Health & Fitness: Birth Control: Vanishing Options

Lawsuits and other safety concerns mean new worries in bed

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Rhonda Issler chose the Pill as her first contraceptive when she was a young adult in the early 1970s. But after five years, news of the Pill's potentially harmful side effects made her switch to an intrauterine device. Soon after, she suffered severe menstrual cramps and a pelvic infection. Issler eventually turned to the diaphragm, but she found its use messy and inhibiting. Now 33 and living in North Hollywood, Calif., the working mother of one relies uneasily on a combination of the rhythm method and the condom. "Birth control is a very important decision, but also a very frustrating one," she says. "The options are so limited."

Issler's lament is a far cry from the sexually liberated pronouncements of the 1960s. "The U.S. is going through a counterrevolution," says Richard Lincoln of New York City's Alan Guttmacher Institute. "We're moving backwards." Reason for the retreat: consumers' health worries and manufacturers' concerns about spiraling liability claims. Last January the IUD was nearly eliminated from the American market when G.D. Searle discontinued the Copper-7 and the Tatum-T. Defending just four Copper-7 liability suits cost the firm $1.5 million in legal fees, even though it won the cases. Sales of the Copper-7 amounted to only $11 million in 1985. A.H. Robins, the marketer of the Dalkon Shield, fared worse. After 9,450 lawsuits that cost $490 million, the pharmaceutical company still faces 6,000 legal claims and last year sought bankruptcy protections.

Loss of the Copper-7 has upset many family-planning experts. "In the past, inferior products have been pulled off the market," notes Dr. Louise Tyrer of Planned Parenthood. "Now superior products are being abandoned because of high insurance costs." The IUD has a failure rate of only 5% in the first year of use, she points out, in contrast to 19% for the diaphragm, l7% to 24% for sponges, 18% for spermicidal foams and jellies and 10% for condoms. But, observes Dr. Bruce Stadel of the National Institutes of Health, "a pharmaceutical company would have to be altruistic to the point of suicidal to market an IUD today."

A similar sentiment may soon apply to the manufacturers of spermicides. Earlier this year, a jury awarded $4.7 million in damages to a woman who claimed that her child's birth defects resulted from her use of Ortho-Gynol jelly. Most scientists have found the product safe, and the company, which is appealing, insists it has no plans to remove its foams and gels from the market. But, says Ortho's James Murray, "if the costs of litigation begin to exceed earnings, we couldn't very well continue."

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