Faced with the threat of multimillion-dollar lawsuits, stringent regulatory requirements and opposition from anti-abortion groups, many U.S. drug firms have stopped developing new contraceptives. Non-profits and smaller firms are trying to fill the void, but they don't have the financial resources to sustain the level of research necessary to produce new products and drugs. As a result, American women have fewer birth-control options than women in most other countries.
For American women struggling to find an alternative birth-control method, a trip abroad can be an eye-opening—if not frustrating—experience. In Jamaica, women routinely receive injections to protect themselves against pregnancy for up to three months. In Sweden, a woman can have a matchstick-sized capsule implanted under her skin that protects her against conception for five years. In West Germany, women can buy a low-estrogen oral contraceptive that is manufactured by an American company but is not available in the United States. None of these products is currently approved for sale in the United States, although some of them could reach the market here in the next two to three years.
For now, American women must choose between contraceptives that are highly effective but can carry health risks—such as the pill or intrauterine devices (IUDs)—and those with a lower risk of side-effects but a higher risk of pregnancy—such as the diaphragm, the cervical cap or the condom. Frequently, a so-called barrier method like the diaphragm carries with it the additional nuisance of interfering with sexual spontaneity, since it must be inserted shortly before sexual intercourse. “We need a contraceptive supermarket,” Stanford University chemist Carl Djerassi, an early developer of the pill, told a scientific audience at the Institute of Medicine in Washington, D.C., on Oct. 19. “There will not be one ideal contraceptive for everyone.”