Jacqueline Sherris_ Ph.rtf

							The Emergency Contraceptive Newsletter
Fall 1999, Vol. 4, No. 2
ABOUT THIS NEWSLETTER:

This newsletter is prepared and distributed as a voluntary activity on behalf of the American
Society for Emergency Contraception and the international Consortium for Emergency
Contraception.It is distributed electronically twice each year to anyone who wishes to receive
it.To contribute a news item, please send it to Charlotte Ellertson
(cellertson@popcouncil.org.mx) or to Kelly Blanchard (AmSocEc@aol.com).Annik Sorhaindo
(asorhaindo@popcouncil.org.mx) is currently the editor of the newsletter.We reserve the right to
check and edit items as appropriate.To join or remove your name from the newsletter circulation
list, please write to AmSocEC@aol.com.

ABOUT THE AMERICAN SOCIETY FOR EMERGENCY CONTRACEPTION:

The American Society for Emergency Contraception (ASEC) is a voluntary collaboration of
organizations that promote the availability of emergency contraception for women.Founded in
1997, ASEC has four mandates: 1) to serve as a source of information for the media and others
who want information on emergency contraception; 2) to serve as a watchdog for inaccurate or
biased articles in the press and respond with accurate letters to the editor, and to watch for abuses
of reproductive rights related to emergency contraception, and draw attention to these problems;
3) to promulgate policies on emergency contraception and to support and disseminate the
statements and guidelines of other organizations willing to endorse the method; and4) to link the
members of the emergency contraception field, primarily by sending out (in collaboration with
the international Consortium on Emergency Contraception) this semi-annual electronic
newsletter on recent events in emergency contraception and by organizing an annual meeting
(held on the first Friday in October in New York) to share information with researchers, policy
makers and the pharmaceutical industry.

ASEC is open to industry participation, although it will not endorse one method or regimen over
others that are also safe and effective.Membership is free, and although the focus is primarily on
the United States, international affiliates are welcome.To receive a list of the member
organizations, please write to AmSocEC@aol.com.The Executive Director of ASEC is currently
Kelly Blanchard, who can be reached at (212) 339-0656.ASEC is managed by a volunteer
steering committee consisting of Charlotte Ellertson (Population Council), James Trussell
(Princeton University), Kirsten Moore (Bass and Howes), Laneta Dorflinger (Family Health
International), Allen Rosenfield (Columbia University), Elisa Wells (Consortium for Emergency
Contraception) and Jackie Buster Lawrence (Planned Parenthood Federation of America).

ABOUT THE CONSORTIUM:

The Consortium for Emergency Contraception is an innovative collaboration among eighteen
nongovernmental and public sector organizations and a private sector industry partner. The
Consortium's immediate objectives include the introduction of a dedicated product for
emergency contraception into the public and private sector markets of four developing
countries—Indonesia, Kenya, Mexico, and Sri Lanka. The larger goals of the Consortium's
introduction program are to identify and disseminate "best practices" for the delivery of
emergency contraceptive services and to demonstrate for the world's policymakers, health care
providers, and pharmaceutical manufacturers the widespread acceptability and need for the
method.

The Consortium has recently expanded its membership to include:

      Asociacion Para la Prevencion de Embarazos No Deseados
   
      AVSC International
   
      British Pregnancy Advisory Service
   
      Concept Foundation*
   
      CONRAD Program
   
      DKT International
   
      Family Health International
   
      Institute for Reproductive Health
   
      International Planned Parenthood Federation (including Family Planning Association of
       Sri Lanka and IPPF/Western Hemisphere Region)*
   
      Ipas
   
      Marie Stopes International
   
      Meridian Development Foundation
   
      Pacific Institute for Women's Health*
   
      PATH (Program for Appropriate Technology in Health)
   
      Pathfinder International*
   
      Population Council*
   
      Population Services International (PSI)
   
      WHO Special Programme of Research, Development and Research Training in Human
       Reproduction (WHO/HRP)*
    
(*founding members, 1995)

The Consortium's industry partner is Gedeon Richter, one of Europe's largest pharmaceutical
companies.

For information about the Consortium, please contact any of the member organizations.To obtain
Consortium materials, contact the Consortium Coordinator, Elisa Wells, 3224 Purdue Street,
Anchorage, AK99508.Phone/fax: (907) 279-2055.E-mail: elisa@alaskalife.net.

PRODUCT NEWS:

Plan B on the Market in the United States

This summer the FDA approved the first progestin-only pill developed for emergency
contraception. The package consists of two 0.75mg tablets of levonorgestrel. According to two
World Health Organization (WHO) studies, levonorgestrel is highly effective and produces less
nausea and vomiting than other emergency contraceptive regimens. Women's Capital
Corporation is the United States distributor for Plan B.

Contact:
Irene Look
Asst. Account Executive
Elgin DDB
Tel: (206) 344-3435
Fax: (206) 326-5114
Email: irene.look@elgin.com

Progestin-only EC available

ASEC was recently made a generous offer by HRA-Pharma, the company marketing NorLevo®.
NorLevo® is a progestin-only EC product recently approved in France and available directly
from pharmacists.Due to the change in labeling required when the product moved from
prescription-only status to pharmacist provision - orp status (which happened only one day after
the product was approved!) HRA-Pharma had to recall a large amount of the product.They are
generously making these supplies available for research or humanitarian purposes through
ASEC.This offer is made with the following provisions:

      the product cannot be used for any reason in France or its overseas territories;
   
      ASEC and organizations requesting supplies agree that the product should in no instance
       be traded or used for commercial purposes;
   
      HRA Pharma will not re-label the boxes (the packaging and patient leaflet are in French);
   
      HRA Pharma is prepared to send the boxes at its own cost to organizations provided that
       individual orders are of not less than 2,000 boxes;
   
      ASEC and users agree to forward to HRA Pharma any information regarding side-effects
       which occur with the use of these products;
   
      the data generated by research using these products should be made freely available to the
       medical and scientific community;
   
      if a publication is made with results obtained with the products, HRA Pharma should be
       entitled to review the manuscript for information 30 days before its submission;in
       addition, it will be acknowledged that NorLevo® was donated by HRA Pharma ;
   
      if a patent is filed based on discoveries made with the product, HRA Pharma would
       automatically be granted a free license to use this patent.
    
Please contact ASEC if your organization is interested in obtaining supplies of Norlevo®.Please
provide us with the amount of product you would like to receive, the purpose for which you
intend to use it, and where it should be shipped.ASEC has agreed to serve as a clearing house for
requests, and requests will be considered on a first-come, first-serve basis.

Contact:
André Ulmann
HRA-Pharma
63, Rue de la Colonie
75013, Paris
FRANCE
Tel: 33-1-4033-1130
Fax: 33–1-40-33-1231
Email: a_ulmann@aol.com

FDA Grants Gynétics Less Restrictive Labeling for PREVENTM

The US FDA has given approval to Gynétics to change the label on their emergency
contraception product, PREVENTM, to a less restrictive one. The previous "Black Box Warning"
label cautioned women "...that cigarette smoking increases the risk of serious cardiovascular side
effects from use of combination oral contraceptives.This risk increases with age and heavy
smoking (15 or more cigarettes a day) and is quite marked in women over 35 years of age.
Women who use combined oral contraceptives should strongly be advised not to smoke." The
new label notes that the warning is given for daily use of cyclical combination oral
contraceptives and that is it unknown whether the warning applies to emergency contraception.
Gynétics feels this change allows them to communicate better with consumers and medical
professionals.
Contact:
Sherry Bump
Gynétics Inc.
105 Raider Boulevard
Suite 203
Belle Mead, NJ 08502-1510
Tel: (908) 359-2429
Fax: (908) 359-6660
Email: info@gynetics.com

PREVENTM Supporters Picket Walmart

In August of this year, protesters picketed a Central Florida Walmart in response to the
company's refusal to dispense the contraceptive kit, PREVENTM, through their pharmacies.
Fourteen protesters held signs reading "Don't get between me and my MD." The protesters were
especially concerned with the organization Pharmacists for Life International, which is currently
lobbying several states to create conscience clauses that would allow pharmacists to refuse to
prescribe medications with which the they have moral, ethical or religious conflicts.Protesters
argued that pharmacists should leave the profession if they do not agree with the products they
dispense.

Contacts: The Kaiser Daily Reproductive Health Report
1501 M St., NW
Washington, DC 20005
Tel: (202) 672-5990
Fax: (202) 672-5767
Email: report@kff.org

PREVENTM goes to Canada

Gynétics Inc. has recently announced an agreement to grant Canadian marketing rights to
PREVENTM to the Roberts Pharmaceutical Corporation for six-years. The Roberts
Pharmaceutical Corporation currently markets women's healthcare products such as REPLENS,
a vaginal moisturizer and ADVANTAGE 24, a nonoxynol-9 spermicidal gel, in Canada.
Gynétics hopes this alliance will allow PREVEN TM to have the same impact on unintended
pregnancies and abortions in Canada as it has in the United States.

Contact:
Roderick Mackenzie
Gynétics Inc.
105 Rider Boulevard
Belle Mead, NJ 08502
Tel: (908) 359-2429
Fax: (908) 359-6660
Email: info@gynectics.com
COUNTRY UPDATES:

BPAS provides EC to women in advance

Following the WHO study that showed emergency contraception was 50% more effective if
taken within 12 hours of having unprotected sex, the British Pregnancy Advisory Service
(BPAS) launched a program to provide EC to women in advance of need. The program,
launched in July, advises women to call a special hotline number and book an appointment with
a physician where she will be advised about the pills. The program has become so popular in
some areas that BPAS has set up "walk-in" services so that women do not even need to make
appointments to receive an ECP supply in advance. Until this program, women were only able to
receive emergency contraception through a prescription after seeing a health professional within
three days of unprotected sex. For many women whose physicians or clinics do not provide
extended hours or are not open over the weekend, the time constraint created a barrier to access.
In addition, the WHO study findings show that it is important for women to have access to EC as
soon as possible. BPAS has a network of 40 clinics around Britain, which will provide EC to
women so that they can have it on hand in the case of an emergency.

Contact:
Ann Furedi
Director of Communications
BPAS
Austy Manor, Wootton Wawen
Solihull, West Midlands, B95 6BX
UNITED KINGDOM
Tel: 01564 794935
Fax:
Email: comm@bpas.demon.co.uk

Emergency Contraception as a Woman's Right: Collaborating with Women's
Organizations in Latin America

The Pacific Institute for Women's Health is working with women's NGOs in Latin America to
strengthen their capacity to provide information on EC and make it known and accepted in their
communities.In 1998, PIWH surveyed women's groups throughout Latin America and the
Caribbean to determine their familiarity with, and interest in emergency contraception.In 1999,
PIWH collaborated with Colectivo de Mujeres Xochilt in Nicaragua, and in Mexico with
Organizacion Lilith de Mujeres Independientes and Instituto Mexicano de Investigación de
Familia y Población (IMIFAP), to develop materials, conduct workshops, and initiate advocacy.

Contact:
Barbara Pillsbury and Helen Rodriguez-Trias
The Pacific Institute for Women's Health
2999 Overland Avenue
Suite 218
Los Angeles, CA 90064
Tel: (310) 842-6828
Fax: (310) 280-0600
Email: bpillsbury@piwh.org

Activists are Concerned about EC Overuse in Thailand

While in other countries EC has only been available by prescription, in Thailand it has been
dispensed freely for the past 20 years.Lately there has been growing concern that EC has
replaced condoms as the primary source of contraception for Thai couples. In fact, many young
men are carrying around EC instead of condoms. Although it is widely used, many people are
not well informed about when or how they should take it.Health officials are concerned that this
behavior will add to the already major problem of HIV infection and urge officials to increase
public awareness about EC.

Contact:
The Kaiser Daily Reproductive Health Report
1501 M St., NW
Washington, DC 20005
Tel: (202) 672-5990
Fax: (202) 672-5767
Email: report@kff.org

UNFPA Provides EC to Countries in Crisis

Since 1994, UNFPA has provided on request to selected countries in crisis, emergency
contraception through grants of Postinor 1 and 2 from Gedeon Richter and PC4 from Schering.
PC4 is included in subkit 3 of the emergency kit has been provided in
Uganda, Senegal, Madagascar, Eritrea, Rwanda, Lesotho, Guinea Conakry, Tanzania, Albania
and Macedonia. Subkit 4 contains combined oral contraceptives and subkit 7 includes IUDs
which both could be used as emergency contraceptives if needed. As UNFPA is currently
evaluating the impact of the kits, they have no precise data on the exact number of EC kits
distributed, their popularity, or the kits' effect on the population.

In Albania, the climate is highly favorable to the dissemination of emergency contraception as it
has recently been legalized. EC is now officially part of national reproductive health programs.

In Angola, a new project called "the starter project" is soon to be launched. This project consists
of the distribution of packages containing 1 female condom, several male condoms, a sanitary
pad and one dose of EC pills. 10,000 doses of NorLevo® pills will be provided in Angola for
this project, as well as 10,000 female condoms provided free of charge by pharmaceutical
companies.

In general, there is not a great demand of EC in areas with high rates of reported rape. Often, the
time elapsed between the rape and the potential prescription of EC is too long. In Kosovo, for
example, raped women walked for days before reaching the border, so that EC could not be
administered efficiently. EC will only have an impact on reducing unwanted pregnancies due to
rape if women are not ostracized by the community and family, know what are the methods,
where they are available, and consult in time.

Contact:
Daniel Pierotti
UNFPA/ERO
Principal Officer Crisis Relief
9 Chemin des Anemones
Chatelaine 1219 Geneve
Tel: (41-22) 917-8314
Fax: (41-22) 917-8049
Email: unfpaero@undp.org

Emergency Contraception in Israel

SHILO, a non-profit family planning education and counseling center in Jerusalem Israel, is
launching a public awareness campaign on the availability and accessibility of emergency
contraception. Weekly advertisements will inform the public of the existence of emergency
contraception in the most widely circulated local newspaper to dispel the myth that it is only
effective the morning-after, and provide telephone numbers where more information can be
received. SHILO's drop-in center is open 5 days a week and provides emergency contraception,
following counseling and medical approval.

The prescribing of birth control pills as emergency contraception was officially approved by the
Israeli Ministry of Health two years ago. However, most women still do not know of its
availability, how to get it or how to use it. SHILO has been committed to informing the
adolescent population about emergency contraception. As a result, the number of requests by
adolescents for emergency contraception at our counseling center has more then doubled over
the past year. The current media campaign, sponsored by US/Israel Women to Women, will
focus more on informing young women in their twenties and thirties, who for the most part are
unaware of emergency contraception . SHILO plans evaluate the effectiveness of the campaign
by the number of phone calls received asking for information and the number of women who
turn to our counseling service requesting emergency contraception.

Contact:
Joanne Zack-Pakes
Director, SHILO
5 King George Street
P.O.Box 2284
Jerusalem 91022
ISRAEL
Tel:972-2-6258841 or 6248412
Fax:972-2-6259741
Email: zack-pak@netvision.net.il
Many American Women Still Have Not Heard of EC

Even with the recent release of dedicated products and large ad campaigns for emergency
contraception, many women are still not aware of the method. A recent survey by the Henry J,
Kaiser Family Foundation found that 90% of OB/GYNs say they do not regularly discuss
emergency contraception with patients. As a result, only 11% of women are aware of EC and
only 1% have ever used it. Many women are confused about the nature of the drug and either are
not aware that they are regular oral contraceptives or mistaken it for the abortion pill, RU
486.Increased use of EC could greatly reduce the number of unintended pregnancies and the
need for abortion.

Contact:
The Kaiser Daily Reproductive Health Report
1501 M St. NW
Washington, DC 20005
Tel: (202) 672-5990
Fax: (202) 672-5767
Email:

Five California Nurses Express their Right to Choose to Not to Dispense EC

This summer five nurses quit their jobs at a county-run health clinic in California because they
did not want to dispense emergency contraception. When the demand for emergency
contraception at the clinic increased, the nurses were asked the sign a list of job expectations by
the County Health Services Agency. The Agency wanted to avoid the possibility of their nurses
imposing their personal views of emergency contraception on the patients.As a result, five nurses
quit their jobs at the clinic. Supporters of emergency contraception believe it is a violation of
federal law to refuse to dispense the medication. Some feel the nurses have the right to express
their beliefs at their jobs, but agree that the women should not be required to work in the clinic.
Another nurse in the clinic opposes emergency contraception as well, but said she believes each
woman should have the right to choose.

Contact:
The Kaiser Daily Reproductive Health Report
1501 M St., NW
Washington, DC 20005
Tel: (202) 672-5990
Fax: (202) 672-5767
Email: report@kff.org

American College of Obstetricians and Gynecologists (ACOG) Criticize Wal-Mart's
decision Not to Dispense Preven

Following the report that one of America's largest pharmacy chains, Wal-Mart, had refused to
distribute the dedicated product for emergency contraception, Preven, members of ACOG have
expressed their disapproval of the company's position.Some members feel that Wal-Mart has a
moral obligation to ensure that women's reproductive rights are not limited.Pharmacists have the
right to refuse to dispense drugs that they feel are morally objectionable according to the
American Pharmaceutical Association. However, ACOG feels pharmacists have an ethical and
moral obligation to refer the patient to another provider for emergency contraception.

Contact:


NEW MATERIALS AND CAMPAIGNS:

Planned Parenthood of Connecticut begins "Dial EC" program

Beginning last fall, Planned Parenthood of Connecticut (PPC) has had an after-hours nurse
practitioner on duty for weekends and evenings, taking calls and calling prescriptions for EC into
pharmacies for Planned Parenthood patients and non-Planned Parenthood patients. From
September to July, 665 prescriptions had been called in to Connecticut pharmacies. Of these
calls, 44% of calls were from teenagers ages 14 to 19 and 60% of calls were not from PPC
patients. Since April, there has been an average of 85 calls a month. Seventy-eight percent of the
calls are over the weekend.

Contact:
Susan Yolen
Vice President, Public Affairs and Communication
Planned Parenthood of Connecticut
129 Whitney Avenue
New Haven, CT 06510
Tel: (203) 865-5158
Fax: (203) 624-1333
Email: susan_yolen@ppfa.org

Planned Parenthood of Connecticut brings EC to Rock Concerts

Planned Parenthood of Connecticut (PPC) has recently experimented with including a clinician
to a booth that they usually have at rock concerts hoping to sell EC "in advance of need." They
found it very difficult to interest young women in purchasing EC before the need. Most young
women felt that if it was available when they did need it, they were not inclined to spend the
money ahead of time. They also administered quizzes at concerts to test the knowledge of teens
and other in attendance about EC. They found that 78% of the women polled at a recent concert
had heard about EC. In addition, 70% of teens under 18 were aware of EC and 79% of women
18-22 had heard about EC. Of EC users, 50% knew it was effective up to 72 hours after
unprotected sex.

Contact:
Susan Yolen
Vice President, Public Affairs and Communication
Planned Parenthood of Connecticut
129 Whitney Avenue
New Haven, CT 06510
Tel: (203) 865-5158
Fax: (203) 624-1333
Email: Susan.Yolen@ppfa.org

The American Medical Women's Association Launches Sex and Sensibility Campaign

AMWA has recently launched an emergency contraception public education campaign to
provide information to women who are unaware or misinformed about EC. The campaign
includes an online quiz to inform women of emergency contraception and explain that it is not an
abortafacient. Dr. Drew Pinsky from MTV's Loveline in the campaign spokesperson.

Contact:
Wendy Chavkin
Editor-in-Chief
Journal of the American Medical Women's Association
Columbia University, CEFH
60 Haven Avenue, B-3
New York, NY 10032
Tel: (212) 304-5552
Fax: (212) 304-5550

Reproductive Health Technology Project Develops EC Campaigns in LA and Philadelphia

In response to focus group research, RHTP has developed multi-faceted strategies incorporating
both traditional media outlets and community-based outreach. Thus far, each campaign has
sparked the interest of the communities of focus. In Los Angeles, brochures and posters in
Spanish and English have been developed and are being distributed to campaign partners and
health educators in the San Fernando Valley, Unicorporated East Los Angeles and Southeast Los
Angeles. Several provider briefings have been conducted to engage health care professionals in
the campaign. In addition, media kits including the brochure and poster, information about
emergency contraception and a press release on the campaign have been distributed to
Latino-focused media outlets in Los Angeles.

In Philadelphia, radio ads with the theme of "After the Fact; After the Act" have been developed
and are currently playing on top urban stations. Since the launch of radio ads in Philadelphia, call
volume to the Emergency Contraception Hotline has more than doubled. Campaign materials
including posters, brochures and postcards are being distributed to over 200 campaign partner
organizations which range from hair and nail salons and recreation centers to residents' councils
in public housing associations and individual prominent community. The Family Planning
Council and Choice of Philadelphia have paid for an additional print run of 30,000 brochures
with inserts of local clinics and the Choice Hotline for distribution within their network of
clinics. Events throughout the city including participation in Black Women's Forums, a joint
promotional effort with the Power 99 van at a YMCA and community college, and a
1-888-NOT-2-LATE challenge marathon between organizations to generate calls to the Hotline
are also planned in the upcoming few weeks.

Contact:
Kirsten Moore
Program Manager
Reproductive Health Technologies Project
Bass and Howes
1818 N Street, NW, Suite 450
Washington, DC 20036
Tel: (202) 530-2900
Fax:
Email: kmoore@basshowes.com

Pharmacy Access Partnership Project

The Pacific Institute for Women's Health (PIWH) has been awarded approximately $100,000 in
the last 6 months to assist with planning efforts to develop a project to explore issues related to
expanding the role of pharmacies in the prevention of unintended pregnancy and sexually
transmitted diseases. This project includes initiating emergency contraception distribution
through pharmacies. The awards were granted by the Gold, Packard and Gerbode foundations.
The project seeks to reform policy; expand public awareness; and implement and evaluate a
series of demonstration projects.Fund raising efforts will soon start for the implementation phase
of this project. Approximately $4.8 million will be sought for collaborative foundation support to
actual implement this project over a three year period.

Contact:
Jane Boggess
Project Director
Pacific Institute for Women's Health
Tel:
Fax:
Email: jeboggess@aol.com

From Secret to Shelf: How Collaboration is Bringing Emergency Contraception to Women

The Pacific Institute for Women's Health, in collaboration with the Packard Foundation, has
brought together in a publication the exciting story of what it took to move emergency
contraception from being "America's best kept secret" to becoming available at the corner
pharmacy.Women's health activists and philanthropic foundations have been major forces in this
important achievement.It will be available in the Fall 1999.

Contact:
Barbara Pillsbury , Francine Coeytaux and Andrea Johnson
The Pacific Institute for Women's Health
2999 Overland Avenue
Suite 218
Los Angeles, CA 90064
Tel:
Fax:
Email: bpillsbury@piwh.org

Pharmacists in British Columbia want to Collaborate with Physicians to Dispense EC

Plans are underway in British Columbia to move forward with an emergency contraception
program involving pharmacists working in collaborative agreement with physicians.The College
of Pharmacists of British Columbia (CPBC - regulatory body) and the British Columbia
Pharmacy Association (BCPhA - voluntary group) are working together toward a launch date of
spring 2000 for several pilot communities in the province.The CPBC recently surveyed 3,000
pharmacists to gauge interest in the program and work has begun to identify pharmacists who
will attend a "train-the-trainers" session in cooperation with the Washington Pharmacists
Association.

Contact:
Judy Schlachter
Director, Communications
British Columbia Pharmacy Association
150-3751 Shell Road
Richmond, BC V6X 2W2
Tel: (604) 279-2053
Fax: (604) 279-2065
Email: judys@bcpharm.bc.ca

RESEARCH RESULTS AND UPDATES:

Recent American Journal of Obstetrics and Gynecology article discusses rape–related
pregnancy rate

A study published in the American Journal of Obstetrics and Gynecology in August 1996 found
that the rape-related pregnancy rate is 5.0% among women aged 12 to 45.Researchers found that
among adult women an estimated 32, 101 pregnancies result from rape each year. Many
unwanted pregnancies are the result of sexual violence. Such information helps to emphasize the
need for emergency contraception to prevent pregnancies that may result from rape.

* Source: American Journal of Obstetrics and Gynecology 1996 August; 175(2):320-4

Contact:

Results of a Provider Survey on ECPs in Ghana
In 1997, a survey was conducted among 325 health care providers in Ghana. About one-third
(34%) had heard of EC, but no provider had sufficient knowledge to prescribe EC correctly.
However, a clear majority (76%) favored EC provision.The three top reasons given were that it
prevents unwanted pregnancy (72%), avoids abortions (16%), and is safe and effective (14%).
Less than a quarter of providers (21%) opposed EC provision. Those who did oppose said that it
is a form of abortion (39%), that it may not be safe (32%), and that it promotes
casual/unprotected sex (12%).The results of this survey highlight an area where there is a need
for increased awareness and education in emergency contraception.

Contact:
Markus Steiner
Family Health International
PO Box 13950
Research Triangle Park
North Carolina, 27709
USA
Tel: (919) 544-7040
Fax: (208) 275-6440
Email:msteiner@fhi.org

Provision of ECPs to Spermicide Users in Ghana

Family Health International (FHI) has recently completed a study of two approaches to provision
of ECPs to spermicide users at four clinics of the Planned Parenthood Association of Ghana.
ECPs had not previously been dispensed at any of these clinics. The objectives of the study were
to evaluate ECP use and unprotected intercourse after the introduction of ECPs.At two clinics,
women were counseled about ECPs and invited to obtain them at the clinic when needed, and at
the other two clinics, women were given a packet of ECPs to use at home if needed. Women
were asked to keep pictorial coital diaries for eight weeks and to return to the clinic for follow-up
at 4 and 8 weeks. A total of 208 women were enrolled.Follow-up ended in spring
1999.Preliminary analysis indicates that women at all clinics used ECPs after almost all
unprotected acts of intercourse and that considering the high total amount of intercourse in this
population, the number of unprotected acts was low at three of the clinics.A final analysis should
be available shortly.

Contact:
Elizabeth Raymond
Family Health International
PO Box 13950
Research Triangle Park
North Carolina 27709
USA
Tel: (919) 544-7040
Fax:
Email:eraymond@fhi.org
Recent Study on EC in India Shows Wide Acceptance

In a recent study on increasing access to emergency contraception in India, researchers found
that 50% of women interviewed would like EC to able available over-the-counter. Currently, EC
is only available through private medical practitioners.The study was conducted in Andhra,
Pradesh, Orissa and New Delhi and found that the major barriers to emergency contraception use
in India were lack of knowledge, awareness, availability and concern about possible side effects.
Supporters want to promote EC through the government family planning programs and are
planning to target policy makers, providers and clients through EC campaigns.

Contact:


RECENT OR UPCOMING MEETINGS:

****Special Notice*****

At the recent ASEC meeting, representatives from Mexico requested that members sign a
petition to the Mexican Ministry of Health supporting the promotion of emergency contraception
in Mexico and worldwide. ASEC wants signatures from individuals around the world,
particularly outside of the United States, who are in favor of emergency contraception and agree
with the following statement:

   TO THE HONORABLE MINISTER OF HEALTH
   DR. JUAN RAMON DE LA FUENTE

   MEXICO

   New York City, October 1st, 1999

   We the undersigned individuals, joined together in a collaborative international effort to
   promote the accessibility and appropriate use of emergency contraception around the world,
   wish to express to your institution and you personally our support for your endeavors to give
   Mexican citizens a revised Official Norm for Family Planning Services in line with the latest
   international medical standards.

   As interdisciplinary professionals deeply involved in reproductive health issues, we want to
   reiterate that hormonal emergency contraception is a safe, effective, simple and widely
   accepted method to prevent unwanted pregnancies. Emergency contraception does not act as
   an abortifacient as it cannot interrupt an established pregnancy. On the contrary, it is a
   preventive method that, when used properly, can help women avoid resorting to unsafe
   abortions.

   We strongly believe that this method should be made available to women worldwide as one
   of the contraceptive options to which they are entitled.
If you would like to add your name to the list please contact Elisa Wells at:

Elisa Wells
Consortium Coordinator
3224 Purdue Street
Anchorage, AK 99508
Tel: (907) 279-2055
Fax: (907) 279-2005
Email: elisa@alaskalife.net

Correction:

In the Spring 1999 newsletter a error was made in the piece titled, "Society for Obstetricians and
Gynecologists of Canada (SOGC) Petitions for OTC EC." We incorrectly stated that the petition
was supported by the WHO. Also in that newsletter, the piece titled, "The Sooner the Better:
Yuzpe and Levo-only Regimens of EC are Most Effective Within 12 Hours of Unprotected Sex,"
said pregnancy risk doubled when treatment was given 61 and 72 hours after unprotected
intercourse. The statement should read, "when the first dose was delayed by 12 hours the odds of
pregnancy increased by almost 50%."