Contraception (birth control)

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Teachers Required to Give Students False Information

Monday, August 12th, 2013

In a prime example of why parents must stay informed about their children’s school curriculum, North Carolina governor Pat McCrory signed a bill in July requiring that middle school students must be taught that abortion is a preventable cause of preterm births. Incidentally, this comes after McCrory’s promise not to sign any bills regarding abortion, period. But McCrory did not act alone; 73 state senators agreed that it was okay to give students erroneous information in the classroom.

I realize that this is a hot button issue for many, but let’s focus on the real issue here: middle school teachers required by law to lie to students. Is lie too strong a word? Absolutely not, and here’s why: There is no scientific evidence that abortions cause preterm labor. Let me say that again. There is no scientific evidence to support the idea that abortion causes preterm labor. This seems to be just another thinly disguised attempt to limit women’s ability to make choices for their own lives.

Proponents of the bill point to recent studies that show a limited risk of preterm births following abortions, but these studies and the recommendations made based on them are flawed. For one, they did not distinguish between successful medical abortions and those requiring surgery. In addition, they did not distinguish between induced and spontaneous abortions. Furthermore, legislators ignore the fact that the studies showed no increase at all in preterm births after abortions from 2000 onward, a fact probably contributable to modernized abortion methods.

In fact, David Grimes, a North Carolina professor of obstetrics and gynecology, called the bill “state sponsored ideology,” and pointed out that “the World Health Organization, the CDC, the American College of Obstetrics and Gynecologists, the American Academy of Pediatrics… and the American Public Health Association have all concluded that abortion does not cause prematurity.”

So why would these legislators support this bill? Do they have their own agendas, or do they just not understand the facts? Who knows – just do your part by staying informed, thinking for yourself, and getting your facts from the experts, not the politicians. Have a conversation with your middle school kids about this and other sex education topics. Don’t leave it to the schools.

To close, let me be crystal clear on this. This issue has nothing to do with how anyone may feel about abortion. It has only to do with the integrity of our schools’ curriculum being compromised by untruth. Be the voice of accuracy at home. Teach your kids how to find reliable information. You are free to teach your children about your moral beliefs. But at least tell the truth about the facts so that they are free to develop their own morals and form their own conclusions based in reality, not folklore.

– Yvonne S. Thornton, M. D., M. P. H.

Studies Show Lack of Evidence that IVF Causes Birth Defects

Monday, June 24th, 2013

From the moment a woman realizes she is pregnant, she is overwhelmed with worries about the health of her future child. These worries are only compounded when the woman in question has had a difficult time becoming pregnant. Those women who have undergone infertility treatment in order to conceive have perhaps the most difficult task ahead of them as they await the delivery of their child—a wait that is made only more difficult by the belief that many people have that infertility treatments cause birth defects and birth complications at a higher rate than among women who conceived naturally.

It certainly raises a lot of questions. If it were true that births after infertility treatment produced higher rates of birth defects, it would also raise quite the moral dilemma. Do doctors and potential parents have the right to produce children that may suffer health problems and defects? Infertility treatments have been the subject of much debate since the first test-tube baby was born, and many people are still uncomfortable with the idea. However, for millions of parents who would have been unable to conceive, IVF is a blessing. It’s my opinion that everybody has the right to become a parent, and thought it is wonderful that many parents can conceive naturally, it is also wonderful that there is an option for parents who face more difficulty in having children.

Thankfully, studies have shown that the worries people have about children produced through IVF may be unfounded. The rate of birth defects in children born through IVF are no higher than the rates among children born through natural conception once parental factors have been taken into account. People who are still worried about the health “risks” of IVF for children in this day and age need to learn to trust the research rather than the propaganda, and they need to stop spreading misinformation that might lead parents who turn to treatment to conceive to feel guilty about their decision.

– Yvonne S. Thornton, M. D., M. P. H.

Ease of Use Most Important Factor in Contraceptive Method

Thursday, May 16th, 2013

A wide variety of women use contraception in the modern day, whether they are simply putting off having a child for the time being or they have decided not to have a child at all. The type of contraception that a woman chooses can have a big impact on her life, and is one of the most important decisions that she can make. One study examined the contraception methods used by a variety of women, across both age and social lines, to determine what factors were most important in determining the type of contraception used.

Not surprisingly, one of the most important factors used by women in determining their method of birth control is its ease of use. The birth control pill can be notoriously difficult for some women to keep track of. It must be administered at the same time, every day, to be effective. That is why an increasing number of women are turning to other contraceptive methods, such as IUDs, to prevent pregnancy.

However, as a doctor I feel it’s my duty to urge women to think a little bit more about what contraception is best for them. There are a number of other factors besides ease of use to consider when choosing a method of birth control, from the permanence of the method you want to use to biological issues which may play a huge role in determining the efficacy of your chosen method. For example, an IUD may be best suited for a woman who has already had children and is looking for a more long-term solution to prevent pregnancy. Before making a decision about your birth control, be certain you engage in a dialogue with your doctor to determine what solution is best for you. There are so many options out there that it is easy in this day and age to find something tailored to your individual needs.

 

– Yvonne S. Thornton, M. D., M. P. H.

Can A Low-Dose Birth Control Help Control PMS?

Monday, April 29th, 2013

Being a woman is tough, especially when you have to deal with the monthly effects of premenstrual syndrome. PMS can have a range of effects, as every woman knows, and while for some it may be nothing more than a minor annoyance, for others it can be pretty difficult to get up and go while they’re dealing with symptoms such as moodiness, aches, pains, and bloating. I understand that, and part of my job is making sure that women have all the resources they need so they can live healthy, comfortable lives, no matter what their bodies are putting them through.

While birth control and other drugs been used for years to deal with the more serious symptoms of more severe cases of PMS, or even premenstrual dysphoric disorder, (PMDD), both women and physicians hesitate to give full doses of birth control to women who don’t need or want it. The birth control pill comes with a lot of side effects, as any woman who has taken it knows, and this can cause a lot of concerns for women who are already dealing with the effects of PMS. Fortunately, low-dose birth control can do a lot to regulate your menstrual cycle, and it comes with far fewer side effects than its more estrogen-heavy counterpart. Studies show that it can also help to alleviate the symptoms of PMS, so it may be an option for women who are trying to deal with the worst symptoms of their oncoming menstrual cycle.

If you think your PMS symptoms are bad enough to warrant medical intervention, make sure you bring it up during your next appointment with your doctor. It’s important to have a dialogue with the person in charge of your health about what is going on with your body, and what can be done to make you more comfortable, and your life a little easier. It’s also important to trust your doctor’s judgment when it comes to low-dose birth control, or any other form of treatment. They will know what is best for your body, and can talk you through your options.

 

– Yvonne S. Thornton, M. D., M. P. H.

Do Failed Emergency Contraceptive Result in Birth Defects?

Monday, December 31st, 2012

As I’ve discussed before, emergency contraceptives should never serve as your main form of birth control. In certain circumstances, the morning after pill is perfectly acceptable. Maybe your usual form of birth control didn’t work, or maybe your sexual encounter was unplanned, or—worse yet—unwanted. Occasional use of emergency contraceptives such as the Plan B pill is fine, especially if it will prevent the birth of a baby that cannot be properly cared for. However, these pills are not always 100% effective in preventing pregnancy. If you took an emergency contraceptive but still got pregnant, you’re probably wondering how the hormones might negatively affect your baby’s health.

Luckily, the creators of the emergency contraceptive already thought of that, and they are designed in a way that will not harm a developing baby should the hormones be ineffective at preventing pregnancy. One study in particular showed that emergency contraceptives had absolutely no effect on the likelihood that a woman would have an ectopic pregnancy. Ectopic pregnancies are extremely dangerous for the woman having it, and most are aborted so that the mother can live through them. They occur when the fetus is growing outside the uterus. If you took an emergency contraceptive and it failed, you are just as likely to have a normal, healthy baby as if you hadn’t taken anything at all. Preventing pregnancy with an emergency contraceptive is just as safe as preventing it with regular birth control, even though “morning after” pills such as Plan B give you twice the amount of hormones as a high dose birth control pill.

While you’ll have a perfectly safe pregnancy if an emergency contraceptive fails, you should absolutely never rely on it as your only birth control. If you know that you are going to be having sex, you should already be on birth control to prevent pregnancy. On top of that, you should be using a condom if you aren’t sure of the sexual history of your partner. Doctors aren’t entirely sure what the long-term effects of high doses of hormones are, so taking pills like Plan B regularly could easily lead to blood clots or strokes. If you need to take an emergency contraceptive in a true emergency, rest assured that it will probably work. If it doesn’t, you’ll soon be the mother of a healthy new baby.

 – Yvonne S. Thornton, M. D., M. P. H.

 

Should You Stop Smoking to Start Birth Control?

Monday, November 26th, 2012

You already know that smoking is bad for your health. If you’re a smoker, you’re already making the choice to ignore certain health warnings that could significantly alter your health for the rest of your life, and that’s a choice that no one else can make for you.  My telling you about all of the risks associated with smoking cigarettes would be a waste of time. However, I do feel it’s important that you know the increased risks associated with oral contraceptives for women who are smokers.

For the most part, modern oral contraceptives are safe. Even problems that have been tied to birth control for decades are now less common as the medicine improves and doctors work towards making the pill safer and with fewer side effects. However, by smoking while taking contraceptives, you’re increasing your risk for complications in multiple ways. Blood clots and stroke are both much more common in women taking birth control and smoking, especially in women who are 35 years old or older.  In fact, there is a ten-fold increase of death attributed to cardiovascular disease and the use of oral contraceptives in women who smoked above the age of 35 years.  [Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756661/]

The biggest risk for women who are smoking while on the pill is any cardiovascular complication and you’re increasing your risk by simultaneously restricting your blood vessels with the tobacco. The exact mechanism is not known as to the etiology of the increased risk, but according to a recent study, the risk of death due to such complications is low for women under 35 years old. Women who smoke while taking birth control are at a higher risk for heart attacks, high blood pressure, and increased blood vessel tension.

I’m not going to tell you to stop smoking, though as a physician, I certainly think you should. However, I urge you to take a closer look at the risks and benefits when it comes to combining your birth control with tobacco. If you feel that you need to continue smoking while taking your  oral contraceptives, consider looking other types of birth control that don’t use hormones, such as an intrauterine device or even the old tried and true diaphragm.

 – Yvonne S. Thornton, M. D., M. P. H.

 

Is Your Birth Control Making You Gain Weight?

Thursday, November 1st, 2012

All medications have side effects. From Advil to Zantac, every medication we need for common ailments might have a drawback. For women, birth control can be a bittersweet prescription. On the one hand, women who take it will be protected from pregnancy. However, those same women might experience some unwanted side effects such as moodiness, fatigue and a change in their sex drives. One of the major concerns about birth control—especially for women in the United States—is the potential for weight gain as a side effect. We all try to maintain a healthy weight, so adding birth control into the mix of challenges can be disheartening. Luckily, recent studies show that weight gain might not actually be a side effect of modern birth control.

Every birth control is different, but they are all combinations of the same hormones. They either contain progestin and estrogen, or progestin on its own. However, the levels of each are low, and they have no real effect on weight gain or weight loss. So, why do women think birth control causes weight gain? Many brands list this as a side effect to cover themselves, but the notion started in the 1960’s when birth control became available. The pills back then contained almost 1,000 times the amount needed to prevent pregnancy, so side effects ran rampant.

The hormones themselves might not cause weight gain anymore, but that’s not to say the weight you gain while taking a contraceptive isn’t related to the pill, ring, or patch. Birth control has many other, real side effects that could easily affect your weight. For example, the hormones might cause changes in your mood, which could leave you feeling down in the dumps more than usual. If you’re like most women, you might eat when you’re sad, so weight gain will be inevitable in that scenario. More bad days will lead to more overeating, which will lead to weight gain. You might feel (and act) like a bottomless pit at every meal. Most pills also cause water retention in one form or another, so you might feel especially bloated.

If you notice significant weight gain and feel that it’s related to your birth control, talk to your doctor about switching brands. The hormones alone do not do it, so there’s a good chance your side effects are especially strong. Different brands affect people differently, so try your luck with another.

– Yvonne S. Thornton, M. D., M. P. H.

Legitimate Rape or Legitimate Ignorance?

Thursday, September 6th, 2012

In February, there was a hearing chaired by Daryl Issa for the House Committee on Oversight and Government Reform Hearing on the Contraceptive Coverage Rule.  Unfortunately, the panel was entirely male.  Talk about oversight!  This prompted many female members of congress to walk out of the hearing in protest, much to the confusion of the chair.  When asked about the walkout, Senator Kirsten Gillibrand said, “If our republican colleagues want to continue to take this issue head on, we will stand here as long as necessary.”  In August, women received a fresh reminder of the Republican male’s perspective on rape when Representative Tod Akin proclaimed, “If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.”

Women around the world are wondering what constitutes the difference between rape and legitimate rape.  John C. Wilke, who is not an obstetrician, but a general practitioner of almost 90 years old, and who is the former President of the National Right to Life Committee is the only doctor who supports Akin’s remarks regarding whether or not the reproductive system of a woman shuts down during rape.  With such credentials, it goes without saying that he may have a bias and outdated view of rape and the female body, and experts disagree with his supposedly medical explanation for his belief.  In fact, one in 15 raped women become pregnant, no matter what definition of rape you choose.  Are Akin and Wilke suggesting that those rapes were not legitimate?  I doubt it seemed that way to the women when it was happening.

The most disconcerting part of all of this is that representative Akin has the power to influence laws in our country.  In this day and age, we hope that men have at least the decency and empathy to listen to the voices of women in our country, and, heaven forbid, include us in panels and decision-making regarding our own reproductive rights.  Hopefully, there are a lot of women and understanding men out there willing to make their vote count in order to make a positive change for all of us.  I wonder, is it pure prejudice keeping men like Akin in the dark when it comes to women’s health issues and reproductive rights, or is it legitimate ignorance?

 

– Yvonne S. Thornton, M. D., M. P. H.

Just Because You’re On the Pill, Doesn’t Mean You Won’t Get Pregnant

Monday, May 28th, 2012

With contraception so much in the news lately, it seems that we have heard all there is to say about it.  A recent study regarding birth control though, has something quite different to say that definitely deserves our attention.  It’s evident from the attention that political contraceptive debates received that there are a lot of women in the US who take the pill or some other form of birth control.  According to the American Journal of Obstetrics and Gynecology though, many of those women wrongly assume that their contraception is infallible.

According to the Guttmacher Institute, 99% of women of reproductive age who have had sex use contraception.  That’s a lot of women, but Researchers at Washington University in St. Louis found that a shocking 45% of those women believe that contraception can prevent pregnancy 100% of the time.  With so many people taking birth control under this false assumption, it’s obvious there’s a need for education and media exposure.  While the pill, which is the most popular form of contraception, is mostly successful at preventing pregnancy, it can indeed fail between 2%-9% of the time.  And that’s the failure rate if you remember to take it every single day.  The failure rate can increase when women miss pills, are in their first month of taking the pill, switching dosages, or taking medications like antibiotics, migraine medications, or antidepressants.  Condoms have an even bigger failure rate of 15%-24%. This is why it’s so important for women to discuss their birth control options with their physician, and that discussion should include how effective each option is.  The rates of contraception failure with respect to perfect use and average use are outlined in my health book, Inside Information for Women.  Hopefully, that chapter will give you a better understanding of the types of contraception offered, their effectiveness and their applicability to your lifestyle.

This information shouldn’t make anyone panic, because as a whole, birth control is fairly effective, especially when compared to not using any contraception at all, which has a failure rate is 85%! However, knowing more about failure rates should make people aware of the actual risk involved in being sexually active, even while taking birth control.  This information probably won’t cause people to think again before having sex, and it may not prevent unintended pregnancies.  At the very least though, it gives parents like me yet another reason to teach our children that sexual activity does have consequences and is better saved for a time in our lives when we are ready to be responsible for our actions.

 

– Yvonne S. Thornton, M. D., M. P. H.

Jobs Should Provide Health Insurance, Not Moral Judgment

Thursday, May 17th, 2012

The debate over health insurance has certainly been heated over the past few years, and most of those arguments stemmed from concerns over financing and constitutional rights.  More recently though, it seems they have decided to narrow their focus to something a little more personal for women, and that’s contraception.  Although employers rarely want to know what you’re using your health insurance for due to privacy concerns, some would like to prevent their female employees from using their insurance for birth control.

The arguments behind this have been few.  Some claim that cutting birth control out of their health insurance plans would save money.  While this is somewhat true, in the grand scheme of things, it’s a bit ridiculous.  Birth control is easy to produce and access, and with so many competing contraception options and companies, the price is affordable.  Additionally, when female employees take birth control, they prevent pregnancies, which are much more costly for health insurance plans in the way of prenatal check-ups, hospital stays, maternity leave, and eventually, another family member to add to the plan.  In the long run, employers would actually save money by giving their employees access to contraception.

Money isn’t the only argument though.  There are religious organizations that don’t want to provide birth control to their employees out of religious, or moral, concerns.  Although the foundation of their organization stems from a particular religion, they employ people who are not necessarily a part of that faith.  There are religious hospitals, private schools, and nonprofit organizations for example, who have hundreds of staff members from all walks of life.  They feel that they have a right to impose their moral judgment on all of their employees. If they must abide by the same antidiscrimination laws that prevent them from firing someone because of their religion, race, or sexual orientation, then why should they be allowed to discriminate when it comes to health insurance?

Obviously, as a physician, I believe that the gift of life is precious.  That’s also why I believe though, that women need to be ready to receive that gift.  It takes a huge commitment to raise a child, and even more to develop that child into an intelligent, caring, and well-balanced person.  Our jobs are there to give us the opportunity to provide for our families, both in terms of money and health insurance and in terms of allowing a woman, mother or not, to feel as if she is self-sufficient, contributing and using the talents that she has developed over a lifetime. Mothers especially need an outlet other than their children.  Our jobs have no right to decide when we start that family though and by no means do they have the authority to judge the morality of our decisions.

– Yvonne S. Thornton, M. D., M. P. H.