To Risk Pregnancy or Death … Should That Even Be A Question?

She thought that the patch would patch up all her sexual limitations, but for Adrianna Duffy, it only created a huge hole in hearts of the people who knew her—a hole that no patch will ever be able to seal shut.

It was just a regular school night at my boarding school in April 2009. I was in the bathroom washing my face when my roommate and her friend Adrianna stumbled into the bathroom in a fit of giggles. As we talked about the future and what we would be like when we got older, Adrianna turned to me and said, “I could see you being one of those sweet old ladies that I would leave my kids with.” I thanked her and we dispersed for the night. Little did we all know that neither I nor anyone else would ever have the opportunity to watch Adrianna’s kids.

Like many teenage girls, Adrianna was in a serious relationship with her boyfriend and engaging in sexual activity. Unlike many teenage girls, however, Adrianna knew exactly what sort of risk such sexual activity would imply without protection. Herself the product of teen pregnancy, Adrianna knew that she did not want to be a teen mom. Adrianna had the courage to seek the protection she needed by going on birth control. What makes Adrianna’s story so tragic is that the one life that she tried to protect is the very one that she ended up losing—her own.

Sex is everywhere. It is on the shows we watch. It is sold with the food we eat and the clothes we wear. It is—literally—what made us. Yet every day people try to push sex out of their thoughts and act like sex does not exist. Then when people finally do engage in sex, they tend to feel guilty and ashamed. This stigma surrounding sex is one of our society’s biggest hypocrisies. When society chooses to shame something that is so natural and fundamental to our existence, it is baffling. But when women’s lives are put at a greater risk because of this sex-avoidant mentality, it becomes more than baffling—it becomes a crisis.

Adrianna, a 17-year-old college freshman, died in September 2009 of a pulmonary embolism (a blood clot of the lungs).  An autopsy found that Adrianna’s birth control, Ortho Evra (also known as the patch), was to blame. Not many women know that the patch contains 60% more estrogen than most common forms of birth control. As was revealed in a Today show special following Adrianna’s death, this high amount of estrogen applied directly into the bloodstream makes women 12 times more likely to experience strokes and 18 times more likely to experience blood clots.

Blood clots become fatal when they travel to the heart and lungs, as in Adrianna’s case. Despite overwhelming evidence that demonstrates Ortho Evra is too dangerous a product to be on the market, the maker, Johnson & Johnson, refuses to pull the product. What makes this refusal even more shocking is that, even before the patch was launched in 2002, the makers knew of the dangerous risks associated with the patch’s use.

The Food and Drug Administration (FDA) also refuses to pull the product off the market, and doctors across the nation have written nearly 40 million prescriptions for the patch. Apparently these doctors believe that the benefits of not becoming pregnant outweigh the high risks of death or other serious complications. The refusal of the FDA and Johnson & Johnson to remove a product that has stolen too many lives is not only a crime against women but also a loud and clear message that sexually active women ought to face harsh repercussions for their decision to have sex: they must risk pregnancy, or death.

When I think about Adrianna, it is very hard for me to picture her lying in a casket instead of being in college and living her life. I tell her story not to bash all hormonal methods of birth control. After all, some of these products have revolutionized the way women can control their sexual and reproductive lives. Her story, rather, should stress to women how crucial it is to know all their birth control options, especially the risks associated with them. It is important to remember that every body is different, and that some methods of birth control might not be right for you. Luckily there are a wide variety of methods available. Don’t forget that birth control is supposed to give women control over their lives, not control their lives.

It is important to know all your options when deciding what birth control may be right for you. Condoms should always be used because they are the most effective method for preventing the spread of STIs. If you are looking for an extra layer of protection against pregnancy, here is a list of commonly effective and available methods of birth control for women. For a more comprehensive list including risks, costs, and ease of use, check out www.plannedparenthood.org or www.itsyoursexlife.com. To learn more about the risks associated with the patch, Google ‘Adrianna Duffy’ and click on the Today show link, “Did drugmaker hide birth control patch risks?”
Birth Control Guide: These methods of birth control are for women and involve putting external devices and hormones into the body to decrease the likelihood of pregnancy. It should be noted that all of these forms of birth control (except the ParaGard IUD) are not effective immediately and need at least seven days to build up in your system. It should also be noted that certain medicines will make these birth control methods less effective (such as the antibiotic rifampin or certain medications for treating yeast infections). Condoms should always be used. Make sure to talk to your doctor or a healthcare provider before starting any of these methods of birth control, and find out any personal risk factors you might have.

Birth Control Pills
Combination Pills: Also known as “the pill,” this form of birth control contains the hormones progestin and estrogen. Both act to inhibit ovulation from occurring. Progestin makes the cervical mucus to the entrance to the uterus too thick for the sperm to get through to the egg and the estrogen increases the blood’s ability to clot. These pills are taken daily at the same time and include 21 active pills and 7 placebo or reminder pills. With correct daily use, fewer than 1 in 100 (less than 1%) of users will still become pregnant in first year of use. About 8 in 100 (8%) of users who are late taking or miss taking pills will become pregnant in first year of use. This method is available by prescription only.
Progestin only pills (POPs): Also known as the “minipill,” this form of birth control pills only contains the hormone progestin, which makes the cervical mucus to the entrance to the uterus too thick for the sperm to get through to the egg. These pills are taken daily at the same time and do not include placebo pills. With correct daily use, fewer than 1 in 200 (0.5%) of users will still get pregnant in the first year. About 1 in 20 (5%) of users who are late taking or miss taking pills will get pregnant in the first year of use. This method is available by prescription only.

Birth control shot (Depo-Provera): Also known as “the shot,” this form of birth control contains the hormone progestin and works in the same way as the minipill. It is injected into the arm and lasts for 3 months. If used correctly, fewer than 1 in 100 (less than 1%) of users will still become pregnant in first year of use. About 6 in 100 (6%) of users who do not use the shot as directed (i.e. not getting the next shot on schedule) will become pregnant in first year of use. This method is available by prescription only and must be administered by a trained professional every time.

Birth control implant (Implanon): Also known as the “implant,” this form of birth control contains the hormone progestin and works in the same way as the minipill. It is the size of a matchstick and is inserted into the arm. It lasts for 3 years. This is a very effective form of birth control because fewer than 1 out of 100 women (less than 1%) will become pregnant during each year of use. This method is available only through a healthcare professional and must be surgically inserted and removed by a trained professional.

Birth control vaginal ring (NuvaRing): Just known as the NuvaRing, this form of birth control contains the hormones estrogen and progestin and works in the same way as the combination birth control pill. It is a small ring that a woman inserts into her vagina once a month. The ring lasts for 3 weeks, at which point it is removed and menstruation occurs. If used correctly, fewer than 1 out of 100 (less than 1%) women will become pregnant in first year of use. About 9 out of 100 (9%) of users who do not use the ring as directed will become pregnant in first year. This method is available by prescription only.

Intrauterine device (IUD): Most commonly known as the IUD, this form of birth control comes in two forms, the Mirena and the ParaGard. Both work to keep the sperm from being able to join with an egg by creating a hostile environment for the sperm to travel in. Both are made of flexible plastic and are in the shape of a small T that is inserted into the uterus. The Mirena IUD uses the hormone progestin and lasts for 5 years and the ParaGard IUD uses copper and lasts for 12 years. The IUD is one of the most effective forms of birth control because fewer than 1 in 100 women (less than 1%) will get pregnant each year of use. This method is available only through your healthcare professional and must be inserted and removed by a trained professional.

Birth control patch (Otho Evra): Most commonly known as “the patch,” this form of birth control contains the hormones estrogen and progestin and works in the same way as the combination birth control pill. The patch releases these hormones directly into the bloodstream. It is a small adhesive patch that a woman attaches once a week for 3 weeks per month. It can be attached to the buttocks, upper arm or lower abdomen. If used correctly, fewer than 1 in 100 women (less than 1%) will still become pregnant in the first year of use. About 9 in 100 (9%) of users who do not use the patch as directed will become pregnant in the first year. This method is available by prescription only.