Medicine: Doubts About lUDs

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Of the various contraceptives available in the U.S. today, few have stirred more debate than the intrauterine device (IUD), which is now used by anywhere from 3 to 5 million American women. Developers of lUDs claim that the loops, coils and other designs are safe and effective. Opponents claim that they are neither. Last week actions by government agencies supported both sides of the argument.

The Department of Health, Education and Welfare ordered more than 3,000 federally funded family planning clinics to stop prescribing a device called the Dalkon Shield, which is used by more than 2 million women. HEW also asked private physicians not to recommend it until doubts about the safety and effectiveness of the Dalkon Shield can be resolved. One recent study showed an unusually high 10% pregnancy rate among women using the Dalkon Shield (the rate for other IUDs is about 3%). More seriously, other findings indicate that pregnancy resulting from the Dalkon Shield's failure can be perilous. The manufacturer, A.H. Robins Co., has reported that more than 100 women, who became pregnant even though they used the device, developed uterine infections; seven of the women died from the infections.

HEW has stopped short of urging present Dalkon users to switch to another method of contraception immediately. But it is unlikely that physicians will prescribe Dalkon Shields for a while. Yielding to the request of the U.S. Food and Drug Administration, the manufacturer has agreed to take the device off the market.

Meanwhile, the U.S. Public Health Service's Center for Disease Control in Atlanta gave most IUDs a stamp of at least limited approval. A CDC study conducted last year found lUD-related mortality (roughly 20 per million users per year) no higher than that from birth control pills, which can cause blood-clotting problems in some women. For that matter, both IUDs and pills are less risky than pregnancy itself.