wmartin@brl-tgr.ARPA (Will Martin ) (01/26/85)
NPR's "All Things Considered" had a piece some days ago about the use of the Dalkon Shield in Third World countries, and some general info about it. The subject has also been on "60 Minutes" and other news programs. One thing I do not recall ever seeing/hearing was an explanation of just WHY the Dalkon Shield had such bad effects, and why it was designed the way it was, and why it differed from other IUDs. For those who didn't know, or have forgotten, the Dalkon Shield is shaped somewhat like a horseshoe crab -- a curved body with backward-pointing projections. The thing looks somewhat dangerous just in pictures -- one would expect that such relatively sharp projections could become embedded in and damage delicate tissues. Other IUDs I've seen pictured are much more innocuous; they are simple plastic twists or smoother shapes. They look safer, and, from all the uproar about the Dalkon Shield, I guess they are! So I have several questions, and I hope knowledgeable medical types could offer some answers: 1) Why was the Dalkon Shield made in the shape it was? From what I've seen about IUDs, it seems that the shape or material isn't as important in the contraceptive role as the simple fact that this alien body is in the uterus, and its mere presence prevents egg implantation. So why not use smooth, safe devices, as long as they are shaped or large enough to not be expelled or fall out? 2) What actually does the Dalkon Shield DO that causes all the infections? Does it tear the uterine lining with its projections and create wounds which become infected from other causes? 3) It is obvious that these things cost next to nothing to make; they are plastic forms which probably cost as much to manufacture as the plastic top of a pill bottle -- something well under 1 cent. Equally obviously, they were sold for vastly more than they cost -- many thousands of percent markup. Given that situation, why would any drug company be so stupid as to make a form that caused problems, when they could churn out safer IUDs, and still "coin money" by peddling them? The company now is paying vast sums in settlements and legal fees as a result. What on earth possessed them to act so contrary to their own interest? It can't just be "short-term profits" -- they could have made just as much money making a another-shaped IUD. What is going on? 4) Is this IUD any more effective at contraception than any other IUD? If not, why was this particular one so popular, and so widely used by third-world population-control agencies? Simply graft, corruption, and kickbacks? Or more involved reasons? I'd appreciate learning more on this issue from those of you who have more information. Regards, Will Martin USENET: seismo!brl-bmd!wmartin or ARPA/MILNET: wmartin@almsa-1.ARPA
rbg@cbosgd.UUCP (Richard Goldschmidt) (01/28/85)
NPR's recent discussion raised the possibility (denied by the manufacturer,
A.H. Robbins) that the Dalkon Shield had more health risks because it had
two long strings attached rather than one shorter one. These strings are
thought to produce a "wicking" effect which allows bacteria from the vagina
to enter the uterus, producing frequent infections. There may well be other
health hazards associated with the design. The point that impressed me most
about their interveiw with an A.H. Robbins official was his reaction. He
emphasized the financial and image problems faced by the company as a result
of lawsuits, and said that if they had it to do over again they certainly
wouldn't. It is upsetting that those concerns are paramount rather than the
women who died or have become infertile as a result of this device.
Rich Goldschmidt {ucbvax,ihnp4,decvax,allegra} !cbosgd!rbg
ARPA: cbosgd!rbg@ucbvaxdyer@vaxuum.DEC (No Strings Attached) (01/31/85)
Re: IUDs & the Dalkon Shield___________________________________________________
The Dalkon Shield, like other IUDs, has a string attached from it so
that its owner can check its placement in the uterus. Its string, however, is
a number of strands wrapped together. This works like a wick, drawing infec-
tion into the uterus.
As for their motives, your guess is as good as mine. The manufacturer
(A.H. Robins) discovered these infection problems when they tested the product;
but they marketed it anyways! Perhaps they had a huge investment in research
for it. I don't know.
It was very heavily promoted, and sold well in this country. It was
later withdrawn from the market because of its dangers. Many women have had
irreparable damage done to their reproductive systems and a number were killed!
Having lost the American market, Robins decided to cut their losses and
sell the Dalkon Shield in the third world. Again, heavy promotion has led to
its popularity. And to more suffering.
It's not uncommon for manufacturers to find overseas markets (usually
in the third world) for products banned in this country. DDT is still being
made here and sold abroad. Those Tris-coated pajamas are, too.
Not only do they sell the leftovers that they have on hand, they keep
manufacturing more! Probably because they have an investment in the system
that produces these things.
I think it's terrible. For those of you with a "that's their problem"
attitude, remember this: DDT shipped out to a third-world country can come
back from the third world in your bananas or your coffee.
<_Jym_>
:::::::::::::::: Jym Dyer
::::' :: `:::: Dracut, Massachusetts
::' :: `::
:: :: :: DYER%VAXUUM.DEC@DECWRL.ARPA
:: .::::. :: {allegra|decvax|ihnp4|ucbvax}!decwrl!dec-rhea!dec-vaxuum!dyer
::..:' :: `:..::
::::. :: .:::: Statements made in this article are my own; they might not
:::::::::::::::: reflect the views of |d|i|g|i|t|a|l| Equipment Corporation.psal@othervax.UUCP (01/31/85)
==== < FOR THE LINE EATER > ==== The actual danger in the DALKON shield was in the cable-type removal string. It permitted the migration of bacteria from the vagina to the uterus.
annab@azure.UUCP (A Beaver) (02/06/85)
> Re: IUDs & the Dalkon Shield___________________________________________________ > > The Dalkon Shield, like other IUDs, has a string attached from it so > that its owner can check its placement in the uterus. Its string, however, is > a number of strands wrapped together. This works like a wick, drawing infec- > tion into the uterus. > but they marketed it anyways! Perhaps they had a huge investment in research > for it. I don't know. > > I think it's terrible. For those of you with a "that's their problem" > <_Jym_> Back in 1972 I (a person who had never had cramps or problems) had an IUD put in at the local planned parenthood clinic. I bled for 3 months before I was able to convince them to remove it. The next month, I broke down and went to a doctor, who said that I had a pretty bad infection. It took about 3 months to get rid of it. For the next 10-11 years, I had problems with ovarian systs and I often had cramps and discomfort when they were present. They at times would get about as big as a plum or small orange and would at times block off my bowls. It was those times when the syst would rupture and I would once again have to fight an infection. The 3rd time I had a syst rupture, My 30th birthday, I got an infection that after 4months of trying to kill, settled in my tubes. They did my hysterectomy in March. (My birthday is in Oct) One of the doctors that I saw years ago, in an emergency clinic, said that He felt that my problems started with that IUD. Though the systs would come and go almost monthly I was lucky that I only had 3 ruptures. I have two friends who have similar problems, but they are in their mid 20s and the doctors tell them that they should live with it a few more years. 'You're too young for a hysterectomy' I had been on my back in pain (I COULD NOT sit) for almost 6 months continuous, before I convinced the doctor that my age had NOTHING to do with it. Still young enough to enjoy life... Annadiana Beaver A Beaver@Tektronix "The mind must be tuned to the right Frequency" -offonoff-
andrea@hp-sdd.UUCP (andrea) (02/23/85)
There was another danger to the Dalkon shield - it was a triangular
piece, with VERY sharp pointy corners. When I decided to go off the
pill in college and try an IUD, the college health center used only
Dalkon shields (wonderful choice). Of course, since I had never had
a child my uterus was somewhat small, so the doctor used the smallest
one and placed it as high as it could be placed.
I had some slight pain and spotting, and could feel the IUD sticking
into me. The doctor (in the supercilious, arrogant MCP way that is
unfortunately typical of the majority of male gynecologists I have
known) informed me that it was impossible for me to feel the IUD
sticking me, since there were no nerves there. Since I was inside my
body and he was outside, this pronouncement didn't impress me with his
level of expertise or sensitivity.
A couple weeks later, in a biochemistry recitation section, I was
doubled over by the most powerful cramps I'd ever had. I literally
couldn't straighten up. They started coming more and more frequently,
and when they stabilized at every six minutes a couple friends helped
me to hobble (bent over, pale and sweating) to the health center.
The doctor got me into the stirrups, and announced that I was attempting
to give birth to the IUD! The thing had slipped down until it's two
top points were wedged firmly into the cervix; the cervix, being built
for one function essentially, was stimulated into action.
Unfortunately, the pseudo-birth contractions didn't have soft flesh but
hard pointy plastic to clamp down on, yielding excruciating pain and
much blood. All this time, the doctor was telling me (in a very blase
and condescending voice) that it was no worse than menstrual cramps
(how the @#$%@ would he know?) and that there were no nerves in the
cervix anyway.
I was actually dumb enough (at the age of 17) to have the shield
re-inserted, but it happened again in only three days - at which time
I had the thing (which I'd started thinking of as an instrument of
torture) removed.
Years later, I had only slightly better luck with the Copper-7 (it
tried to perforate my uterus, but since I had decided to believe my
internal sensations more than the doctor's pronouncements, I realized
it in time before the perforation was total).
Sigh - back to the pill. (Unfortunately, I haven't found a really GOOD
form of birth control yet - as a country, we seem to spend more on
research to keep lipstick looking wet and shiny than we do on letting
people control their fertility in nondamaging and healthful ways).
Fortunately, though, at least I've found an intelligent and sensitive
gynecologist!
Andrea Frankel, Hewlett-Packard (San Diego Division) (619) 487-4100 x4664
net: {allegra|ihnp4|decvax|ucbvax}!hplabs!hp-sdd!andrea
...searchlights casting for faults in the clouds of delusion