
Birth Control via App Finds Footing Under Political Radar - sethbannon
http://www.nytimes.com/2016/06/20/health/birth-control-options-websites.html
======
ars
"With nearly 40 percent of all pregnancies in the United States unintended,
birth control is a critical public health issue."

But check the actual source and:

"Among women who had unintended births in the United States in 1998–2002,
about 40% were using contraception"

So that's very misleading reporting.

Note that they tracked women for 4 years - track someone for their entire life
and the numbers who had at least one child while on birth control at some
point in their life will rise.

Contraception just isn't effective enough to eliminate pregnancy, it can only
function to _reduce_ fertility (number of children).

A typical couple using birth control through their entire life will still have
one or two children - which is the average (more or less) of people in the US
who choose to have children.

The only function of birth control is to reduce fertility from around 10 to
around 2.

~~~
maxerickson
From the third paragraph of the abstract:

 _Results—About 37% of births in the United States were unintended at the time
of conception._

~~~
ars
Did you even read what I wrote? They were not [all] unintended as a result of
lack of birth control.

Giving everyone access to birth control will NOT stop unintended births. It's
not able to do that.

~~~
maxerickson
Sure I read what you wrote. The line you quoted _With nearly 40 percent of all
pregnancies in the United States unintended, birth control is a critical
public health issue._ isn't claiming birth control is 100% effective, it's
saying that there are a lot of people that might benefit from access.

I posted what I posted because I didn't think it was particularly misleading
for the article to state a fact that was important enough to the report to
appear in the abstract. Your language _But check the actual source_ also sort
of implies that the article had misstated the fact. But it did not.

~~~
ars
> it's saying that there are a lot of people that might benefit from access.

Not as many as you would think. The number of people who: 1. want birth
control, 2. are unable to get it, 3. had an child as a result, 4. and would
have preferred not to, is a much smaller number than the article makes it out
to be.

I find that misleading. I don't know why you don't.

These apps are about saving _time_ for people, they will do nothing at all to
the national birth rate.

~~~
DanBC
You said:

> "With nearly 40 percent of all pregnancies in the United States unintended,
> birth control is a critical public health issue."

> But check the actual source and:

And maxericson quoted the actual source, which says

> Results—About 37% of births in the United States were unintended at the time
> of conception.

It seems the report accurately quoted the abstract, and so I'm confused why
you think it didn't.

------
mamon
On one level you are right: this will probably lead to some people harming
themselves with medication obtained without proper medical advice.

On another level: we should not protect people from themselves. If someone is
stupid enough to do something harmfull to him/herself we should let them.
Natural selection will do the rest.

~~~
az0xff
This comment completely glosses over the cases of people who can be pushing
the button but can be affected by circumstances that they really can't control
(like a mental illness). To say that they deserve to die for the sake of
"natural selection" is insensitive and frankly disturbing.

------
tcj_phx
There is a problem with birth control that the media doesn't like to talk
about. While millions of women take birth control, almost all of them
eventually (or immediately) hate the side effects. So most women take these
awful drugs only because they are seen as the best way to prevent pregnancy.

Cruising over to reddit's /r/birthcontrol now, this submission was from 16
hours ago:

> So because I was losing hair after I got my Mirena IUD like a labrador in
> summer, my gyno decided to put me on beyaz (the top anti-androgen) to try
> and stop that. however, we didn't take out mirena because she "wasn't sure
> that was what was causing it"... so basically I'm wondering if anyone else
> is in that situation? [...] > > \-
> [https://www.reddit.com/r/birthcontrol/comments/4orqo1/im_on_...](https://www.reddit.com/r/birthcontrol/comments/4orqo1/im_on_mirena_and_beyazquestion/)

Beyaz is not an anti-androgen, it is a drug that uses the synthetic xeno-
estrogen ethinyl estradiol, and the progestin drug Drospirenone. Progestins
are forms of 'fake progesterone', and usually cause the body's progesterone
production to decrease dramatically. Progesterone is also a brain hormone, so
this is why women on birth control frequently get depressed.

My girlfriend was hurt by her doctor with birth control maybe 10 years before
I met her. They said the depo-provera induced bleeding would stop, eventually.
She let them give her a second 3-month injection, then a third 3-month
injection... Then she decided the doctors were stupid, and stopped after the
3rd injection. That would've been about a year of direct iatrogenic injury.
Maybe this drug directly contributed to her later mental health struggles.

She's amenorrheic right now... 3 or 4 years ago, in her late 20's, some stupid
endocrinologists said that her hot flashes were because she was "going through
menopause" (maybe that's not what the doctors actually said, but they didn't
do anything to help resolve the complaints, so their medical advice was quite
harmful, imho).

I'm well aware the my girlfriend could very well pop an egg out at any time. I
expect her periods will restart as soon as the underlying condition is
addressed. So I've taken out my sperm production using the old heat methods.
It works, I've checked.

I like this site's take on the problem:

> _Women’s unique health concerns are seen by Wall Street as opportunities for
> obscene profit. The development of the ‘hormonal’ birth control (so-called)
> started with good intentions. Science’s understanding of the steroid system
> has advanced since the 1950’s, and real Scientists now know that the fake-
> hormones used as ‘birth control’ cannot improve women’s health. But Wall
> Street has FDA-approved pills to sell and investors’ dividends to pay. The
> drugs are reasonably-effective at suppressing women’s fertility, but are
> defective if women’s complete health profile is taken into consideration
> too._

> _Apologists for the hormonal birth control peddlers acknowledge that these
> drugs have potent side effects. The thinking seems to be “the needs of the
> many outweigh the needs of the few”: while women are still maimed and killed
> by prescription birth control, it’s more important that the women who
> (probably) won’t be killed right away are able to use these drugs to keep
> babies away._

> _The most blatant of Big Drug’s ‘hormonal’ rip-offs are the so-called
> “emergency contraceptive” pills, where profiteers sell women 1.5-cents of
> active ingredients for $50._

> _WOMEN’S HEALTH: A Modern Tragedy_ ,
> [http://swindledandpimped.org/womens_health_a_modern_tragedy/](http://swindledandpimped.org/womens_health_a_modern_tragedy/)

(edits: clarity, typos)

~~~
guard-of-terra
Hundreds of millions also take those without negative side-effects.

~~~
Asparagirl
Yes, but hundreds of millions of women also bounce around _between_ different
types of hormonal birth control (variations in pill type versus Depo shots
versus NuvaRing versus Mirena versus the patch, etc.) because they have
miserable experiences with physical and/or emotional side effects.

I know this is anecdata, but I know two different young healthy women who
suffered strokes or Deep Vein Thrombosis before the age of thirty because of
Yaz. (Both fully recovered, thank God, but will never be able to take hormonal
pills again for life.)

~~~
tcj_phx
> I know this is anecdata, but I know two different young healthy women who
> suffered strokes or Deep Vein Thrombosis before the age of thirty because of
> Yaz. (Both fully recovered, thank God, but will never be able to take
> hormonal pills again for life.)

The cause/effect relationship between elevated estrogen levels and clotting
disorders is well understood by physiologists. All the old high-estrogen
contraceptive pills have been pulled, because the data shows that they were
not safe.

~~~
Asparagirl
Well understood _now_ , yes, but Yaz was heavily marketed to young women as
being the latest and greatest thing on the market, and it passed FDA approval
and came from major manufacturers -- yet it didn't get pulled off the shelves
until 2011, after many deaths and strokes.

I support women having easier access to birth control, but my point is that
even today, this stuff has a different safety profile than, like, Pepto Bismol
or Advil.

(But then again, so does Tylenol, and that's legal, so...)

------
fiatmoney
"Birth control" is ridiculously available. "Hormonal birth control" can have
serious side effects and interactions, at least at the level of something like
tylenol-fortified opiods or mild antidepressants, to say nothing of any net
public-health effects (even after you account for "unwanted pregnancies").
Hell, testosterone, the direct analog, is Schedule III.

But some people have a political interest in promoting infertility, so quasi-
OTC it goes.

------
PretzelFisch
How do you know this app is reputable and deliverers real medicine? I wish the
author had mentioned this. It's not an issue when the app is provided by your
health insurance company. But if it's not how do you know?

~~~
smt88
The app doesn't deliver medicine. Regular pharmacies do. The app just makes it
quicker, easier, and more private to get the prescription in the first place.

From the article:

"...a doctor reviews a woman’s medical information and sends a pill
prescription to a local pharmacy.

"'I thought it was just a setup to get money,' [a user] said. But after she
answered the health questions one evening, 'a doctor actually contacted me
after office hours,' and the next morning, she picked up three months’ worth
of pills."

~~~
PretzelFisch
"All prescribe birth control pills, and some prescribe patches, rings and
morning-after pills. Some ship contraceptives directly to women’s doors."

It's the ship directly to the door part that sounds like it could allow the
selling of fraudulent medicine.

~~~
smt88
Nurx is the one that ships directly to the customer, and the drugs still come
from local pharmacies[1]. They're probably connecting the pharmacies to the
users with some third-party, last-mile delivery service.

1\. [http://www.nurx.co/howitworks.html](http://www.nurx.co/howitworks.html)

------
cperciva
_she used the app Nurx for birth control because she felt uncomfortable
visiting a doctor_

Frankly, this terrifies me. Getting medication which is generally accepted to
be mostly safe from a pharmacy because it's cheaper and more convenient than
seeing a doctor, sure. But if you're not comfortable seeing a doctor... you
should probably be seeing a doctor.

~~~
eli
Agreed, though I was under the impression that the reasons birth control still
requires a prescription is not entirely based in science.

~~~
cperciva
If you take the politics and religion out of it (aka. you move outside of the
USA) then some oral contraceptives require a prescription and some don't.
Preventing pregnancy is quite easy -- screw with pretty much anything hormonal
and you'll dramatically decrease the odds -- but doing that without causing
unpleasant or dangerous side effects is much harder. Some formulations have
had enough testing that we can say that they are generally safe; others should
only be prescribed after a physician has ruled out certain risk factors.

The dangerous bit in this case is that there are many formulations which fall
into the category of "generally safe, but if you experience X, Y, or Z then
you should see a doctor" due to rare but dangerous side effects. In such cases
there's no need to consult a physician before taking the drugs; but they
should not be given to a patient who is "not comfortable visiting a doctor"
and would not obtain medical care if such complications arose.

~~~
mynameislegion
There are plenty of patients who are "not comfortable visiting a doctor" to
get birth control, but who would certainly obtain medical care if
complications arose.

Some doctors require a full pelvic and breast exam for birth control
prescriptions. Patients who've previously been sexually assaulted can be very
uncomfortable being touched _naked_ by anyone other than a chosen and trusted
partner, but still accept the need to be treated for complications. Exam-less
options are a godsend for anyone who cannot handle their first experience
being with a speculum, or who need more time working through trust or intimacy
issues.

------
exstudent2
This is really good news for women (and men in long term relationships with
women). The amount of hoops you have to jump through to get birth control is
ridiculous. Have you ever been in a planned parenthood? It's basically the DMV
(with an equal level of cleanliness). Women have to make at least yearly
visits to this place to get absurd and intrusive medical evaluations just to
get the pill.

Birth control should be over the counter, full-stop.

~~~
bootload
_" The amount of hoops you have to jump through to get birth control is
ridiculous."_

What country is this? In Aus, this is a medical/GP issue and birth control
pharmaceuticals are available at the chemist via a script.

~~~
Zak
Planned Parenthood is often used by women who are not regularly visiting a GP.

~~~
bootload
thanks Zak, that must be difficult.

