology.
Anti-abortionists vow to fight emergency contraception, saying it's really abortion. An Illinois bishop has ordered Catholic hospitals in his diocese not to offer morning-after pills to rape victims for that reason. MEMO: EMERGENCY CONTRACEPTION
The Food and Drug Administration has not approved birth control pills
for ``morning-after'' use, but medical texts list certain brands as
potential pregnancy blockers after unprotected intercourse. The
following regimen is from ``Contraceptive Technology'' by Dr. Robert
Hatcher of Emory University:
Two Ovral pills taken as soon as possible but no later than 72 hours
after sex, followed by another two pills 12 hours later.
For the following five brands, four pills no later than 72 hours after
intercourse, followed by another four pills 12 hours later: Lo/Ovral,
Nordette, Levlen, and the yellow-colored pills of Triphasil or
Tri-Levlen.
WARNINGS
From ``Contraceptive Technology,'' about the use of birth control
pills after intercourse:
Only one brand should be taken, and no more pills than described
should be taken.
Women who have had breast cancer, stroke, blood clots or any serious
disease such as diabetes or hypertension should see a doctor before
taking any pills.
Women should see a doctor for the following symptoms: severe leg or
abdominal pain; chest pain, cough or shortness of breath; severe
headaches, dizziness, weakness or numbness; vision problems or
jaundice.
Nausea and vomiting are common, but severe cases call for a doctor.
The pills may not work, so women should see a doctor if their periods
don't start within four weeks.
Post-coital pill use is for one-time emergencies only, not regular
contraception.
by CNB