WHAT IS NORPLANT? Norplant is a convenient new contraceptive option for women, effective for up to five years.

It is a set of contraceptive implants, six tiny capsules filled with a single hormone called levonorgestrel, a form of progesterone which is the same hormone used in the mini-pill and the contraceptive injection. Norplant inserts can be inserted immediately after a miscarriage or abortion, six weeks after childbirth, or while a woman is experiencing a normal menstrual period.

The implants can also be removed at any time the woman desires and fertility will be restored immediately.

HOW IS IT USED? After careful and extensive counselling by trained personnel, the capsules are placed under the skin on the inside of the woman's upper arm, they will be removed from the same site. Both insertion and removal are minor surgical procedures done under a local anaesthetic. No stitches are required. After insertion the capsules may be felt under the woman's skin but they are in no way unsightly. Protection against pregnancy is achieved after 24 hours.

CONVENIENCE There is nothing for the user to remember, no resupply problem, and Norplant is unrelated to sexual activity.

WOMEN WHO MIGHT CHOSE NORPLANT Women who do not want a child for several years but who may want a child later, women who do not want any more children but do not want sterilisation, women who want nothing to remember daily or before sexual relations, women who are troubled by the oestrogen side effects of pills, and women who can accept changes in menstrual bleeding patterns are among those who might choose to use Norplant.

WHO CAN NOT USE NORPLANT? Women with a history of breast cancer, liver disease or blood clotting disorders should not use Norplant.

EFFICIENCY The risk of pregnancy occurring is one in 500 after one year of use. This compares favourably with contraceptive methods such as the pill, IUD, diaphragm or injection. It is more effective than other methods such as contraceptive creams, gels, inserts or periodic abstinence. If not removed after five years the failure rate becomes one in 25. In women weighing over 160 pounds, Norplant must be removed after three years.

SAFETY Testing of Norplant commenced in 1980 and it is now used in 14 countries worldwide, including the United States. In studies it has been found that 75 percent of women who have Norplant are still using it after one year. It does not appear to have an adverse effect on blood pressure.

SIDE EFFECTS Most women using Norplant will experience some changes in the menstrual bleeding pattern, but by the end of the first year a regular pattern is usually established or long periods with no menstrual bleeding may be noted. A few women experience such side effects as headaches, skin rashes or discolouration, breast pain or enlargement, weight gain and enlarged ovaries.

these side effects also will usually disappear after the first year.

FOLLOW-UP CARE After insertion the site will be covered with a bandage and must be kept dry for three days. The woman should return to the clinic after one month and then after six months for a check-up. After this she need only return once a year when she has her pap test done as well.

Of course if the woman is not happy with the implants she may return at any time to have them removed.

THE FUTURE At present a "Norplant 2'' is being tested. This will consist of only two rods, which will make for much easier insertion and removal. Other forms of implants are now being tested.

Two staff members of the clinic have been to the University of the West Indies in Jamaica for training and it is hoped that within the next six months we will be able to safely offer this method locally.

NURSE BRENDA ROWSE MATERNAL HEALTH AND FAMILY PLANNING