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Reproductive Mortality and Oral Contraceptives

Allan Rosenfield, MD; Irvin Cushner, MD
JAMA. 1983;249(8):1003. doi:10.1001/jama.1983.03330320011006.
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To the Editor.—  The article by Sachs et al entitled "Reproductive Mortality in the United States," which appeared in The Journal (1982;247:2789) could be misleading to a reader on a few important points. For example, the article implied that the number of reproductive deaths would be reduced by almost half if women stopped using oral contraceptives. This assumes that no woman who stopped using the pill would die of any pregnancy-related cause. In fact, some women would get pregnant because they used a less effective contraceptive method, and some of these women would die of some disease related to pregnancy.In addition, there are reliable epidemiologic data that suggest that the pill protects women against such serious diseases as ovarian and endometrial cancer, pelvic inflammatory disease, and ectopic pregnancy. Some women who stopped taking the pill would die of these causes. The article noted that 45% of reproductive deaths in


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