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With a single decision, a woman can elect to have up to five years of effective contraception with the Norplant implant. Since it is coitus-independent, Norplant offers an excellent form of contraception for women who have difficulty remembering to use a birth control method at the time of intercourse or to take a daily pill.1
Despite its benefits, use of the implant system, marketed by Wyeth-Ayerst Laboratories of Phila delphia, lags in the United States. More than 70% of providers who responded to the 1999 Contracep tive Technology Update Contraception Survey say they inserted no implants during the past year. This represents a slight increase from 1998, when 68% reported no insertions. (See charts at right.)
Levels of insertion were consistent with 1998 figures:
• About 16% of providers reported one to five insertions, compared with 18% in 1998;
• 6.5% noted six to 10, the same as in 1998;
• 3.4% indicated 11 to 25, slightly less than the 5% in 1998;
• 1.6% said they inserted 25 or more implants. In 1998, that figure was 4%.
Joanne Shope, FNP, family nurse practitioner at El Dorado County Health Department in South Lake Tahoe, CA, says that while Norplant use decreased for a few years, she is now seeing a resurgence of interest. "I continue at 30 to 50 insertions per year," she notes. "Removals continue about the same level [11 to 25] — probably half at five years, and half for other reasons."
Interest in Norplant has increased over the past year at the Anchorage (AK) Health Department, says Lorraine Charvet, NP, OB/GYN nurse practitioner, who performed six to 10 insertions during the last year. "I’m not sure if it is real interest or because the community is aware that the Norplant system in our clinic is available on a sliding fee scale," she comments.
Levels of Norplant removals appear to be slowing, according to CTU survey results. Almost 70% of providers say they removed no implants in the last year, compared with 62% in 1998.
Fourteen percent said they removed one to five implants, compared with 12% in 1998. Six percent noted six to 10 removals, slightly below 1998’s 9% figure. The largest decrease was seen in the 11 to 25 removal category: 6% in 1999, half of 1998’s 12% level. Three percent said they removed 25 or more implants, compared with 5% in 1998.
1. Hatcher RA, Trussell J, Stewart F, et al. Contraceptive Technology. 17th ed. New York City: Ardent Media; 1998.