The Best in the World

It is exciting whenever one has the opportunity to see the best.  Like Rabun Wright, Eva Lathrop and Dr. Skoot Dimon whom I described last week’s article.  Like Caroline White whom I get to work with each week. Like my wife, Maggie, the incredible gardener, whom I get to live with every day. Like Dr. Ward Cates, whose enthusiastic encouragement brings out the best in all around him. And like Steve Hall, my favorite minister of the past 6 decades. So, to all of you, thank you.  Your excellence has made my days better days.

Each of us is in contact with the best from time to time and all too often we see it, focus on it for several moments, say “great,” and move right on without really celebrating what we have seen.

Well, on May 19, 2010, I saw the best up close and personal when I visited the CHOICE project in the Department of Obstetrics and Gynecology at Washington University in St. Louis.

Final Choice Logo

And these words, “the best family planning program in the world” are not just hyperbole. These words are not said just because the person who developed this program, Dr. Jeffrey Peipert, was an Emory Medical School graduate whom I was privileged to work with for protracted periods of time early in his career. They are objectively the truth and the research papers coming out of this program will prove this.

On May 20th, on my return from St. Louis to Tiger, Georgia, I read a remarkable article on family planning by Nicholas D. Kristof in the New York Times. He writes about Poverty and the Pill.

Kristof begins with these words: “Earthquakes are more dramatic. Tsunamis make better television. AIDS is more visceral.

“But here’s a far more widespread challenge, one that’s also more fixable: the unavailability of birth control in many poor countries.”

Kristof says later in his opinion piece: “If contraception were broadly available in poor countries, more than 50 million unwanted pregnancies could be averted annually. One result would be 25 million fewer abortions per year. Another would be saving the lives of as many as 150,000 women who now die annually in childbirth.”

So why is the St. Louis CHOICE project the best? Why could programs like the CHOICE project change the family planning landscape worldwide? CHOICE has provided completely voluntary contraceptive services to Just over 6,000 women. Mirena IUDs have been chosen by 46.9% of the women. This is the IUD that decreases menstrual blood loss by 90% (decreasing anemia in women using this IUD) and markedly decreases menstrual cramps and pain.  Mirena provides the most effective contraception of any reversible contraceptive for 5 to 7 years.

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Another 10.5% of CHOICE women have chosen the copper IUD, called ParaGard.  This IUD provides excellent contraception for 12 years.  And 12.4% of women have left the CHOICE clinics using an Implanon implant that lasts for 3 years.

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ParaGardIUDhand

These 3 methods, used by 69.8% of CHOICE patients, are called the LARC methods, the methods that are Long Acting Reversible Contraceptives. Others have called these 3 contraceptives the “You can’t forget me methods” because once in place there is nothing a woman needs to do to remain protected against an unwanted pregnancy.

The CHOICE project will soon be telling the world of lower contraceptive discontinuation rates, higher levels of satisfaction, lower rates of pregnancy and lower rates of repeat abortion with the “you can’t forget me methods.”

I also hope to tell you in another article about the woman whom Jeff Peipert calls “my boss,” Gina Secura. Gina manages the team of 50 clinicians and research assistants collecting data from the women in this superb contraceptive program.

Aside from their love and concern and wisdom, Gina and Jeff may have their hands on the most detailed information of any contraceptive program in the past decade.  The devil is in the details and Gina is on top of the details. She is one of the major reasons why this program is the best family planning program in the world.