S&P 500 gains for fourth session on light volume

NEW YORK (Reuters) - Stocks finished modestly higher on Wednesday, with the S&P 500 up for a fourth session, although volume was one of the year's lowest on the day ahead of the Thanksgiving holiday.

Investors welcomed news that a ceasefire was declared to end the flare-up in violence between Israel and the Palestinians, though the lack of a deal to release emergency aid for Greece limited the market's advance.

Investors also remained anxious about the mandatory tax increases and spending cuts that would go into effect in the new year if a deal is not reached to prevent it - known as the "fiscal cliff" - though policymakers are not expected to get back to negotiations until after Thursday's Thanksgiving holiday.

About 4.76 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with year-to-date daily average volume of 6.5 billion shares. On Thursday, the U.S. stock market will be closed for the Thanksgiving holiday, and on Friday, it will close early at 1 p.m. (1800 GMT).

"Usually on patriotic holidays, which I think Thanksgiving is one, we often see a rally on a light volume. So I wouldn't be surprised if we see that on Friday, if there is no major news," said J.J. Kinahan, chief derivatives strategist at TD Ameritrade in Chicago.

"So far this week, we have heard good news in terms of (the) fiscal cliff. Both sides seem to be playing nice, but we will start to see big day-to-day swings (in the market) from next week, when we get more details."

Greece's international lenders failed again to reach a deal to release emergency aid to the debt-saddled country. Lenders will try again next Monday, but Germany signaled that significant divisions remain.

A truce between Israel and Hamas gave stocks some support around midday after Egypt announced a ceasefire would come into effect later in the day.

Fears that the fiscal cliff discussions in Washington could be drawn out or yield no resolution have been at the forefront of investors' minds in recent weeks. Combined with concerns about the euro zone's continued debt problems, the worries had driven a sell-off that has taken more than 5 percent off the S&P 500 since Election Day in early November.

Positive comments from U.S. politicians that they will work to find common ground have helped the S&P 500 recoup some of that loss in recent sessions.

The Dow Jones industrial average <.dji> gained 48.38 points, or 0.38 percent, to end at 12,836.89. The Standard & Poor's 500 Index <.spx> added 3.22 points, or 0.23 percent, to finish at 1,391.03. The Nasdaq Composite Index <.ixic> rose 9.87 points, or 0.34 percent, to close at 2,926.55.

St Jude Medical shares tumbled 12.2 percent to $31.37 after an inspection report from health regulators raised new safety concerns about one of the company's leads that are used with implantable defibrillators, analysts said.

A modest gain in International Business Machines helped the Dow outperform the other indexes. IBM rose 0.6 percent to $190.29.

Dow component Hewlett-Packard Co climbed 2 percent to close on Wednesday at $11.94, recouping a small slice of Tuesday's loss, when the stock slid to a 10-year low after the computer and printer maker reported a $5 billion charge related to "accounting improprieties" at Autonomy, a British software company that HP bought last year. At least two brokerages have cut their ratings on HP's stock, while analysts at several firms lowered their price targets.

Salesforce.com Inc jumped 8.8 percent to $158.78 a day after the business software provider reported results that beat Wall Street's expectations for the third quarter and maintained its outlook for the rest of the year.

But Deere & Co dragged on the S&P 500 after the world's largest farm equipment maker reported a weaker-than-expected quarterly profit. Its stock lost 3.7 percent to $82.83.

The market did not derive much direction from the day's economic data, with initial jobless claims falling last week, as expected.

Other data showed manufacturing picked up at its quickest pace in five months in November, while the Thomson Reuters/University of Michigan's final reading for November showed the consumer sentiment index improved only slightly from the previous month.

The focus will likely turn to retailers on Friday as analysts try to assess how strong the holiday shopping season will be this year, according to Kurt Brunner, portfolio manager at Swarthmore Group in Philadelphia.

The S&P 500 retail sector index <.spxrt> was up 0.6 percent.

Holiday shopping traditionally kicks off the day after Thanksgiving, known as Black Friday, as stores offer deals and discounts to lure consumers.

Advancers beat decliners by a ratio of about 2 to 1 on both the New York Stock Exchange and the Nasdaq.

(Editing by Jan Paschal)

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Cease-Fire Between Israel and Hamas Takes Effect

CAIRO — Israel and Hamas agreed to a cease-fire on Wednesday, the eighth day of lethal fighting over the Gaza Strip, in a deal completed under strong American and Egyptian diplomatic pressure that quieted an aerial battle of rockets and bombs and forestalled — for now — an escalation into an Israeli invasion.

The cease-fire, which took effect at 9 p.m. local time (2 p.m. Eastern), was formally announced by Secretary of State Hillary Rodham Clinton and Foreign Minister Mohamed Amr of Egypt after intensive negotiations in Cairo. It was welcomed by all sides, but whether the cease-fire could hold was uncertain.

Even in the minutes leading up to the effective start time, the antagonists were firing at each other, and the Israeli authorities reported at least five Palestinian rockets were lobbed into southern Israel shortly after the cease-fire had begun. But no damage or injuries were reported and the rocket fire seemed to end in the second hour. In Gaza, thousands of residents came outside to celebrate.

“This is a critical moment for the region,” Mrs. Clinton, who rushed to the Middle East late Tuesday in an intensified effort to halt the hostilities, told reporters in Cairo. She thanked Egypt’s president, Mohamed Morsi, who played a pivotal role in the negotiations, for “assuming the leadership that has long made this country a cornerstone of regional stability and peace.”

Mrs. Clinton also pledged to work “with our partners across the region to consolidate this progress, improve conditions for the people of Gaza, provide security for the people of Israel.”

Mr. Amr said Egypt’s role in reaching the agreement reflected its “historical commitment to the Palestinian cause” and Egypt’s efforts to “bring together the gap between the Palestinian factions.”

The top leader of Hamas, Khaled Meshal, also had strong words of praise for the Egyptian leader, a former official in the Muslim Brotherhood, in which Hamas has roots. At a news conference in Cairo, Mr. Meshal thanked Egypt for its role and said Israel had “failed in all its objectives.”

The negotiators reached an agreement after days of nearly nonstop Israeli aerial assaults on Gaza, the Mediterranean enclave run by Hamas, and the firing of hundreds of rockets into Israel from an arsenal Hamas had been amassing since the three-week Israeli invasion four years ago.

Under the terms distributed after the cease-fire was announced, Israel agreed to stop all land, sea and air hostilities in Gaza, including the “targeting of individuals” — a reference to militants of Hamas and its affiliates who have been killed. The cease-fire also called on the Palestinian factions in Gaza to stop all hostilities against Israel, including rocket attacks and attacks along the border.

But the terms also state that underlying grievances of Gazans, most notably the border restrictions Israel has imposed that impede the movement of people and goods through Gaza, will be addressed starting 24 hours after the cease-fire is in effect. Precisely how they will be addressed was left unclear.

Also left unclear was how the agreement would be enforced, but the terms stated that “each party shall commit itself not to perform any acts that would breach this understanding.”

The agreement came despite a bus bombing in Tel Aviv earlier in the day, applauded by Hamas and other Palestinian militant groups, which invited Israeli reprisals and threatened to derail the talks. Also complicating the path to the cease-fire were Israeli strikes overnight on Gaza.

Prime Minister Benjamin Netanyahu of Israel, who had been threatening to start another ground invasion if the Gaza rockets did not stop, said in a statement that he was satisfied, for the moment, with the outcome. But he left open the possibility of more military action.

The statement issued by his office said Mr. Netanyahu had spoken with President Obama and “responded positively to his recommendation to give a chance to the Egyptian proposal for a cease-fire and to allow an opportunity to stabilize the situation and to calm it down before there is a need to use much greater force.”

An agreement had been on the verge of completion on Tuesday, but was delayed over a number of issues, including Hamas’s demands for unfettered access to Gaza via the Rafah crossing into Egypt and other steps that would ease Israel’s economic and border control over other aspects of life for the more than one million Palestinian residents of Gaza, which Israel vacated in 2005 after 38 years of occupation.

David D. Kirkpatrick reported from Cairo, Ethan Bronner from Jerusalem and Rick Gladstone from New York. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza, Isabel Kershner from Jerusalem, Alan Cowell from London, Andrea Bruce from Rafah and Christine Hauser from New York.

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6 actually useful smartphone apps to get you through Black Friday

Gracefully navigate the shopping madness by doing a little prep work on your iPhone or Android before you leave the house

Ah, the holidays! Big-box stores compete with online behemoths for customers, while customers compete with each other to get the best Black Friday savings. And, in a new digital twist, Black-Friday-focused apps are competing with one another for downloads. Developers are creating all sorts of helpful ways for customers to sniff out bargains, track spending, and manage their nephew’s wish list. Now that The Week has advised you on Black Friday “deals” to avoid, here’s a rundown of some of the more helpful apps out there: 

Black Friday by BradsDeals
The folks behind BradsDeals.com, a site known for tracking down coupons and discounts, put together this helpful Black Friday app that shows you all the leaked ads and discounted items from 100 major retailers like Sears, Kohls, and Macy’s. Who needs a newspaper? (iPhone-only)

Black Friday Deal Finder by Fat Wallet
Search for deals using variables like free shipping, doorbusters, online availability, rebates, and more. Useful for planning but also recommended for any quick-witted shopper who wants to do in-store product comparisons. (iPhone-only)

Black Friday app from DealNews
Both PC World and PC Magazine voted DealNews tops in its category thanks to its exhaustive, well-organized catalog. Like the other apps, this one lets you browse “leaked” and “confirmed” ads from major retailers so you can plot out your plan of attack beforehand. (iPhone, Android)

ShopSavvy Barcode Scanner
Use your phone’s camera to scan products for instant price comparisons — no need to painstakingly input your search queries while angry shoppers slam you with their carts. If there’s a better deal around you or online, this app will let you know. (iPhone, Android)

Wunderlist
Was it your nephew Charlie who wanted the new Call of Duty game? Or was that your boss’ son Jimmy? Instead of checking your list twice, try WunderList, a super-simple task management tool that syncs lists on your desktop, iPhone, and more. (iPhone, Android) 

Mint.com Personal Finance
The whirlwind holiday shopping season can make it difficult to keep your finances in check. One solution: Mint, a virtual-money manager that automatically keeps tabs on your bank and credit card accounts to help you master your budget with a friendly, easy-to-use interface. Best of all, it’s useful well after January rolls around; no wonder TIME Magazine named it one of the 50 best iPhone apps out there. (iPhone, Android)

SEE ALSO: Get rich quick: 6 people who accidentally found a fortune

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Mayim Bialik and Michael Stone Divorcing

By Mike Fleeman

11/21/2012 at 05:00 PM EST

After "much consideration and soul-searching," Mayim Bialik announced Wednesday that she and husband Michael Stone are divorcing after nine years of marriage.

The Big Bang Theory star, who has sons Miles, 7, and Fred, 4, with Stone, cites "irreconcilable differences" for the split, which she revealed in a statement on her Kveller.com parenting blog.

"Divorce is terribly sad, painful and incomprehensible for children. It is not something we have decided lightly," she writes.

The former star of TV's Blossom, 36, also says that the split is not due to the attachment parenting she discusses in her book Beyond the Sling. "Relationships are complicated no matter what style of parenting you choose," she says.

"The main priority for us now is to make the transition to two loving homes as smooth and painless as possible," Bialik, 36, continues. "Our sons deserve parents committed to their growth and health and that’s what we are focusing on. Our privacy has always been important and is even more so now, and we thank you in advance for respecting it as we negotiate this new terrain."

She concludes by saying, "We will be ok."

The couple were married in August 2003 in Pasadena, Calif.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Bernanke's "cliff" comments break two-day rally

NEW YORK (Reuters) - Wall Street halted its two-day rally on Tuesday, after Federal Reserve Chairman Ben Bernanke said the central bank lacks tools to cushion the economy from the impact of the "fiscal cliff."

The day's biggest disappointment was Hewlett-Packard Co shares , which sank to a 10-year low after the computer and printer maker swung to a fourth-quarter loss and announced a $5 billion charge related to "accounting improprieties." The stock slid 12 percent to close at $11.71.

Bernanke, in comments before the Economic Club of New York, said the Fed does not have the ability to offset the damage that would result if politicians fail to strike a deal to prevent a series of mandatory tax increases and spending cuts scheduled to go into effect early next year.

The statement caused a downdraft in the market, though the equity market cut most of its losses before the end of the day.

"This is a more realistic and pragmatic picture of where we are, compared to what we've been hearing for the past couple of days from politicians that are mostly PR stunts," said James Dailey, portfolio manager at TEAM Asset Strategy Fund in Harrisburg, Pennsylvania.

Stocks had rallied for the last two sessions after Washington politicians sounded an encouraging note that a deal to avoid the U.S. fiscal cliff could be reached. The gains followed two weeks of sharp losses that pushed the S&P 500 down through the 200-day moving average, a key benchmark of the market's long-term trend.

The S&P ended Tuesday near that level, which was 1,382.68.

The Dow Jones industrial average <.dji> slipped 7.45 points, or 0.06 percent, to 12,788.51 at the close. But the Standard & Poor's 500 Index <.spx> edged up 0.93 of a point, or 0.07 percent, to finish at 1,387.82. The Nasdaq Composite Index <.ixic> inched up 0.61 of a point, or 0.02 percent, to close at 2,916.68.

Dow component HP said it took an $8.8 billion charge in the quarter, with $5 billion related to its acquisition of software firm Autonomy, citing "serious accounting improprieties." HP's market value is now just $23 billion, compared with $100 billion just two years ago.

Best Buy Co shares fell 13 percent to $11.96 after the consumer electronics retailer reported a net loss of $13 million for the third quarter on weaker-than-expected sales at its established stores.

Another factor weighing on stocks was Moody's Investors Service's reduction of France's sovereign rating by one notch to Aa1 after the market's close on Monday. Moody's cited an uncertain fiscal outlook as a result of the weakening economy.

"This brings forward a whole new set of problems to the euro -zone issue. When the lifeguards, in this case, Germany and France, are in trouble, when they need to save people like Greece and Spain, that could be a big concern," Dailey said.

Earlier, data showed U.S. housing starts rose to their highest rate in more than four years in October, suggesting the housing market recovery was picking up momentum, even though permits for future construction fell.

An index of housing-related shares <.hgx> shot up 2.5 percent.

Volume was roughly 5.6 billion shares on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the year-to-date average daily closing volume of around 6.5 billion.

Advancers outnumbers decliners on the NYSE by a ratio of about 4 to 3. On Nasdaq, the opposite trend took hold, with about 13 stocks falling for every 12 that rose.

(Reporting by Angela Moon; Editing by Jan Paschal)

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Clinton Arrives in Middle East as Egypt Says Truce in Gaza Is Close

JERUSALEM — Diplomatic efforts accelerated on Tuesday to end the lethal confrontation between Israel and Palestinian militants in Gaza on one of the most violent days yet in the conflict, as the United States sent Secretary of State Hillary Rodham Clinton to the Middle East and Egypt’s president and his senior aides expressed confidence that a cease-fire was close.

But by late evening there was no announcement, and Mrs. Clinton said she would be working in coming days to complete an agreement. Appearing beside Prime Minister Benjamin Netanyahu of Israel to speak briefly to the press, Mrs. Clinton said she hoped to achieve an end to the hostilities with a deal that moves “toward a comprehensive peace for all people in the region.” Mr. Netanyahu told Mrs. Clinton that if the rocket fire from Gaza stopped he was prepared to agree on a “long-term solution.”

The diplomatic moves to end the nearly week-old crisis came as the antagonists on both sides intensified their attacks before any cease-fire takes effect.

Israeli aerial and naval forces assaulted several Gaza targets in multiple strikes, including a suspected rocket-launching site near Al Shifa hospital, which killed more than a dozen people. Those deaths brought the total number of fatalities in Gaza so far to more than 130 — roughly half of them civilians, the Gaza Health Ministry said. A delegation visiting from the Arab League canceled a news conference at the hospital because of the Israeli aerial assaults as wailing ambulances brought victims in, some of them decapitated.

The Israeli assaults carried into early Wednesday, with multiple blasts punctuating the darkened Gaza skies.

Militants in Gaza fired a barrage of at least 200 rockets into Israel, killing an Israeli soldier — the first military casualty on the Israeli side since the hostilities broke out last week. The Israel Defense Forces said the soldier, identified as Yosef Fartuk, 18, died from a rocket strike that hit an area near Gaza. Israeli officials said a civilian military contractor working near the Gaza border was also killed, bringing the total number of fatalities in Israel from the past week of rocket mayhem to five.

Other Palestinian rockets hit the southern Israeli cities of Beersheba and Ashdod, and longer-range rockets were fired at Tel Aviv and Jerusalem, but neither main city was struck and no casualties were reported. One Gaza rocket hit a building in the Israeli city of Rishon Lezion, just south of Tel Aviv, injuring one person and wrecking the top three floors.

Senior Egyptian officials in Cairo said Israel and Hamas, the militant Islamist group that governs Gaza, were “very close” to a cease-fire agreement that could be announced within hours. “We have not received final approval but I hope to receive it any moment,” said Essam el-Haddad, President Mohamed Morsi’s top foreign affairs adviser.

Foreign diplomats who were briefed on the outlines of a tentative agreement said it had been structured in stages — first, an announcement of a cease-fire, followed by its implementation for 48 hours. That would allow time for Mrs. Clinton to involve herself in the process on the ground here and create a window for negotiators to agree on conditions for a longer-term cessation of hostilities.

By late evening, however, there was no word on an announcement, and Israeli television was saying the talks needed more time. In Cairo, Egyptian news reports quoted Hamas officials as blaming Israel for delaying a deal and an announcement was unlikely before Wednesday.

The announcement of Mrs. Clinton’s active role in efforts to defuse the crisis added a strong new dimension to the multinational push to avert a new Middle East war. Israel has amassed thousands of soldiers on the border with Gaza and has threatened to invade the crowded Palestinian enclave for the second time in four years to stop the persistent rockets that have been lobbed at Israel.

Mrs. Clinton, who accompanied President Obama on his three-country Asia trip, left Cambodia on her own plane immediately for the Israel, and upon arrival in the late evening went into immediate talks with Israeli leaders.

She was scheduled to visit the West Bank later to meet with Palestinian leaders and then go to Cairo to consult with Egyptian officials.

Isabel Kershner reported from Jerusalem; Peter Baker from Phnom Penh, Cambodia; and Rick Gladstone from New York. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza City, David D. Kirkpatrick from Cairo, Ethan Bronner from Jerusalem and David E. Sanger from Washington.

This article has been revised to reflect the following correction:

Correction: November 20, 2012

Because of an editing error, an earlier version of this article misspelled the family name of the Israeli soldier who was killed in a Palestinian rocket attack on Tuesday. He is Yosef Fartuk, not Yosef Faruk. 

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News Summary: India outrage over Facebook arrests

WHAT HAPPENED: As India‘s financial capital shut down for the weekend funeral of a powerful politician linked to waves of mob violence, a woman posted on Facebook that the closures in Mumbai were “due to fear, not due to respect.” A friend of hers hit the “like” button. For that, both women were arrested.

THE RATIONALE: The arrests were seen as a move by police to prevent any outbreak of violence by supporters of Bal Thackeray, a powerful Hindu fundamentalist politician who died Saturday.

THE REACTION: But analysts and the media are slamming the Maharashtra state government for what they said was a flagrant misuse of the law and an attempt to curb freedom of expression.

Social Media News Headlines – Yahoo! News

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Leonor Varela Welcomes a Son

Mom & Babies
Celebrity Baby Blog

11/20/2012 at 07:00 PM ET

David Livingston/Getty

Leonor Varela‘s days as villainous vixen may be over, but her role in motherhood has only just begun.

The former Dallas actress, 39, and producer Lucas Akoskin have welcomed their first child together, the new mom announced on Twitter Tuesday.

“Matteo V. Akoskin is finally in our arms!” Varela writes, keeping any further details under wraps.

Confirming the pregnancy in July, Varela and Akoskin were elated to be starting a family together. “The couple are over the moon,” her rep told PEOPLE at the time.

Courtesy Leonor Varela

– Anya Leon

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor's exam needed: The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday's surprise opinion from these gatekeepers of contraception could boost longtime efforts by women's advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it's not clear if any are considering it. Plus there are big questions about what such a move would mean for many women's wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn't need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it's safe to sell the pill that way.

Wait, why would doctors who make money from women's yearly visits for a birth-control prescription advocate giving that up?

Half of the nation's pregnancies every year are unintended, a rate that hasn't changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

"It's unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem," said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

ACOG's opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month's supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

___

Online:

OB/GYN group: http://www.acog.org

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