Is the pill getting safer?

The Office of Population Census and Surveys in London maintains a constant observation of possible drug-related mortality in the United Kingdom. In 1969 there were 28 deaths in England where on the certificate of registration the doctor had implicated oral contraceptives as a possible cause of death. The number of deaths in which therapeutic drugs have been implicated, in selected categories, for the years 1967, 1968, 1969, and 1970, respectively, are: contraceptives, 2, 17, 28, and l3; for analgesics, 17, 20, 19, and 24; for anticoagulants, 18, 30, 32, and 28; for antirheumatics, 21, 35, 31, and 27; for corticosteroids and similar drugs, 31, 62, 59, and 57; and psychiatric, 9, 11, 15, and 7. In 21 cases of death from oral contraceptives this was due to venous thrombosis and embolism, in 1 case to coronary thrombosis, and the remaining 6 were ascribed to other adverse effects of estrogen. In 1970 there were 13 such deaths reported: 7 cases of venous thrombosis and embolism, 2 of coronary thrombosis, and 4 resulting from other adverse effects of estrogen. Death certification is not necessarily totally accurate, and in some cases the pill may have been wrongly implicated and in other cases its possible causal relationship may not have been reported on the death certificate. However, Adelstein, reviewing these data, writes: "Although these comparisons are based on relatively few cases, they afford highly suggestive evidence that mortality related to the pill has decreased materially. Hopefully, one could speculate that any morbidity that may be related to the pill should have diminished, roughly speaking, in parallel." The number of oral contraceptive users in England has now returned to the level reported before the adverse publicity which oral contraceptives received early in 1969.