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© Richard Grossman MD, 2008


            A number of years ago I came up with a brilliant invention—a rip-stop condom. Like rip-stop Nylon, it was thin but had a mesh to make it stronger.

I enjoyed the challenges of patenting this invention. The next step was to sell the patent to a manufacturer. The companies I talked with wanted proof that my design was superior to current condoms.

The Akron Rubber Development Laboratory was happy to help test my design. We worked together for several months until I realized that my invention was actually inferior to what was already on the market. I had to give up my dream of making it big in condoms.

            We have many different family planning methods available, but none is perfect. Some have side effects that make them unacceptable to some people. Other methods require a high level of compliance, such as taking a pill every day. One, the male condom, has a high failure rate due to ruptures.

Some methods are so expensive to be prohibitive for many people. For instance, it costs a woman several hundred dollars to get one of the two IUDs that are available. Even birth control pills cost several hundred dollars each year. This high cost may be justified by the price of bringing a new contraceptive product to the market—many millions of dollars.

Fortunately there are imaginative, dedicated people working on finding better family planning methods. Some of them have better ideas and better backing than me.

A few years ago I met Dr. Marcus Filshie at dinner during a medical meeting. I had never thought about the Filshie clip as having been invented by a real person, but I was to learn more at lunch the next day. His invention proved to be more successful than mine.

            Dr. Filshie finished his training in obstetrics and gynecology shortly after The Population Bomb hit the bookstores and raised interest in human population. He worked in Uganda, Africa, where miscarriages are a major problem. Without good medical care, an early pregnancy loss can lead to life threatening hemorrhage or infection. It is essential to remove the dead tissue from the woman’s uterus before it causes a problem. The traditional medical way is with a D&C, but that is “resource intensive”. This minor surgery is usually done with general anesthesia in a hospital. In a developing country there are just weren’t enough facilities or trained people.

Dr. Filshie investigated ways to simplify the care of women with miscarriage. He refined an easy-to-learn technique by perfecting the use of simple instruments that don’t require electricity. It is so straightforward that medical assistants can perform it safely, freeing physicians for more complicated care. He described this technique in a paper published in the prestigious medical journal “Lancet”. His article drew the attention of a medical think tank, the Simon Population Trust, which funded an instructional video illustrating care of a miscarriage.

            The Trust decided that a safe, effective method of doing tubal ligations would benefit women’s health by reducing unwanted fertility. A clip already in use for female sterilization had a high failure rate. The Trust sponsored Dr. Filshie’s research to invent a better clip that is easy to apply using minimally invasive surgery.

            This little clip is titanium around soft Silicone rubber. If a woman wishes sterility, one can be put on each Fallopian tube. This can be done right after the birth of a baby through a small incision in her belly button, or by other surgical techniques. Over 4 million women worldwide have had voluntary sterilization with these clips.

Although Filshie clips are not available in Durango because of cost (destroying a tubal segment with electricity is less expensive), they have at least two advantages over other methods of female sterilization. These clips have a very low failure rate. Furthermore, they only destroy a short segment of the woman’s tube. If she changes her mind and wants another baby, the chances of success with reversal surgery are quite good.

            Worldwide it is estimated that there are two hundred million couples who want to limit their fertility, but don’t have access to modern contraceptive methods. Offering them modern contraceptive choices will go a long way toward slowing the population explosion and toward solving the climate change crisis. Even in this country there are people who have difficulty finding and affording a method that will work well for them. There definitely is need for innovative people to find new ways to help control fertility.

By Richard

I am a retired obstetrician-gynecologist who has been fortunate to live and work in the wonderful community of Durango, Colorado for 40 years.

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