Norplant entered Canada through the back door
Newsletter 1994(45): 16
1994
PMID: 12318719 Document Number: 285565
Three women's groups registered their concerns and recommendations about the use of Norplant in Canada, where it was approved for use in November, 1993. The National Action Committee on the Status of Women had the following reservations: 1) Norplant requires trained personnel for its insertion and removal (both minor surgical procedures), which makes it controlled by the provider; 2) there is a potential for misuse without adequate informed consent, especially among welfare recipients, disabled women, or those whose first language is not English or French (women in the United States have been given financial incentives or had Norplant made a probation requirement); and 3) discontinuation rates have equalled 50% in clinical trials because of side effects that are often perceived differently because of culture. The Toronto Women's Health Network is concerned that Norplant use among teens, welfare recipients, and women of color will lead to higher rates of sexually transmitted disease (STD) and human immunodeficiency virus (HIV). The Women's Health Clinic has the following recommendations: 1) a clear policy with guidelines on informed consent, 2) an accredited certification program for health professionals that includes training and supervision of insertion, removal, and counseling techniques, and a process for client follow-up; 3) a policy limiting availability to centers with accredited staff and adequate infrastructure; 4) the development of a program that follows mobile patients, perhaps, via prescriptions; 5) the promotion of Norplant in professional literature only; 6) comprehensive and understandable patient education materials for women of diverse backgrounds; 7) ongoing qualitative and epidemiological studies designed with input from consumers and experts; and 8) reform of the drug approval process ensuring mechanisms for openness, consumer input and public discussion.