Roundup: A Warning About A Generic Contraceptive, Lack of Access to Contraceptives Driving Unsafe Abortion in Uganda

Oct 21, 2009, 8:46am

Wendy Atterberry shares her experience and a warning about her switch from a branded to a generic contraceptive; lack of access to contraceptives drives unsafe abortion in Uganda; lawmakers in Peru consider expansion of indications for legal abortion; bioethicist asserts women are being treated as a "special interest" in health care reform debate.

A warning about Tri-Lo Sprintec birth control

Writing at The Frisky, Wendy Atterberry shares her recent experience with a switch from the original prescription birth control to a generic version after her insurance company changed its coverage and her pharmacist reassured her the generic version be "the same" as the branded version.

They were not.

Earlier this year, the FDA approved a generic low-dose birth control
called Tri-Lo Sprintec. Afterward, many insurance companies — including
mine — switched coverage from the name-brand Ortho Tri-Cyclen Lo to the
much cheaper, newly approved generic brand. In July, just a few days
before my wedding, my pharmacist informed me of the switch and said
that if I wanted to continue taking the name brand, I’d now have to pay
the full cost, which would be an increase of $60 over what I’d been
paying when my insurance still covered it. After the pharmacist assured
me the formula in the two pills was “exactly the same,” I decided to
save some money and try the generic brand, Tri-Lo Sprintec. Since then,
I’ve been experiencing all kinds of unpleasant side effects.

Atterberry writes that her "side effects increased exponentially after I
switched to the generic brand."

In fact, on OTC, they barely even
registered on my radar. In addition to the weight gain, boob growth and
uncomfortable bloating in my midsection, I’d also been experiencing
intense full-body itching — so bad, it was keeping me awake at night.
About a month ago, I even started breaking out in hives — on my face,
my neck, my elbow, my armpits. I’ve been miserable! I knew the weight
gain and my suddenly overflowing cup-size were probably results of this
new Pill, but it wasn’t until I started reading a variety of message
boards on the subject this weekend that I realized my itchy skin and
hives were a side effect as well.

After researching her experiences and searching message boards about this issue, she discovered she was not alone.

I was simultaneously relieved and appalled to learn that hundreds of
women — and probably thousands more who haven’t written reviews yet
— are experiencing exactly the same reaction to Tri-Lo Sprintec that I
am. Just like me, most of them had been on Ortho Tri-Cylcen Lo with
limited problems, but switched to the generic brand when their
insurance companies stopped coverage of OTC. Like me, they were told by
their pharmacists and doctors that the formulas were “exactly the
same,” and, just like me, many, many of them have experienced terrible
side effects from Tri-Lo Sprintec. When some of the women complained to
their doctors and pharmacists about what was happening, they were told
they were “crazy,” and that “no one else has complained.” On the
message boards, pharmacists are even weighing in saying that women who
demand the name brand over the generic are “psycho” and simply don’t
realize the two medications are comprised of the same ingredients.

"Ladies," writes Atterberry:

I want this to be a warning to you: The formulas in Ortho Tri-Cyclen Lo and the generic Tri-Lo Sprintec are not the same! The active ingredients may be similar — not the same, similar — but the inactive “filler” ingredients are different (compare here and here)
and it’s very possible that you, like me, may be allergic to whatever
fillers are used in either pill. Don’t let pharmacists or doctors
intimidate you — you’re not “crazy” or “psycho” by questioning whether
a particular prescription is right for you. You know your body better
than they do — you’re not just “confused” if you’re experiencing
unpleasant side effects on medication prescribed by your doctor, even
if you’re told the formula is “exactly the same” as whatever else you
may have taken in the past. What the FDA calls “identical” — and,
therefore, the way many doctors and pharmacists use the word
“identical” — is a legal interpretation, not literal!

Lack of access to contraceptives drives high rate of unsafe abortion in Uganda

Lack of access to modern contraceptives is one of the key factors behind high rates of unsafe abortion and maternal deaths among women in Uganda, notes AllAfrica.com in a report on the recent Guttmacher study on abortion trends worldwide.

The article quotes Dr Peter Ibembe, the National Programme Manager for
Reproductive Health Uganda, saying that "increased use of contraceptives can reduce
maternal mortality and improve women’s health by preventing unwanted
and high risk pregnancies, which usually end in clandestine abortions."

Uganda’s unmet need for family planning services currently stands at 41 percent. Close to 270,000 induced abortions are performed every year in
Uganda, with 85,000 of the cases ending in complications and sometimes
death.

Peru’s Congress considers legislation to expand conditions for legal abortion

Approximately 370,000 illegal abortions are performed each year in Peru, notes Agence France Presse, in an article on recent efforts to liberalize Peru’s abortion laws. A bill now before the Peruvian Congress would expand a 1924
law which currently allows abortion only when the expectant mother’s health or
life are in jeopardy. The new bill, if passed, would expand these conditions to include rape and fetal deformity.

Strong opposition by the Roman Catholic Church and Defense Minister
Rafael Rey, who says he will resign if the bill is approved, prompted a
"technical" review of the measure. Opposition has been spearheaded by Peruvian Cardinal Juan Luis Cipriani, who calls the measure a "death
penalty" for the innocent, the church has openly lobbied lawmakers to
drop the proposed legislation. As Congressional deliberations continued, protests have been held by both pro- and anti-choice groups.

If
the abortion bill is passed, Peru would join a small group of Latin
American nations that allow abortion only in cases of rape or to save
the life of the expectant mother.

Women’s
groups say that 22 percent of women in Lima are sexual abuse victims. Complications of unsafe abortion are the leading cause of maternal death in Peru, which has the highest rate of maternal mortality in Latin America.

Bioethicist argues policymakers must stop treating women as a "special interest" in health care debate

Speaking at a Planned Parenthood Luncheon in Madison, Wisconsin last week, bioethics professor Alta Charo of UW Madison expressed alarm at "how women are treated
as "special interests" in the health care debate when not only do
they outnumber men in the health care system, but by age 85 women
outnumber men 2-1," writes Dave Zweifel of the Capital Times.

"Health care ought to be built around women," argued Charo, "not treat them as a special interest."

During her speech, Charo told the now-infamous story of the exchange between Senators Kyl and Stabenow that encapsulates perfectly the disconnect many male policymakers, especially conservative policymakers, have about women’s health.

Just before the Senate Finance Committee wrapped up debate
over its Sen. Max Baucus-designed health care bill, its members
debated one of Sen. Jon Kyl’s amendments, which would have cut
language defining which benefits employers are required to
cover.

Sen. Debbie Stabenow, D-Mich., argued that insurers must be
required to cover basic maternity care. (In several states there
are no such requirements.)

"I don’t need maternity care," said Kyl, R-Ariz. "So
requiring that on my insurance policy is something that I don’t
need and will make the policy more expensive."

Stabenow interrupted: "I think your mom probably
did."

The amendment was defeated, 9 to 14.

"That anecdote explains a lot about what’s been wrong with the
health care debate in Washington these past several months," Charo told her audience.

Too many people working on health care reform don’t understand
insurance – that it should be designed to spread the risk among us
all, not to exclude certain classes of people so that policies cost
less. Kyl obviously doesn’t understand it.

"If you don’t want to cover women’s maternity care, then don’t
ask us to cover your prostate cancer treatments or, better yet,
don’t ask us to cover the costs of your Viagra prescription," the
internationally recognized bioethicist said.

The reason "women are considered a special interest is because
health care becomes a debate on moralism and politics rather than
on science – something well known to Planned Parenthood," wrote Zweifel. "The
ideologues use misinformation to get their way."

Charo added that it’s why reproductive health in the U.S. is
rotten, why we have 65 million people with incurable sexually
transmitted diseases, why we have high infant mortality rates, why
we have so many unintended pregnancies.

"We’ve got to stop treating health care as a Sunday school
scolding," Charo said.

For example, we keep pumping millions of taxpayer dollars into
abstinence-only sex education when study after study has shown that
it doesn’t work. We lead kids to believe that they never have to
have sex and then when they do, they know nothing about birth
control. And, of course, the burden typically falls on women and
the poor.

She warned the crowd that the right to life lobby may well gets
its way on abortion in the health care debate. Several amendments
have already been proposed that would ban any health insurer from
covering an abortion if the firm gets any federal subsidy. That
would cover all insurance companies because their low-income
policyholders will be subsidized with federal funds.

In order to get health reform in the end, she worries, Congress
may give in to the abortion ban unless women and others speak
clearly and loudly to their senators and representatives.

October 21, 2009

OnMedica News: Women just as likely to use condoms as the Pill

Health Service Journal: Community contraception clinics grow in popularity

All Africa: Low Contraceptive Use Blamed for High Abortion

Arizona Republic: Judge: No prepayment for abortion transport

Loyola Phoenix: Catholic group opposes internships

Boston Globe: No patch for deepest cut

Times Online: Condom catches up with the Pill but caution still needed

October 20th, 2009

Feministing: When the personal is political – and vice versa

Kansas Liberty: Missouri-based foundation helps raise awareness of pro-life pregnancy clinics in Kansas City area

AFP: Abortion debate heats up in Peru