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There have been some improvements in U.S. contraceptive options, but they have been incremental rather than revolutionary. Manufacturers of the Pill have developed low-dose versions that avoid most of the side effects associated with earlier varieties. IUDs have improved greatly in the past decade and are now about as safe and effective as the Pill. And owing largely to the fear of AIDS, the condom, which dates back to the age of the Pharaohs, has come out from behind the pharmacists' counters and is now prominently displayed at stores across the U.S. in various colors, shapes and sizes.
Even the Food and Drug Administration-sanctioned Norplant -- the long- lasting hormone implant hailed as the first new contraceptive device approved for use in the U.S. in three decades -- is really a repackaging of the same chemical used in the Pill. Norplant is housed in matchstick-size tubes and inserted under the skin of a woman's arm. Its main advantage is that it does not depend on someone's remembering to take it every day. But it can cause irregular bleeding, and its cost (up to $1,000) puts it out of the price range of many who need it.
In Europe sexually active couples can choose from a wide selection of contraceptive approaches that includes more than two dozen different kinds of pills, monthly and bimonthly contraceptive injections, and an IUD that boosts its effectiveness with the slow release of hormones. The big news this summer is Britain's decision to become the second country -- after France -- to approve the sale of RU-486, the controversial postcoital contraceptive.
Carl Djerassi, the Stanford chemist who helped develop the original Pill in the early 1950s, calls RU-486 "the single most important new development in contraception of the past two decades." Reason: it gives women, for the first time, a relatively safe way to avoid pregnancy after they have had unprotected intercourse -- thus fully removing the decision to exercise birth control from the decision to have sex. Basically, RU-486 is a menses inducer. Used in conjunction with a prostaglandin, it brings on a woman's period whether or not she is pregnant. Although there has been one death associated with its use ; (triggered by an allergic reaction to the prostaglandin), it is considered fairly safe. Several states, including conservative New Hampshire, are lining up to become test sites to speed its adoption in the U.S.
That is not likely to happen soon. Right-to-life groups have made opposition to the "French death pill" a rallying cry and have vowed to boycott not just it but all products made by any drug company that dares distribute it in the U.S. They argue that the notion of postcoital birth control is just abortion by another name; in addition, they are not enamored of the idea of separating sex from its consequences. "The problem is not that contraceptives are not available; the problem is that many people are not behaving responsibly," says Allan Carlson, president of the traditionalist Rockford Institute.