Norplant

by J.C. Willke MD

Norplant consists of six tiny pellets that are inserted under the skin of the upper arm.  These create a slow release of a synthetic form of the female hormone progesterone.  They continue to release this medication over a period of five years.

According to all the publicity you are seeing, this reduces her chance for pregnancy down to one percent or less.  You may have read that different people have seized on it as a possible way of cutting down on teenage pregnancies either voluntarily and possibly even compulsory.

Today I would like to explore whether it is a contraceptive or an abortifacient.  I have looked through the scientific literature pertaining to this rather thoroughly.  Here is one:  "The rate of an ovulation varied between 25 and 80% over a seven year period."  Here is another one Feb. '90 in Contraception, "in their testing 33%, ovulated."  Another one from Population Reports, "Norplant suppresses ovulation in at least half of the menstrual cycles."  The Journal of Fertility and Sterility, July, 1991 said, "Almost half the cycles among Norplant users did not ovulate."  August 1991, Fertility and Sterility , "During the first two years 80 to 90% did not ovulate.  By the fifth year 55% did ovulate."  Contraception March, 1985, "41% ovulated."

Clearly, Norplant does not suppress ovulation all of the time,  eggs are released.  So the question is, "Is there conception or fertilization?"  Most of these same articles describe the drug's second effect, to thicken the mucus plug at the mouth of the womb.  This retards sperm passage.  If sperm cannot get out to the ovary, there can be no fertilization.

A third function is mentioned, the effect it has on the lining of the womb.  This is the one that sends up a red alert to us.

First, if there is no egg released there can not be conception.  This is contraception.             
Second, if the sperm can not get out to the ovary there can be no conception.           

Third, if there is fertilization and this tiny new embryo migrates through the tube, but cannot plant within the nutrient lining of the womb, then we have a micro-abortion occurring at one week of life.  This is an abortion.

So, Norplant does act as a contraceptive.  It is also clear from the studies that conception can occur in as many as 20 to 40% of the cycles.  Many of these eggs are fertilized, but the embryos cannot implant.

Norplant is a contraceptive, but Norplant is also very frequently an abortifacient.  It is more frequently a contraceptive in the first years, it is more frequently an abortifacient in the later years.

Let's be accurate.  Don't call Norplant a contraceptive.  Call it what it is--an abortifacient.