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Why We Need Contraception Innovation

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TECHNOLOGY BIRTH CONTROL
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In his oh-so-perfect parody of conservatives' reaction to the announcement of no co-pay birth control, Steven Colbert has a throwaway line about spermicidal FroYo. I wish.

I just joined the "i" universe and am amazed by the breathless anticipation, speculation and whispered rumors otherwise known as the run-up to the release of the next-generation iPhone.

As a reproductive health advocate, I can't help but wonder: What if we were as devoted, critical and insistent when it comes to contraceptive technologies as we are when it comes to cell phones?

Each time a new iPhone is released, reviews and comparisons flood the Internet. Is it better than the old version? Does it have enough features? It is the right balance of style and function? Will it do everything I want faster and better than the competition? Consumers and wannabe consumers chat, tweet and blog about the features they love, the bugs they hate and the software or hardware changes they would like to see next time around. Apple pays close attention to this chatter, as do their competitors.

What if every year, Americans pored over academic blogs, FDA approval chatter and leaked corporate press releases for clues about what's next? What if we, as consumers, demanded new and diverse contraceptive technologies to fit the fast-paced and complex lives we lead? And what if public and private funding sources marshaled the resources to answer that demand with truly innovative products and methods?

OK, maybe birth control isn't as sexy as a smart phone, but shouldn't it be? Actually, shouldn't it be sexier?

Experts estimate that there are 1 million acts of unprotected intercourse every day.

That fact may be less of a shock when you learn that most women (71 perent) who use contraception are relying on the rotary dial -- methods like birth control pills, tubal sterilization or male condoms, which have been around for 50 years or more. True, newer methods, like the birth control patch or the ring, give women more flexibility by freeing them from the daily task of taking a pill, but when it comes to innovation, contraception seems to have stalled out at the basic flip phone.

Not surprisingly, many consumers are not satisfied with that they're using. For example, 57 percent of women report being dissatisfied with their pill regimen. Seven percent of women aged 15 to 44 who are at risk for unintended pregnancy use no method at all. While some women face barriers to access or information, it is equally true that for many women and couples, the right birth control method has yet to be developed.

What else should be on the horizon?

Remember when we had digital cameras, phones and MP3 players crowding our purses? Now we have one multipurpose device that does it all -- and fits neatly into the pocket of those skinny jeans. Why not ask for the same from birth control? Multipurpose prevention technologies would do just that: combining pregnancy prevention with STI or HIV prevention. Like a condom, these innovations would do "double duty" and may come in the form of a vaginal ring, topical cream or other delivery system.

What about "green" birth control? As more consumers look for ways to limit their ecological footprint, women have begun asking questions about the impact of their birth control method on the environment. A study by UCSF has put to rest one myth -- that birth control pills are a major contributor to estrogen in waterways. (Good news: they're not!) Still, more questions remain about the "life cycle" of contraceptives: the energy and materials that go into their production and the waste they create. For some women, an eco-friendly birth control may be just what the doctor ordered.

And of course, men might appreciate having their own Smartpill. Encouragingly, there are signs that an alternative to the male condom may be inching closer to availability.

Moving beyond the device itself, when it comes to smartphones, there are endlessly customizable combinations of service plans and apps tailored to individual needs, desires and whims. What if we had that kind of variability for birth control?

Sure, you can get a daily reminder about taking the pill. There's an app that charts your cycle so you know when you're most likely to become pregnant if you have unprotected sex. But Consumer Reports has an app that allows you to scan QR tags on appliances and pull up ratings. Imagine if you could do that for birth control methods -- walk into a store and get a "read" on different methods, and find out how other consumers have rated it?

Wait, imagine that you can walk into a store and get birth control! Currently, a woman who wants to purchase birth control over the counter can buy male or female condoms or spermicides. These methods provide protection against STIs, including HIV, but they are less effective in preventing pregnancy than prescription-only methods. Imagine a safe, effective, daily birth control pill regimen available on store shelves alongside condoms and cough medicine. What if there were a Sunglass Hut for contraception?

Each of these innovations has promise, and many are in various stages of development right now (although I can't vouch for the spermicidal FroYo). But without demand from the marketplace and public and private sector investment, they will not become meaningfully accessible to the women and men who need them.

The opportunities for innovation in products and services are as varied as the women and men who need them. There is no one silver bullet (or pill, or condom) when it comes to contraception: each woman is different and has unique and changing life circumstances. As consumers, we need to talk about what we like, what we don't like and what we wish we had when it comes to birth control.

After all, it was the synergy of consumer demand and technological innovation that gave us these incredible little devices. Isn't it about time we did the same for contraception? Why should our smart phones be sexier than sex?