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From: wmartin@brl-tgr.ARPA (Will Martin )
Newsgroups: net.med,net.women
Subject: IUDs & the Dalkon Shield
Message-ID: <7719@brl-tgr.ARPA>
Date: Fri, 25-Jan-85 18:07:36 EST
Article-I.D.: brl-tgr.7719
Posted: Fri Jan 25 18:07:36 1985
Date-Received: Mon, 28-Jan-85 07:34:23 EST
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NPR's "All Things Considered" had a piece some days ago about the use
of the Dalkon Shield in Third World countries, and some general info
about it. The subject has also been on "60 Minutes" and other news
programs. One thing I do not recall ever seeing/hearing was an
explanation of just WHY the Dalkon Shield had such bad effects, and why
it was designed the way it was, and why it differed from other IUDs.

For those who didn't know, or have forgotten, the Dalkon Shield is shaped
somewhat like a horseshoe crab -- a curved body with backward-pointing
projections. The thing looks somewhat dangerous just in pictures -- one
would expect that such relatively sharp projections could become
embedded in and damage delicate tissues. Other IUDs I've seen pictured
are much more innocuous; they are simple plastic twists or smoother
shapes. They look safer, and, from all the uproar about the Dalkon
Shield, I guess they are!

So I have several questions, and I hope knowledgeable medical types
could offer some answers:

1) Why was the Dalkon Shield made in the shape it was? From what I've
seen about IUDs, it seems that the shape or material isn't as 
important in the contraceptive role as the simple fact that this 
alien body is in the uterus, and its mere presence prevents egg
implantation. So why not use smooth, safe devices, as long as they
are shaped or large enough to not be expelled or fall out?

2) What actually does the Dalkon Shield DO that causes all the
infections? Does it tear the uterine lining with its projections
and create wounds which become infected from other causes?

3) It is obvious that these things cost next to nothing to make;
they are plastic forms which probably cost as much to manufacture
as the plastic top of a pill bottle -- something well under 1 cent.
Equally obviously, they were sold for vastly more than they cost --
many thousands of percent markup. Given that situation, why would any 
drug company be so stupid as to make a form that caused problems,
when they could churn out safer IUDs, and still "coin money" by peddling
them? The company now is paying vast sums in settlements and legal fees
as a result. What on earth possessed them to act so contrary to their
own interest? It can't just be "short-term profits" -- they could have
made just as much money making a another-shaped IUD. What is going on?

4) Is this IUD any more effective at contraception than any other IUD?
If not, why was this particular one so popular, and so widely used by
third-world population-control agencies? Simply graft, corruption, and
kickbacks? Or more involved reasons?

I'd appreciate learning more on this issue from those of you who have
more information.

Regards,
Will Martin

USENET: seismo!brl-bmd!wmartin     or   ARPA/MILNET: wmartin@almsa-1.ARPA