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India and perhaps other developing countries have state-sponsored programs to encourage female sterilization, with the aim of controlling population growth. These programs are controversial with reports of “sterilization mills” and of sterilization procedures performed under less than ideal conditions. A Bloomberg News article describes these conditions (http://www.bloomberg.com/news/2013-06-11/india-s-poorest-women-coerced-into-sterilization.html).
Sumati Devi knew before she arrived at the grimy government clinic in northern India that she would be paid to be sterilized.
She didn’t know that she would lie on an operating table with bloody sheets, that the scalpel used to open her up would be stained with rust …
A less invasive procedure than tubal ligation would perhaps make these programs more acceptable. Conceptus Inc. offers an alternative to tubal ligation, which the company describes on its website.
Conceptus’ flagship product is the Essure® system, the most effective non-surgical permanent birth control method available. CE Mark approved since 2001 and FDA approved since 2002, Essure is the first permanent birth control system that can be performed in the comfort of a physician’s office in less than 10 minutes (average hysteroscopic time) without hormones, cutting, burning or the risks associated with general anesthesia or tubal ligation surgery. Soft, flexible inserts are placed in a woman’s fallopian tubes through the cervix without incisions. Over the next three months, the body forms a natural barrier around and through the micro-inserts to prevent sperm from reaching the egg. Three months after the Essure procedure, a doctor is able to perform an Essure Confirmation Test to confirm that the inserts are properly placed and the fallopian tubes are fully blocked, giving the patient reliance on Essure for permanent birth control.
The Essure procedure is 99.95% effective based on one year of follow up with zero pregnancies reported in clinical trials, making it the most effective form of permanent birth control on the market. … Essure has been proven and trusted by physicians since 2001, with approximately 550,000 women worldwide having undergone the Essure procedure.
One drawback to the Essure system is that women must continue to practice birth control for three months until the fallopian tubes are blocked, and then have a follow-up examination.
In order for the use of Essure to be practical in state-sponsored birth control programs, the cost of the Essure inserts would need to be drastically reduced compared to the cost in developed countries like the US. Presumably, the actual cost of manufacturing the inserts is small, so that it would be feasible for Conceptus to reduce the cost. Drug companies sometimes reduce the cost of drugs in developing countries.
If Essure were used in state-sponsored birth-control programs, the programs might find wider acceptance and result in fewer adverse effects for women participating in the programs.