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Ob.gyns. need to support copay-free contraceptives.

Implementation of the list of preventive services developed by the Institute of Medicine for the U.S. Department of Health and Human Services will save many lives and avoid vast amounts of suffering. The IOM and HSS deserve our accolades, as does ACOG for supporting the recommendations. Sadly, some misguided individuals are fighting against one key component of these preventative services, namely, copayment-free contraceptives. Their objections are based on religion, not science. They believe that the use of condoms and oral contraceptives is immoral. Hence, they mandate the "abstinence only" and "rhythm" methods of family planning. Those of us who have practiced medicine for many years have personally witnessed the abject failure of these ancient methods. Scientific evidence-based medicine has proved that condoms decrease the spread of STDs, including deadly HIY and that oral contraceptives prevent unintended pregnancies. Ironically, and tragically, antiabortion organizations that also campaign against condoms and oral contraceptives inadvertently increase both the transmission of STDs and the number of abortions. As physicians and as advocates for women's health, we must fully support copayment-free contraceptives.

DR. FLAMM is an ob.gyn. practicing in Riverside, Calif He is a member of the Editorial Advisory Board of Ob.Gyn. News. He said he had no relevant financial disclosures.

The adoption by HHS of the recommendations made by the IOM's Committee on Preventive Services for Women will improve women's health. Specifically the provision for co-payment-free contraception will allow more options for women who cannot consider some contraceptives because of the cost. For example, women who cannot afford an IUD will no longer have a financial barrier to one of the most effective forms of contraception. Currently, 49% of all pregnancies in the United States are unintended. Approximately 48% of women terminating a pregnancy were using contraception during the month in which conception occurred. Without a financial barrier, there will not only be more contraceptive options, but also more reliable forms of contraception available for us to discuss with our patients. This provision should be supported by all of us who provide contraception to women.

Dr. Bohon is an ob.gyn in private practice in Washington. She is a member of the Editorial Advisory Board of Ob.Gyn. News. She said she had no relevant financial disclosures.

The list of preventive health services to be covered per the HHS mandate in response to the IOM recommendations is a welcome shift toward the provision of true prevention in health care. Health outcomes for reproductive-age women and their children are absolutely linked to the reproductive health care provided to women. Contraception, health screening, breastfeeding, sexually transmitted infection screening, and intimate partner violence screening address the most immediate health concerns of many women, and are essential in maintaining health. It is important to recognize that although many of these services focus on supporting reproductive health for women, their effects go well beyond reproduction and sexuality. Indeed, these mandated services are linked to 8 of the 10 leading health indicators for "Healthy People 2010." Furthermore, the services go beyond the health of woman by also including their children, families, and links to the greater community. Removing cost as a barrier to preventive health care for women has the power to save dollars and lives.

Dr. Kottke is an assistant professor of ob.gyn. at Emory University and the director of the Jane Fonda Center for Adolescent Reproductive Health, both in Atlanta. She is a member of the Editorial Advisory Board of Ob.Gyn. News. She disclosed that she is a trainer for the implantation of the subcutaneous contraceptive device Implanon.
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Title Annotation:COMMENTARY
Publication:OB GYN News
Date:Sep 1, 2011
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