The rationale of this argument has seen much public exposure. The difficulty with it is the fact that the same can be said of any criminal statute. An individual who has the advantage of resources is definitely better equipped to plan and execute a criminal project than an indigent who must rely solely on his cunning and brute force. Of course, we do not repeal the laws against burglary and murder, etc., because of this inequity. Nor do we repeal the laws because the police are unable to catch all of those who have committed crimes. The Commission cites Boddie v. Connecticut, as standing for the proposition that there can be no economic discrimination. This case held only that the state must pay the filing fees of an indigent person in divorce proceedings. At best, it is a narrow precedent and the court makes it clear that the only reason for the decision was that the state was the source of the need to seek judicial process in obtaining a divorce. In a sense, the state was a party to the action by virtue of the fact it required judicial process for divorce. This is hardly true with abortion regulation. In considering the First, Ninth, and Fourteenth Amendment arguments, the Commission reveals a woeful lack of knowledge of the fact that under Article V of the U.S. Constitution, the people of the United States have the fundamental right to amend their Constitution. To imply, as the Commission does, that the exercise of this constitutional right somehow undermines the Constitution is patently absurd. The purpose of Article V is to give the people the means to amend their Constitution when they deem it necessary. Article V supplies the essential tools to make the necessary changes in the Constitution. The Commission implies that a constitutional amendment aimed at nullifying the Supreme Court abortion decisions in Roe and Doe is somehow invidious when it states that such an amendment would undermine the civil rights fabric of the Constitution. The American people have the right, if not the duty, to rectify an erroneous decision of the Supreme Court. When the Supreme Court engages in social engineering through the use of raw judicial power, and creates new rights not heretofore found in the Constitution, as it did in Roe and Doe, the only recourse left to the America people is the amendment process. We note that this process was used to overturn the effects of the infamous Dred Scott decision, which has been likened to the abortion decisions. This is the process which must be utilized to offset the equally infamous Roe and Doe decisions. THE EMORY UNIVERSITY FAMILY PLANNING PROGRAM 60-577 O 76 PT. IV - 59 PREFACE Contraceptive Technology is written with four objectives in mind: to educate, to inform, to create an awareness and to provide a resource. First, it is our hope that we will educate those involved in the primary delivery of family planning services, be they medical students, physicians, nurse clinicians or paraprofessional health workers. Secondly, it is our desire to inform those with an interest in family planning of innovations made in the methods of birth control and in the delivery of family planning services. Thirdly, we wish to create an awareness within the health community of the services that are available to couples wanting to control their fertility. And fourthly, by creating this awareness, to make every physician's office a resource for family planning information. We would like to see all physicians, regardless of specialty or interest, either provide primary family planning services or be able to refer patients to sources for information and services. This seventh edition of Contraceptive Technology was undertaken in order to update the contraceptive section and to add two other major family planning areas namely sterilization and pregnancy termination. This leaves only one of the major areas of a family planning program uncovered that of infertility. Because of the complexities of infertility, we have chosen not to include it in this edition. The focus of this manual continues to be the preparation of information for the family planning professional or student. This is in contrast to a companion publication, The Joy of Birth Control, which will utilize some of the material in Contraceptive Technology and translate it into a format for use by patients. Joy will be ready for publication in the near future. Over the past several years there have been too many contributors to mention all of them by name. They include a cross section of United States family planners. To all, we are deeply indebted. We would, however, like to give particular thanks in this edition to Drs. Henry Kahn (Atlanta) and Donald Moore (Baltimore and Los Angeles) who provided extensive editorial suggestions. We also received suggestions and criticisms this past year from the following individuals whom we would like to thank: Ms. Stephanie Mills (San Francisco), Dr. Richard Dickey (New Orleans), Dr. Jacob Adams (Atlanta), Ms. Felicia Guest (Atlanta), Dr. Edwin Dale (Atlanta), Dr. Barbara Orlans (Washington, D.C.), and Dr. Malcolm Potts (London). This edition of Contraceptive Technology has lost one of its supporters, contributors, and great friends — Dr. Alan F. Guttmacher, who died March 18, 1974. This edition is dedicated to his memory. Robert A. Hatcher, M.D. Randolph W. Kline School of Medicine, 1976 Gary K. Stewart, M.D. Medical Director, Planned Parenthood Obstetrical Consultant, California State Frankie L. Moorhead Meharry Medical College, 1977 TABLE OF CONTENTS I. Principles of Family Planning 1 II. A Statement on Behalf of Voluntary Family Planning 3 2) Mechanisms of Action of Estrogen as Contraceptive Agents 21 3) Mechanisms of Action of Progestins as Con traceptive Agents 4) Estrogen and Progestin Combined.... 5) Progestins Alone as Contraceptives 6) Estrogen Alone as a Contraceptive... F. Intrauterine Devices. G. Lactation .. H. Pregnancy Termination I. Rhythm J. Spermicidal Preparations K. Sterilization VII. Problem Oriented Record System. VIII. References 21 22 35 40 42 54 54 66 69 70 83 84 |