Tuesday, 11 November 2008

The Scottish Government wants women to use more Long Term Contraceptives.

Women using contraception will be asked to try alternatives to the pill under plans to cut the number of unwanted pregnancies in Scotland.

The government will run a campaign next spring to highlight longer-lasting and more reliable forms of contraception.

Under the strategy, women are to be offered coils, implants and injections. BBC News: 10/11/09

The Scottish government announced yesterday that they will be running a campaign to persuade more women to use longer lasting forms of contraception in order to reduce the number of unwanted pregnancies- or, more importantly it seems, given its repeated highlighting in the various news items, abortions of which there were 13,000 in 2007. And the ages of the women with the highest rate of abortion? 16-19. It will be suggested to women between 18 and 40 who are already on the Pill. Does anyone else see a problem with trying to reduce abortions by not targeting the women most likely to be having abortions? And that doesn't help at all with the 300+ girls below the age of 16 having abortions. I hope (I'd like to say assume but I'm not that optimistic) that along side this initiative there will be another targeting younger people (note the people here- it takes two to fertilize an ovum).

The options that will be suggested:

Long-term contraceptives which could be encouraged include Depo Provera, a hormone injection which lasts for three months, and Implanon, a small rod inserted under the skin in the arm which releases a hormone over three years.

Another option which can last for up to five years is Mirena, a small T-shaped implant which is inserted into the womb and releases a hormone.The Daily Record: 10/11/09

Interestingly only The Herald seems to mention that there have been critics of the scheme, although only in regards to suggesting older women should go on it because of the extended reduced fertility that these options have for women even after they stop having the injections/being implanted/having strange objects lodged inside them. Confusingly, the Herald's article also states that "This latest bid to improve sexual health will focus on improving safe sex, particularly among gay and bisexual men, and the first stage of the campaign next spring will tackle the taboo that still surrounds discussions about sexual health and habits." which makes very little sense since nowhere else in either this article or the other newspapers are social groups other than women of childbearing age even mentioned. Is this rolling out of contraceptive advice just part of a wider scheme? I tried to find something on the Scottish Government's website but my searches produced nothing.

What struck me about this scheme regarding contraception is how biased it is towards women being the sole person responsible for contraception. There's no mention of educating men to wear condoms so as to not accidentally knock up the woman they're sleeping with. No! Because, as we are all fully aware, men don't need to take responsibility for what happens to their sperm- sperm? what's that got to do with pregnancy- it's just the stupid, forgetful, possibly slutty, women who are the only ones that should be thinking about these things. FTBS.

Also, looking up the options being suggested (on Wikipedia, I know, really should find better research sources) reveals problems all of their very own.

Depo Provera can reduce fertility for up to 18 months after the last injection was given. The longer you are on Depo-Provera the more likely you are to suffer from bone density loss which can lead to osteoporosis. It is unknown whether this loss is irreversible. In the states the FDA recommends that women should not be on Depo-Provera for more than two years. Which is a lot of good for women who go on it at the age of 18. Furthermore, based on what I have heard from family members, Doctors do not always seem to be aware of this side effect leading to women who are at risk from loss of bone density- in this case due to an intolerance for dairy- to have been onDepo-Provera for over five years, only becoming aware of the bone density problem when researching for themselves. Are the government going to ensure that the doctors prescribing this medication are aware of the side effects and take it into account?

Implanon has, as a problem, the fact that, if implanted by an inexperienced clinician, nerve damage can occur and also, if misplaced, it doesn't work. If it breaks it can be hard to remove and scar tissue forming around it can also cause problems. Although, other than that, there doesn't seem to be any major problems (besides the normal types of side effects: fucked up periods, migranes, increased anxiety etc). Fertility returns quickly after it has been removed and it can be removed at any time. However, the Wiki page seems quite slight and the information leaflet provided has lots of "It is not known" which indicates that more research may still be needed. The leaflet also mentions that it can cause cysts on the ovaries that may require surgery. Fun.

Mirena "can only be fitted by a qualified medical practitioner" as it is going into the womb and we don't want any yucky bacteria or accidents when playing in there. The cervix needs to be dilated in order to have the IntraUterine System installed... installed sounds like an unfortunate word choice but can't think of the correct one... which in itself is often painful for women. Whether you get a local anesthetic or even just a couple of pain pills is, from the sounds of things, pot luck. It is also possible that this method does not actually prevent conception but rather prevents the fertilised egg from implanting so, if you beleive life begins at conception O_o then this may not be for you either. According to Wiki however noone knows how this bloody contraption works, just that it does. As for fertility, it can be left in for five years and after one year 80% of women are fertile again. It doesn't say what happens to the other 20%. There is also a rare but "potentially" dangerous risk of perforation of the uterine wall and damage to the other internal organs. Oh, and it's not a hundred percent, and if you get pregnant while it is still in there it can cause you to have a miscarriage.

Of course none of these methods (nor the Pill) prevents STDs (or STIs as they appear to be calling them these days). The fact that 300+ under 16s managed to have abortions in 2007 indicates that under 16 are having unprotected sex. Same with all the other age groups. So, surely, promoting condom use would be more useful than having women inject, implant or undergo minor surgery at the risk of their long term health?

And, you know what, with men being the group with the highest incidents of STDs/STIs, promoting condoms and MUTUAL responsibility for contraception might actually do the menfolks some good too.

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