Implanted protection. Women slowly turn to Norplant use
Kobren, G.
Sun 1991: 1c; 5c
1991
PMID: 12290563 Document Number: 337203
More and more US women who want a safe, long-term, effective, and reversible contraceptive are choosing Norplant, the first significant new contraceptive in the US in 25 years. Only trained providers can implant Norplant, but training could not start until the US Food and Drug Administration approved it in December 1990. The first contraceptive implant systems did not arrive to the first physicians trained to implant Norplant until two months later. Providers insert the capsules under the skin of the inside upper arm. The capsules release a progestin that suppresses ovulation and thickens the cervix. Physicians or nurse-midwives anesthetize the upper arm to make a small incision through which they place the six capsules. Any bruise at the site lasts for a few days. After that, the capsules are undetectable in most women. Norplant protects against pregnancy 24 hours after insertion. Fertility returns soon after removal. Contraindications to Norplant include undiagnosed abnormal genital bleeding, known or suspected pregnancy, acute liver disease, cancer, or blood clots in the legs. Norplant is effective for five years. After five years, a new set of capsules can be inserted. In metropolitan Baltimore, Maryland, Norplant is or will soon be offered by Francis Scott Key Medical Center, Maryland General Hospital, Sinai Hospital, Union Memorial Hospital, University of Maryland Medical Center, Greater Baltimore Medical Center, Anne Arundel County and Baltimore City Health Departments, and Planned Parenthood of Maryland clinics. Many private physicians also provide Norplant. Norplant costs range from $595 to $900 in the private sector and is offered on a sliding scale in the public sector. Blue Cross/Blue Shield of Maryland will cover Norplant, but clients must first verify coverage. Women who belong to HMOs or have other kinds of health insurance need to check with their insurance carriers for Norplant coverage. Medicaid is picking up the cost of Norplant for poor women.