Levonorgestrel-releasing implant: Difference between revisions

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===Norplant and Poverty===
===Norplant and Poverty===
Norplant can be understood as a predecessor of other [[sterilization]] methods of the early 20th century like [[tubal ligation]] and [[hysterectomy]] and has been framed as a solution to poverty.<ref>{{cite book|last=Ordover|first=Nancy|title=“New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism|year=2003|publisher=University of Minnesota Press|location=179-201 and Notes}}</ref> Soon after Norplant was approved by [[Food and Drug Administration]] in December 1990, an article was released by the ''[[Philadelphia Inquirer]]'' suggesting that Norplant would be a solution to "black poverty".<ref>{{cite article|author=|year=1993|title=Norplant: Miracle Drug or Threat to Women's|journal=Human Rights|Publisher=American Bar Association|pages=16-17}}</ref><ref>{{cite article|last:Kanakamala|first:K.|last:Ravi Srinivas|first:K.|year=1992|title=Introducing Norplant: Politics of Coercion|journal=Economic and Political Weekly|Publisher=Economic and Political Weekly|pages=1531-1533}}</ref> The ''Philadelphia Inquirer'' article overshadowed Norplant's potential for granting women reproductive autonomy and suggested the reproductive abuse of poor women. The release of the article followed many policy proposals in which Norplant was at the center.<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> <br />
Norplant can be understood as a predecessor of other [[sterilization]] methods of the early 20th century like [[tubal ligation]] and [[hysterectomy]] and has been framed as a solution to poverty.<ref>{{cite book|last=Ordover|first=Nancy|title=“New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism|year=2003|publisher=University of Minnesota Press|location=179-201 and Notes}}</ref> Soon after Norplant was approved by [[Food and Drug Administration]] in December 1990, an article was released by the ''[[Philadelphia Inquirer]]'' suggesting that Norplant would be a solution to "black poverty".<ref>{{cite article|author=|year=1993|title=Norplant: Miracle Drug or Threat to Women's|journal=Human Rights|Publisher=American Bar Association|pages=16-17}}</ref><ref>{{cite article|last:Kanakamala|first:K.|last:Ravi Srinivas|first:K.|year=1992|title=Introducing Norplant: Politics of Coercion|journal=Economic and Political Weekly|Publisher=Economic and Political Weekly|pages=1531-1533}}</ref> The ''Philadelphia Inquirer'' article overshadowed Norplant's potential for granting women reproductive autonomy and suggested the reproductive abuse of poor women. The release of the article followed many policy proposals in which Norplant was at the center.<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> <br />
In the 1990's, poor women, especially poor women of color who would have previously been a target for tubal ligation are now being selected for Norplant centered policies. By 1991 at least 10 states had considered the insertion of Norplant as a condition of receiving public assistance and other states have considered using Norplant as an incentive for women on public assistance.<ref>{{cite article|author=|year=1993|title=Norplant: Miracle Drug or Threat to Women's|journal=Human Rights|Publisher=American Bar Association|pages=16-17}}</ref> Norplant appealed to liberals and conservatives as a means to decrease rates of poverty and crime and as a method of restricting welfare.<ref>{{cite book|last=Ordover|first=Nancy|title=“New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism|year=2003|publisher=University of Minnesota Press|location=179-201 and Notes}}</ref> At least five states in the early 1990's, including Louisiana and Ohio proposed financial incentives to women who receive public aid to use Norplant.<ref>{{cite article|last:Kanakamala|first:K.|last:Ravi Srinivas|first:K.|year=1992|title=Introducing Norplant: Politics of Coercion|journal=Economic and Political Weekly|Publisher=Economic and Political Weekly|pages=1531-1533}}</ref> In 1991, "former grand wizard of the [[Ku Klux Klan]]," Louisiana representative [[David Duke]] proposed a law that would offer poor women (mostly African American women) public assistance recipients a cash payment for the use of Norplant.<ref>{{cite article|last:Dikotter|first:Frank|year=1998|title=Race Culture: Recent Perspectives on the History of Eugenics|journal=The American Historical Review|Publisher=Oxford University Press|pages=467-478}}</ref> None of these policy proposals have been enacted but these proposals demonstrate that the idea to impose Norplant on poor women's bodies is "alive and well." However, in the early 1990's all states made Norplant available to poor women through [[Medicaid]] and some states like Tennessee enacted a law in 1993 that required anyone who receives public assistance be informed in paper of that state's offer of free Norplant.<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> As a result, most of the women in the United States who used Norplant are Medicaid recipients. The rationality was that "since reproduction by the poor perpetuates poverty and other social ills, policies designed to reduce fertility are an efficient means of at once reducing poverty and cutting welfare costs."<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> <br />
In the 1990's, poor women, especially poor women of color who would have previously been a target for tubal ligation are now being selected for Norplant centered policies.Norplant appealed to liberals and conservatives as a means to decrease rates of poverty and crime and as a method of restricting welfare.<ref>{{cite book|last=Ordover|first=Nancy|title=“New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism|year=2003|publisher=University of Minnesota Press|location=179-201 and Notes}}</ref> By 1991 at least 10 states, including Louisiana and Ohio had considered the insertion of Norplant as a condition of receiving public assistance and other states have considered using Norplant as an incentive for women on public assistance.<ref>{{cite article|author=|year=1993|title=Norplant: Miracle Drug or Threat to Women's|journal=Human Rights|Publisher=American Bar Association|pages=16-17}}</ref><ref>{{cite article|last:Kanakamala|first:K.|last:Ravi Srinivas|first:K.|year=1992|title=Introducing Norplant: Politics of Coercion|journal=Economic and Political Weekly|Publisher=Economic and Political Weekly|pages=1531-1533}}</ref> In 1991, "former grand wizard of the [[Ku Klux Klan]]," Louisiana representative [[David Duke]] proposed a law that would offer poor women (mostly African American women) public assistance recipients a cash payment for the use of Norplant.<ref>{{cite article|last:Dikotter|first:Frank|year=1998|title=Race Culture: Recent Perspectives on the History of Eugenics|journal=The American Historical Review|Publisher=Oxford University Press|pages=467-478}}</ref> None of these policy proposals have been enacted but these proposals demonstrate that the idea to impose Norplant on poor women's bodies is "alive and well." However, in the early 1990's all states made Norplant available to poor women through [[Medicaid]] and some states like Tennessee enacted a law in 1993 that required anyone who receives public assistance be informed in paper of that state's offer of free Norplant.<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> As a result, most of the women in the United States who used Norplant are Medicaid recipients. The rationality was that "since reproduction by the poor perpetuates poverty and other social ills, policies designed to reduce fertility are an efficient means of at once reducing poverty and cutting welfare costs."<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> <br />
[[Aid to Families with Dependent Children]] (AFDC) which was replaced in 1996 by [[Temporary Assistance to Needy Families]](TANF) is the federal program that provides most of the public assistance to poor families. Myths and stereotypes of welfare recipients is what justify Norplant's introduction into welfare policies.<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> Despite the small percentage of the federal budget Aid to Families with Dependent Children represented (less than 1 percent in 1994) policymakers and political pundits believed that there was excessive spending on poor families and Norplant the solution.<ref>{{cite book|last=Smith|first=Anna Marie|title=Welfare Reform and Sexual Regulation|year=2007|publisher=Cambridge University Press|pages=85-117}}</ref><ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> That percentage of the federal budget allocated to public assistance or Temporary Assistance to Needy Families decreased to a mere 0.7 percent of the federal budget in 2008.<ref>{{cite news |first=Dylan |last=Matthews |title=Research Desk Tallies: How expensive is welfare?|url=http://voices.washingtonpost.com/ezra-klein/2010/08/research_desk_tallies_how_expe.html |location = London |work=The Washington Post |date= 9 December, 2010}}</ref>
[[Aid to Families with Dependent Children]] (AFDC) which was replaced in 1996 by [[Temporary Assistance to Needy Families]](TANF) is the federal program that provides most of the public assistance to poor families. Myths and stereotypes of welfare recipients is what justify Norplant's introduction into welfare policies.<ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> Despite the small percentage of the federal budget Aid to Families with Dependent Children represented (less than 1 percent in 1994) policymakers and political pundits believed that there was excessive spending on poor families and Norplant the solution.<ref>{{cite book|last=Smith|first=Anna Marie|title=Welfare Reform and Sexual Regulation|year=2007|publisher=Cambridge University Press|pages=85-117}}</ref><ref>{{cite book|last=Roberts|first=Dorothy|title=Killing the Black Body: Race, Reproduction, and the Meaning of Liberty|year=1997|publisher=Pantheon Books|location=Chapter 3}}</ref> That percentage of the federal budget allocated to public assistance or Temporary Assistance to Needy Families decreased to a mere 0.7 percent of the federal budget in 2008.<ref>{{cite news |first=Dylan |last=Matthews |title=Research Desk Tallies: How expensive is welfare?|url=http://voices.washingtonpost.com/ezra-klein/2010/08/research_desk_tallies_how_expe.html |location = London |work=The Washington Post |date= 9 December, 2010}}</ref>


Revision as of 01:02, 10 December 2012

Norplant / Jadelle
Background
TypeHormonal
Progestogen implant
First use1983 (Finland)
Failure rates (first year)
Perfect use0.05%
Typical use0.05%
Usage
Duration effect5 years
ReversibilityProvided correctly inserted
User remindersFollowing product discontinuation, alternative method required after 5 years
Clinic review3 months following insertion
Advantages and disadvantages
STI protectionNo
WeightNo proven effect
Period disadvantagesInitial irregular light spotting
BenefitsNo further user contraceptive action needed
Medical notes
Possible scarring and difficulty in removal

Norplant is a form of birth control developed by Sheldon J. Segal and Horatio B. Croxatto at the Population Council beginning in 1966, with the first clinical trial in Chile in 1974.[1][2][3] It was first approved in Finland on November 23, 1983, where it was manufactured by Leiras Oy Pharmaceuticals.[4] The original Norplant consisted of a set of six small (2.4 mm × 34 mm) silicone capsules, each filled with 36 mg of levonorgestrel (a progestin used in many birth control pills) implanted subdermally in the upper arm and effective for five years.[5] The original (six capsule) Norplant's production has been phased out; USAID's contract ran until December 2006.[6]

The original (six capsule) Norplant was approved by the U.S. Food and Drug Administration (FDA) on December 10, 1990, and marketed in the United States in 1991 by Wyeth Pharmaceuticals.[7] Norplant distribution in the United States ended in 2002; limited supplies still remained in the U.S. until 2004. Norplant was withdrawn from the UK market in 1999.[8]

Norplant II (Norplant-2, Jadelle), also developed by the Population Council and manufactured by Schering Oy, consists of two small (2.5 mm × 43 mm) silicone rods each containing 75 mg of levonorgestrel in a polymer matrix, instead of six capsules. It was approved May 31, 1996 by the FDA as being effective for three years; it was subsequently approved November 22, 2002 by the FDA as being effective for five years. Jadelle has not been marketed in the United States;[9] Jadelle is the successor to the original Norplant in USAID's contract beginning January 2007.[10]

Insertion

Norplant is implanted under the skin in the upper arm of a woman, by creating a small incision and inserting the capsules in a fanlike shape. Insertion of Norplant usually takes 15 minutes.[11] The capsules can sometimes be seen under the skin, although usually they look like small veins. They can also be felt under the skin. Once inserted, the contraceptive works within 24 hours and lasts up to five years.

Function and effectiveness

Norplant works by preventing ovulation, which means that no eggs are released for fertilization, by thickening the mucus of the cervix, which prevents sperm from entering; and by thinning the lining of the uterus, which makes implantation of an embryo less likely.

The way in which Norplant causes these effects is by use of hormones. A small amount of the hormone progestin is released through the capsules continuously, more during the first year and a half, but then at a level similar to most contraceptive pills afterward. According to studies completed, Norplant has been shown to be 99% – 99.95% effective at preventing pregnancy, and is one of the most reliable, though not the most available, forms of birth control.

Like all hormonal contraception, Norplant does not protect against sexually transmitted infections.

Contraindications

Norplant should not be used in women with liver disease, breast cancer, or blood clots. Women who believe they may already be pregnant or those with vaginal bleeding should first see a physician. However, since Norplant does not contain estrogen like some birth control pills, older women, women who smoke, and women with high blood pressure are not restricted from using the system.

Side effects

After three months of using Norplant, women will need to schedule a follow-up appointment to monitor blood pressure and discuss any concerns. Side effects may include irregular menstrual periods for the first approximately three months, including periods lasting longer than normal, bleeding or spotting between periods, heavy bleeding, or going with no period for the mentioned period of time. Common side effects include weight gain, nervousness, anxiety, nausea, vomiting, mastalgia, dizziness, dermatitis/rash, hirsutism, scalp-hair loss, headache, depression, and acne. Sometimes, pain, itching or infection at the site of the implant will occur. Ovarian cysts may also occur, but usually do not require treatment, although they can cause pain even if benign.

Removal

Norplant can be removed at any time by creating a second incision and withdrawing the capsules. Removal is done with a local anesthetic, and takes about 20 minutes.[11] Norplant is normally removed when the five-year period is over, or if:

  • pregnancy is desired,
  • a different form of birth control is preferred, or
  • complications arise.

Normally removal is not complicated. Removal difficulties have been reported with a frequency of 6.2%, based on 849 removals. Removal difficulties include: multiple incisions, capsule fragments remaining, pain, multiple visits, deep placement, lengthy removal procedure, or other.[12]

If desired, a new implant can be inserted at the time of removal.

Due to the cost of removal, a few patients have resorted to self-surgery attempts at removing Norplant, often with improvised instruments that worsened their condition.[13]

Targets

Norplant was essentially a desired form of population control.[14] At first the device was marketed specifically to poor women, and included an incentive of $500 from legislative members, along with an additional $50 dollars supplied to the women each additional year the device remained inserted[15] . Due to the fact that society most often associates welfare recipients to be of African heritage, the black population in turn became the target population; blacks are also five times more likely to live in poverty, furthering the likelihood that they would be supplied the device. In addition to African American women, the teen population was also greatly affected by Norplant. Black birthrates to teen mothers are more than double compared to whites, which unfortunately further links the black race as a direct target for this form of population control.[16] Although effective in decreasing teen birth rates, Norplant produced unintended consequences in relation to sexually transmitted diseases. More specifically, Norplant indirectly offered an incentive to have more sex; Norplant secured teens protection against having children, allowing them to have more sex without the burden of possibly having a child, which thus greatly increased the odds of contracting an STD.[17]

Norplant and Poverty

Norplant can be understood as a predecessor of other sterilization methods of the early 20th century like tubal ligation and hysterectomy and has been framed as a solution to poverty.[18] Soon after Norplant was approved by Food and Drug Administration in December 1990, an article was released by the Philadelphia Inquirer suggesting that Norplant would be a solution to "black poverty".[19][20] The Philadelphia Inquirer article overshadowed Norplant's potential for granting women reproductive autonomy and suggested the reproductive abuse of poor women. The release of the article followed many policy proposals in which Norplant was at the center.[21]
In the 1990's, poor women, especially poor women of color who would have previously been a target for tubal ligation are now being selected for Norplant centered policies.Norplant appealed to liberals and conservatives as a means to decrease rates of poverty and crime and as a method of restricting welfare.[22] By 1991 at least 10 states, including Louisiana and Ohio had considered the insertion of Norplant as a condition of receiving public assistance and other states have considered using Norplant as an incentive for women on public assistance.[23][24] In 1991, "former grand wizard of the Ku Klux Klan," Louisiana representative David Duke proposed a law that would offer poor women (mostly African American women) public assistance recipients a cash payment for the use of Norplant.[25] None of these policy proposals have been enacted but these proposals demonstrate that the idea to impose Norplant on poor women's bodies is "alive and well." However, in the early 1990's all states made Norplant available to poor women through Medicaid and some states like Tennessee enacted a law in 1993 that required anyone who receives public assistance be informed in paper of that state's offer of free Norplant.[26] As a result, most of the women in the United States who used Norplant are Medicaid recipients. The rationality was that "since reproduction by the poor perpetuates poverty and other social ills, policies designed to reduce fertility are an efficient means of at once reducing poverty and cutting welfare costs."[27]
Aid to Families with Dependent Children (AFDC) which was replaced in 1996 by Temporary Assistance to Needy Families(TANF) is the federal program that provides most of the public assistance to poor families. Myths and stereotypes of welfare recipients is what justify Norplant's introduction into welfare policies.[28] Despite the small percentage of the federal budget Aid to Families with Dependent Children represented (less than 1 percent in 1994) policymakers and political pundits believed that there was excessive spending on poor families and Norplant the solution.[29][30] That percentage of the federal budget allocated to public assistance or Temporary Assistance to Needy Families decreased to a mere 0.7 percent of the federal budget in 2008.[31]

Norplant use in the judiciary

Since its approval by the Food and Drug Administration on December 1990, Norplant has been used in at least two state courts where the judge orders the implantation of Norplant as a condition of probation for women convicted of child abuse, child neglect, drug possessions, drug abuse and drug sale.[32][33][34][35] On January 2, 1991 in the Tulare County of California Judge Howard Broadman convicted Darlene Johnson of child abuse and sentenced her to one year in prison and four years of probation on the condition of using Norplant for three years of her probation. Judge Broadman gave Darlene Johnson a choice; it was either four years in prison or to accept Norplant as a condition of granting probation.[36] Similar cases have occurred in Texas and Florida.[37] In the case of Texas, in 1991, a judge suggested Norplant as a condition of a woman's probation. The women who had pleaded guilty to child abuse conceded but Norplant was removed after she experienced a negative reaction but had a tubal litigation instead. In 1990, in Jacksonville, Florida, Tracy Wilder was convicted of manslaughter and was given 2 years of jail time and 10 years of probation on the condition of using birth control. Tracy Wilder was given no other option and could not appeal her sentence.[38][39] Other instances of the use of sterilization or birth control in convictions occurred in 1965 and 1972. In 1965, in California, Victoria Tapia was given a reduced sentence and probation if she consented to a sterilization after her conviction of welfare fraud. In 1972, in Oregon, the Court of Appeals, went in favor of the sterilization of a seventeen-year-old girl because the Court believed the girl would be unable to care for children who would become the wards of the state.[40] The use of Norplant in courts are instances in which women's reproductive freedom and their human right to control their fertility are not recognized.[41]

Availability

Norplant discontinued in the United States

By 1996, more than 50,000 women had filed lawsuits, including 70 class actions, against Wyeth and/or its subsidiaries, or doctors who prescribed Norplant.[42] Wyeth never lost a Norplant lawsuit, even in cases which came before a jury.[43]

On August 26, 1999, after winning 3 jury verdicts, 20 pretrial summary judgments and the dismissal of 14,000 claims, Wyeth offered out-of-court cash settlements of $1,500 each to about 36,000 women who contended that they had not been adequately warned about possible side effects of Norplant such as irregular menstrual bleeding, headaches, nausea and depression. Wyeth said that most of the plaintiffs experienced routine side effects described in Norplant's labeling information. Wyeth did not admit to any wrongdoing, saying the settlement offer "was purely a business decision," noting "our legal success has come at a steep price because lawsuits are time-consuming, expensive, and have a chilling effect on research," and that it would continue to offer Norplant and would contest "any and all new lawsuits aggressively."[44][45]

About 32,000 women accepted the out-of-court $1,500 settlements. On August 14, 2002, Wyeth won partial summary judgment and dismissal of the claims of the 2,960 remaining plaintiffs who had not accepted Wyeth's out-of-court settlement offer.[46]

In August 2000, Wyeth suspended shipments of Norplant in the United States because during regular quality assurance monitoring, representative samples of seven lots distributed beginning October 20, 1999 tested within product specifications, but at the lower end of the release rate specification for shelf life stability, raising concerns about those lots' contraceptive effectiveness. Wyeth recommended that women who had Norplant capsules from those lots implanted use backup contraception until they determined the clinical relevance of the atypically low levels of levonorgestrel release.[47]

On July 26, 2002, Wyeth announced that data from investigations conducted in women with Norplant capsules from the suspect lots did not suggest less contraceptive effectiveness than that reported in clinical trials, and that therefore backup contraception could be safely discontinued. Wyeth also announced that due to limitations in product component supplies, they did not plan to resume marketing the six-capsule Norplant system in the United States.[48]

New Zealand

Jadelle will be subsidized for use in New Zealand by government medical body PHARMAC from August 2010. Medical professionals raised concerns during a consultation process indicating preference for a product which is easier to insert. The agreement between Bayer New Zealand and PHARMAC was conditional on Bayer New Zealand providing adequate training to ensure doctors are comfortable in the insertion and removal technique.[49] The consultation process is not public and it is unclear if this addresses the concerns raised. Medical professionals also suggested follow up. PHARMAC will 'suggest' this to the manufacturer.

Use in the developing world

Despite its discontinuation in the US and the West, Norplant is still used in the developing world. According to one study 6.2 out of 100 rural women interviewed in one region in Bangladesh use the device, according to the United Nations Population Fund.[citation needed] Prior to its approval by the Food and Drug Administration in 1990, Norplant was tested on women from Brazil, Bangladesh, Dominican Republic, Indonesia, and Egypt.[50]

Norplant and other implantable contraceptives are especially effective in the developing world, as they do not require daily administration or access to a hospital to be effective. In addition, no continual contraceptive supplies (pills, condoms, etc.) are necessary, and it is a highly effective, low cost contraceptive over the long term. Although effective in regards to preventing pregnancy, in countries such as Indonesia, those currently taking Norplant are the only ones to receive their paycheck on time. It has also been reported in Indonesia that women have been threatened at gunpoint in order to accept the removal Norplant, in order to control population growth.[51]

References

  1. ^ Subcommittee for Workshop on Implant Contraceptives, Committee on Contraceptive Research and Development, Division of Health Policy, Institute of Medicine (March 9, 1998). "Appendix B: Norplant: historical background". In Harrison, Polly F.; Rosenfield, Allan (eds.). Contraceptive research, introduction, and use: lessons from Norplant. Washington, D.C.: National Academy Press. pp. 107–114. ISBN 978-0-309-05985-5. {{cite book}}: |author= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)CS1 maint: multiple names: authors list (link)
  2. ^ Sivin, Irving; Nash, Harold; Waldman, Sandra (February 28, 2002). "Development and introduction of contraceptive implants". Jadelle® levonorgestrel rod implants: a summary of scientific data and lessons learned from programmatic experience (PDF). New York, N.Y.: Population Council. pp. 1–6. ISBN 0-87834-105-6.
  3. ^ Gunardi, Eka Rusdianto; Affandi, Biran; Muchtar, Armen (January 2011). "Monoplant® the Indonesian implant: the overview of implant and its development". Indoesian Journal of Obstetrics and Gynecology. 35 (1): 40–46. ISSN 0303-7924.
  4. ^ Roy, Subir (1985). "Current status of Norplant subdermal implants for contraception". In Runnebaum, Benno; Rabe, Thomas; Kiesel, Ludwig (eds.). Future aspects in contraception: proceedings of an international symposium held in Heidelberg, 5–8 September 1984; Part 2, Female contraception. Boston, Mass.: MTP Press. pp. 95–106. ISBN 0-85200-906-2. The Finnish National Board of Health approved the NORPLANT sub-dermal implant system as a contraceptive method in Finland on 23 November 1983. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  5. ^ Norplant
  6. ^ CCP: Pearl of the Week
  7. ^ Grimes, William. "Sheldon J. Segal, Who Developed Contraceptives, Dies at 83", The New York Times, October 20, 2009. Accessed October 22, 2009.
  8. ^ "Contraceptive implant withdrawn". BBC News. April 30, 1999. Retrieved May 20, 2010.
  9. ^ Population Council | Jadelle Implants FAQ General Info
  10. ^ Pearl of the Week
  11. ^ a b Norplant Birth Control: Questions and Answers American Academy of Family Physicians. July 1991 Eastern Carolina Family Practice Center.
  12. ^ Norplant side effects (Levonorgestrel (Unavailable in US)) and drug interactions - prescription drugs and medications at RxList
  13. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books.{{cite book}}: CS1 maint: location (link)
  14. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction and the Meaning of Liberty. Chapter 3: Pantheon Books. pp. 109–111.{{cite book}}: CS1 maint: location (link)
  15. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books. pp. 109–111.{{cite book}}: CS1 maint: location (link)
  16. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books. pp. 113–116.{{cite book}}: CS1 maint: location (link)
  17. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books. pp. 116–118.{{cite book}}: CS1 maint: location (link)
  18. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
  19. ^ Template:Cite article
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  21. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books.{{cite book}}: CS1 maint: location (link)
  22. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
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  26. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books.{{cite book}}: CS1 maint: location (link)
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  28. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books.{{cite book}}: CS1 maint: location (link)
  29. ^ Smith, Anna Marie (2007). Welfare Reform and Sexual Regulation. Cambridge University Press. pp. 85–117.
  30. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books.{{cite book}}: CS1 maint: location (link)
  31. ^ Matthews, Dylan (9 December, 2010). "Research Desk Tallies: How expensive is welfare?". The Washington Post. London. {{cite news}}: Check date values in: |date= (help)
  32. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
  33. ^ Template:Cite article
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  36. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
  37. ^ Template:Cite article
  38. ^ Template:Cite article
  39. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
  40. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
  41. ^ Template:Cite article
  42. ^ Erica Johnson (April 1, 2003). "Medical device lawsuits". CBC news.
  43. ^ http://www.arhp.org/files/ndicimplants.pdf
  44. ^ "Contraceptive Maker Wins Woman's Suit Over Side Effects". The New York Times: A.7. 1998. {{cite journal}}: Unknown parameter |month= ignored (help)
  45. ^ Morrow, David J. (1999). "Maker of Norplant Offers a Settlement in Suit Over Effects". The New York Times: A.1. {{cite journal}}: Unknown parameter |month= ignored (help)
  46. ^ Manson, Pamela (2002). "Federal Judge Dismisses Norplant Damage Claims". Texas Lawyer. Retrieved 2007-01-15. {{cite journal}}: Unknown parameter |month= ignored (help)
  47. ^ Medwatch - 2000 Safety Information
  48. ^ Update on Advisory for Norplant Contraceptive Kits
  49. ^ [1] Pharmac - Jadelle funding
  50. ^ Ordover, Nancy (2003). “New Technologies, Old Politics: Norplant and Beyond,” from America Eugenics: Race, Queer Anatomy, and the Science of Nationalism. 179-201 and Notes: University of Minnesota Press.{{cite book}}: CS1 maint: location (link)
  51. ^ Roberts, Dorothy (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Chapter 3: Pantheon Books. p. 19.{{cite book}}: CS1 maint: location (link)

External links

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