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A bitter pill-scare

The thromboembolic risks associated with combined oral contraceptives are well known, but may not always be communicated effectively to potential pill users. In a cautionary tale about communication, consent, medicine and the media, Lucy Cox traces the French response to Marion Larat's successful lawsuit for damages following a pill-related embolic event. An initial over-response in France gave way to greater calm and clearer guidelines from the European Medicines Agency, but many French women remain wary of oral contraception. Meanwhile, Larat continues her campaign against the medical profession and against third- and fourth-generation pills. This offers a sharp reminder that preventing harms, maintaining trust, and containing costs require honest, evidence-based communication. See page 81

What is ‘sensitive’ disposal of fetal tissue after abortion?

Do you know what happens to the ‘products of conception' after abortion? In the UK, regulations on managing fetal tissue after pregnancy loss are underpinned by the concept of ‘sensitive disposal,' and include discussion of possible cremation and religious or other ceremonies. But surveying women who had undergone abortion, Myers and colleagues found that women themselves often had little knowledge of the fate of fetal tissue, or desire to be involved in decisions about its disposal. Particular anxiety was expressed by women undergoing medical abortion at home. The authors argue that policy and guidelines may need to be revised to reflect women's views. See page 84

Waiting for a yolk sac before TOP may be unnecessary

The high sensitivity of pregnancy tests enables women to seek termination soon after a missed period, and before a yolk sac – the gold standard of confirmed intrauterine pregnancy – is visible on ultrasound. This often results in repeat scans and delays for those seeking abortion. This audit of 1155 women provides early evidence that the combination of an eccentrically placed gestation sac, a decidual reaction, and the absence of risk factors or signs or symptoms of ectopic pregnancy, may …

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