Caution on Norplant

March 15, 1991

Now that the new contraceptive known as Norplant has been approved by the Food and Drug Administration and will soon be available to women who can afford it, the logical next step was the one taken by the state Health Department this week -- to allow Medicaid, the health insurance program for the poor, to cover the cost of the implant.

Because the state considers Norplant a prescription drug, and Medicaid covers all FDA-approved prescription drugs, the decision might well be considered routine, bureaucratic business. But Norplant is different from, say, Valium in that it is a contraceptive which, once implanted in a woman's arm, prevents pregnancy for five years unless a trained physician removes it. So the potential for abuse is at once obvious.

The contraceptive had barely won FDA approval before a judge in California ordered a woman convicted of child abuse to have Norplant implanted. An editorial in the Sacramento Bee suggested offering drug-addicted women Norplant instead of mandatory drug treatment. Another editorial, in the Philadelphia Inquirer (for which the newspaper later apologized), suggested that paying black welfare recipients to use Norplant might be a good way reduce the high fertility rate among the underclass. Such notions are reprehensible, evoking images of Big Brotherism.

So even as we applaud the state's decision to make Norplant available to poor women, it is important to add a word of caution: Norplant was developed to enhance women's reproductive rights, not to curtail them, and there is a fine line between encouraging use of an effective birth control method and coercing its use. We must be careful not to cross it.

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