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  • Title: A preliminary report of Norplant implant insertions in a large urban family planning program.
    Author: Crosby UD, Schwarz BE, Gluck KL, Heartwell SF.
    Journal: Contraception; 1993 Oct; 48(4):359-66. PubMed ID: 8222663.
    Abstract:
    During the 21-month period between August 1, 1991, and April 30, 1993, 2,358 women received Norplant system insertions in either Parkland Memorial Hospital or the Dallas Maternal Health and Family Planning clinics. Forty-three percent of these women were teenagers with 14% 16 years of age or less. Overall, 431 patients received Norplant implants insertions postpartum prior to discharge from the hospital. To date, 138 Norplant systems have been removed, with the proportion of contraceptive implant removals among teenagers being essentially the same as that in more mature women. Of the reasons given by women discontinuing the Norplant system, an unanticipated high incidence of pain in the arm containing the implants, hair loss, and mood changes were noted. We have found the Norplant system to be a highly effective and highly acceptable contraceptive method for a large number of indigent women. Between August 1991 and April 1993, in Texas, family planning specialists analyzed prospective data on 2358 women who underwent Norplant system insertions at either the Division of Maternal Health and Family Planning clinics of the University of Texas Southwestern Medical Center or at Parkland Memorial Hospital. The household income of about 90% of the women was at or below the poverty level. Health workers counseled each woman expressing interest in Norplant individually so the women understood the risks, benefits, and side effects. The women had access to health workers via telephone, clinic appointment, or clinic walk-in visits when they had questions and concerns. At the time of insertion, 43% of the women were no older than 19 years of age. 14% were 16-years-old or younger. 63% of the 431 women who received Norplant immediately after delivery were no more than 19-years-old. 74% of all the women had at least one concern about Norplant. The leading concern was pain at the time of insertion (32.1%) followed by weight changes (14.8%), and menstrual changes (12.2%). As of August 1993, only 138 (5.85%) of the women requested removal (adolescents = 40%). The reasons for removal included irregular bleeding (41.3%), headache (22.5%), pain in the arm with Norplant (18.1%), weight gain (14.5%), hair loss (10.1%), mood changes (8%), and desire for pregnancy (8%). The researchers had not anticipated the high incidence rates of arm pain, hair loss, and mood changes. These findings suggested that Norplant is an acceptable longterm contraceptive method. Other studies showed that it is also very effective.
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