Category Archives: Birth Control

Where Disproportionate Need Meets Unequal Access: Plan B in Native American Communities

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Image: FreeDigitalPhotos.net

When President Obama signed the Tribal Law and Order Act into law two years ago, it was a long overdue step to improve public safety in Native American communities — in particular among Native American women. Department of Justice data show that Native American women are more than two-and-a-half times as likely as other women in the United States to be sexually assaulted or raped. Another statistic that sets Native American women apart from other women in the United States is the likelihood that their victimizers will be non-Native men. While other women are usually attacked by men of the same race, 86 percent of reported sexual assaults against Native American women are perpetrated by non-Native men.

Most Native Americans depend on the Indian Health Service for health care; most IHS pharmacies don’t provide emergency contraception.

The feeling that this violence is inevitable is common to many Native American women, a feeling that some have attributed to the history of military outposts on Native American lands and sexual abuse in boarding schools. Historical factors aside, a contemporary jurisdictional dead zone has enabled the problem to persist. Tribal police on Native American reservations don’t have the authority to arrest or detain non-Native suspects. Those suspects fall under federal jurisdiction, but federal marshals are too small in number and too committed to other responsibilities to provide community policing on reservations. The situation of virtual amnesty for non-Native perpetrators has created a scourge that some have dubbed “rape tourism.”

The Tribal Law and Order Act was enacted to prevent victims of sexual violence from falling through the cracks by improving investigation and prosecution of sex crimes. A New York Times article from earlier this year reported that only 13 percent of the sexual assaults reported by Native American women lead to arrests, compared to 35 percent of those reported by black women and 32 percent of those reported by white women. The improvements that the Tribal Law and Order Act promises cannot come soon enough. Continue reading →

Let’s Talk Contraception: Female Condoms, Another Contraceptive Choice

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Are you or your partner allergic to latex? Does your male partner not like to use condoms, or does he want to try something that may feel less restrictive? Would you like to decrease the risk of skin-to-skin transmission of viruses, such as those that cause genital warts or herpes? Do you feel that putting on condoms distracts from the spontaneity of sex? You might be interested in learning about female condoms.

September 12 is Global Female Condom Day.

The female condom, available as the brand name FC2, is a barrier contraceptive that was developed with the dual purpose of allowing women contraceptive control and providing  protection against pregnancy and sexually transmitted diseases, including HIV.

You do not need a prescription or to see a health care provider to get the FC2 — it’s available for sale just like male condoms.

As with other contraceptive methods, it is not foolproof, but when used properly and consistently it is 79 to 95 percent effective in preventing pregnancy. Also, its shape and design allows less skin-to-skin contact where diseases may spread.

The first female condoms were made of polyurethane. The new FC2 is now made of a thin, flexible nitrile sheath with an open ring at one end that covers the outside of the genital area and a smaller closed ring on the end that is inserted in the vagina. Inside the sheath is a silicone lubricant. Because the condom is not latex, it can also be used with any kind of additional lubricant and by those allergic to latex. Continue reading →

What Is Title X? Free or Sliding-Scale Family Planning Services in Arizona

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The Jean Hoffman Health Center in Tucson is a Title X location.

What is Title X (Title 10)? And why should I care?

The short answer: Title X may mean that some people qualify for free or reduced-cost family planning services, which could impact their ability to meaningfully access health care. In a time of rising health care costs and precarious employment, that is no small thing.

The longer explanation: Title X is a federal family planning program that was enacted in 1970. For anyone keeping historical tabs, this means that Republican President Richard Nixon signed this piece of legislation into action. According to the U.S. Department of Health and Human Services Office of Population Affairs, “The Title X program is designed to provide access to contraceptive services, supplies and information to all who want and need them. By law, priority is given to persons from low-income families.” While there are other federally funded health care sources for people with low incomes, Title X remains the only source dedicated specifically to family planning services.

If you can’t afford family-planning and sexual health services, Title X may help.

In Arizona, the Arizona Family Health Partnership uses Title X funds to provide services to approximately 40,000 people each year. Most of these people have incomes at or below the federal poverty line and may not otherwise have access to health care. Four Arizona Planned Parenthood health centers receive Title X funds through the Arizona Family Health Partnership to provide reduced cost sexual and reproductive health care. Continue reading →

¿Qué es Título X? Servicios de planificación familiar en Arizona gratuitos o con escala deslizante

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El Centro de Salud Jean Hoffman en Tucson es una ubicación Título X.

Traducción por Gabriela Zaravia.

¿Que es Título X (Título 10)? ¿Y por qué me debería importar?

La respuesta corta: Título X puede significar que algunas personas califican para servicios de planificación familiar gratuitos o de costo reducido, que podrían afectar su capacidad para acceder significativamente la salud. En tiempo de los gastos de asistencia médica crecientes y empleo precario, no es ninguna cosa pequeña.

La explicación más larga: Título X es un programa de planificación familiar federal que fue decretado en 1970. Para cualquiera que guarda etiquetas históricas, esto significa que el presidente republicano Richard Nixon firmó esta pieza de la legislación en acción. Según el Ministerio de Sanidad estadounidense y Servicios sociales la Oficina de Asuntos Demográficos, “El programa Título X es diseñado para proporcionar el acceso a servicios anticonceptivos, provisiones e información a todos que quieren y los necesitan. Según la ley, dan la prioridad a personas de familias de bajos ingresos.” Mientras hay otras fuentes de asistencia médica federalmente financiadas para la gente con bajos ingresos, el Título X permanece la única fuente dedicada expresamente a servicios de planificación familiar.

Si usted no puede pagar por servicios de salud sexual y planificación familiar, Título X puede ayudar.

En Arizona, la Asociación de Salud de la Familia de Arizona usa fondos de Título X para prestar servicios a aproximadamente 40.000 personas cada año. La mayoría de estas personas tienen ingresos en o por debajo de la línea de pobreza federal y en caso contrario no pueden tener acceso a la atención de la salud. Cuatro centros de salud de Planned Parenthood Arizona reciben fondos de Título X a través de la Asociación de Salud de la Familia de Arizona para proporcionar costo reducido a la asistencia médica sexual y reproductiva. Continue reading →

Over 90 Percent of What Planned Parenthood Does, Part 8: Hormonal Option without Pelvic Exam (HOPE)

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Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

I remember sitting in the exam room, fidgeting with my paper gown and nervously explaining to the doctor that my boyfriend and I had come very close to having sex already, and I would please like to be on birth control pills when it actually happened.

“Sure,” he said, swinging open the stirrups. “Just as soon a we do a pelvic exam.”

I didn’t want one. I really didn’t want one.

While it’s common for health care providers in the United States to require or routinely perform a pelvic examination — with or without a Pap test — prior to prescribing hormonal birth control, several health organizations state that a pelvic exam isn’t necessary in order to be safely prescribed hormonal contraceptive pills, patches, shots, or rings. For instance, the American College of Obstetricians and Gynecologists advises, “A pelvic exam is not needed to get most forms of birth control from a health care provider except for the intrauterine device (IUD), diaphragm, and cervical cap.” In such cases, HOPE (Hormonal Option without Pelvic Exam) may be an appropriate alternative. Continue reading →

Let’s Talk Contraception: The Mini-Pill or Progestin-Only Pill

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Birth control pills usually contain progestin and estrogen, which are both sex hormones. Progestin-only birth control pills (POPs) are sometimes called the mini-pill because they don’t contain estrogen. If you are concerned about taking estrogens because you have high blood pressure, migraines, heart disease, or a history of blood clots, but still would like to take an oral contraceptive, this may be an option for you. It is also a good choice if you are a new mother and breastfeeding.

Progestin-only pills don’t contain estrogen, making them a good option for some people.

POPs are used in the same way as other birth control pills. They come in packs of 28 pills. You take one pill at the same time each day and after the last pill in the pack is taken, you start a new pack the next day; there is no skipping days. Because there is a slightly greater risk of becoming pregnant on progestin-only pills, you must be very careful to take each pill at the same time each day and never miss a day. If your period is late and you missed one or more pills or took them late, you may need to take a pregnancy test.

The effects of POPs are easily reversible and after stopping these pills your chances of getting pregnant should not be delayed. Continue reading →

Keeping Medications and Contraceptives Safe through the Summer

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Highs in the triple digits are common in Arizona during the summer months. As the mercury rises, we’re often reminded about the things we need to do to stay healthy in hot weather, like avoiding dehydration, heat exhaustion, and sunburn. Those tips are important — and can even be potentially life-saving — but what’s often missing from summertime health advice is information about using medications and contraceptives safely and effectively when a hot environment can quickly diminish their integrity. That’s a serious omission when Americans buy about 5 billion over-the-counter drug products annually and nearly half of all Americans use one or more prescription drugs.

Heat can alter the molecular structure of oral contraceptives or shorten a condom’s shelf life.

Extreme heat and cold can cause medications to change physically, and those changes can make medications less potent — and for some medications, unsafe to use. Oral contraceptives and other medications that contain hormones are especially susceptible, since the proteins they contain can change their properties during heat exposure.

The labels on medications, whether over-the-counter or prescription, typically recommend storing them in a cool, dry place and keeping them away from excessive heat and humidity, or might give a specific temperature range, commonly 68 to 77 degrees Fahrenheit (20 to 25 degrees Celsius). That’s an ideal range, but most medications are still usable after storage in temperatures as low as 32 to 58 degrees Fahrenheit (zero to 14 degrees Celsius) and as high as 80 to 86 degrees Fahrenheit (27 to 30 degrees Celsius). Advice varies, so it’s always best to consult a physician or pharmacist when less-than-ideal storage has already happened or is anticipated. Help is also available at Planned Parenthood health centers, where staff can answer questions about general health care and about using contraceptives safely and effectively. Continue reading →

Let’s Talk Contraception: What’s the Difference Between Generic and Brand-Name Birth Control?

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Oral contraceptives (birth control pills) have been around for decades, and many are now available as generics. In general, generics cost less than brand-name medications. Despite saving money, some users question whether generic birth control pills are as “good” as brand-name pills. To confuse the situation, new brand-name birth control pills have been developed that specifically claim other benefits in addition to protection from pregnancy, such as treatment of acne. The cost of these brand-name pills is much higher. To understand the generic vs. brand-name debate, it is first important to understand how drugs are developed.

Clinical evidence doesn’t support the idea that generic birth control pills have different failure rates or side effects than their name-brand counterparts.

When a drug is first discovered and developed it goes through a drug review process. This involves many steps: chemistry experiments to discover the active chemical structure of the drug, manufacturing and testing the chemical drug product, inspections of the manufacturing process, and many other developmental studies. Then there are animal studies to check safety and efficacy — and if the drug works without major side effects. Finally, clinical studies are conducted in people; these studies test to assure bioavailability (the amount of time it takes for the body to absorb the drug). These last tests, in animals and people, show bioequivalence. Bioequivalence means the drug must enter the body, be absorbed in the same time frame, and work in the body the same way consistently.

When a new drug is finally approved by the FDA, it has met strict standards regarding its strength, purity, quality, potency, safety, and clinical effectiveness. New drugs are awarded patents for 20 years, but by the time they come to market, much of that time has run out due to all of the testing requirements. Generics are usually less expensive — manufacturers do not need to repeat discovering the drug, nor must they redo animal and human studies to assure the drug is safe and works as intended. The generic companies also do not need to spend as much money on advertising, marketing, and promotion. Continue reading →