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Biomedical subjects

J D Forrest

Publications and source records attributed to J D Forrest.

At least 19 recordsLinked to original sources
PubMed1994

Epidemiology of unintended pregnancy and contraceptive use.

Almost all women are at risk for unintended pregnancy throughout their reproductive years. However, adolescents, formerly married women, and women of low socioeconomic status are at greater risk for contraceptive nonuse and for contraceptive failure; thus they are also at greater risk for unintended conceptions. Of the 6.4 million pregnancies occurring in the United States in 1988, more than half (56%) were unintended. An equal proportion of unintended pregnancies end in abortion (44%) as with birth (43%), and both options have great personal and social consequences. The level of unintended pregnancy appears to have increased during the last decade after consistent decreases since the early 1960s. Decreasing both the periods of contraceptive nonuse and contraceptive misuse will help lower the rate of unintended pregnancy in this country.

Adolescent↗
PubMed1993

Timing of reproductive life stages.

OBJECTIVE: To identify typical ages at which women pass through reproductive transitions and to ascertain whether they differ by poverty status, race, and ethnicity, and from men's transition ages. METHODS: Using the 1982 and 1988 National Surveys of Family Growth, the 1988 National Survey of Young Men, and the March 1988 Current Population Survey, the timing of transitions between stages was measured by the ages at which respondents had passed specific milestones. RESULTS: By age 17.4, half of the young women surveyed and by age 16.6, half of the young men had had intercourse. The length of time the typical woman spent being sexually active before marriage increased by more than 1.5 years, to nearly 7 years, between 1982 and 1988. Half of all women surveyed had become mothers by age 26 and by age 30 half intended to have no more children; half were sterile for contraceptive or noncontraceptive reasons by age 35.7. Non-Hispanic white and higher-income women typically married before their first birth, whereas half of black women became mothers almost 6 years before a similar proportion had married. Lower-income and Hispanic women demonstrated smaller but similar gaps. CONCLUSIONS: Differences among subgroups and the broad age ranges at which women move between stages highlight the importance of focusing service delivery and education according to the stage of a woman's reproductive life, not just her age. Current patterns of timing are not prescriptive, but provide a framework for directing efforts to provide women and men with needed information and services and to assess the possible effects.

Adolescent↗
PubMed1992

Contraceptives. On their own.

Despite the need for more safe and effective contraceptive drugs and devices, enormous barriers to contraceptive research and development have been raised in the United States. The designation of contraceptives as orphan drugs, with concomitant incentives, may be warranted to encourage private manufacturers to reenter the field.

Contraceptive Agents↗
PubMed1992

Underreporting of abortion in surveys of U.S. women: 1976 to 1988.

Although research on reproductive behavior depends heavily on information from surveys, abortions are characteristically underreported in such data. Estimates of the level of reporting are made for each of the recent major surveys of U.S. women: the 1976, 1982, and 1988 cycles of the National Survey of Family Growth, the 1976 and 1979 National Surveys of Young Women, and the National Longitudinal Surveys of Work Experience of Youth. The estimates are based on comparisons with external counts of abortions taking place. We examine variation by characteristics of women, trends over time, and the possible effects of length of recall and of the way in which questions about abortion are asked. Abortion reporting is found to be highly deficient in all the surveys, although the level varies widely. Whites are more likely to report their abortions than nonwhites. Special, confidential questioning procedures hold promise for improving the results.

Abortion, Legal↗
PubMed1991

An epidemic of antiabortion violence in the United States.

From 1977 to 1988, an epidemic of antiabortion violence took place in the United States, involving 110 cases of arson, firebombing, or bombing. The epidemic peaked in 1984, when there were 29 attacks. Nearly all sites (98%) were clinics that provided abortions. Facilities in 28 states and the District of Columbia were involved. The national rate of violence was 3.7 per 100 abortion providers and 7.2 per 100 nonhospital abortion providers. The national ratio of violence per 100,000 abortions performed was 0.6 Arson was both the most frequent (39% of all cases) and the most damaging (mean cost $141,000) type of violence. The epidemic appears partially attributable to multiple point-source outbreaks of violence caused by small numbers of individuals or groups. Thirty-three persons have been convicted to date. Vigorous prosecution of perpetrators and the reemergence of clinics after damage probably helped to curb the epidemic.

Abortion, Induced↗
PubMed1987

Timing of prenatal care in the United States: how accurate are our measurements?

Timing of prenatal care has become the most widely used indicator of adequacy of care, largely because it is easy to measure and is obtained by national data collection sources. Because it is a crucial input into setting policy goals, it is important that we have an accurate measure of timing of care. This article reviews the existing level of access to prenatal care, as measured by three different national data sources (Vital Statistics, the National Natality Survey, and the National Survey of Family Growth). Differences among the three sources are discussed; and drawing upon what we know of the problems of data collection, we speculate on the most accurate measure of access to care. Finally, suggestions for improving future data collection are made.

Birth Certificates↗
PubMed1984

The impact of U.S. family planning programs on births, abortions and miscarriages, 1970-1979.

This paper estimates births (as well as total pregnancies, abortions and miscarriages) averted by program enrollment during the 1970s based not on the common assumption of constant program impact on birth rates, but on assumptions that take into account the changing use of abortion. Estimates of births averted from two national studies are translated into estimates of unintended pregnancies averted and projections of program impact throughout the decade are made assuming constant program impact on pregnancy rates. The number of pregnancies averted is broken into births, abortions and miscarriages averted based on actual distribution of those unintended pregnancies that did occur each year. This methodology is more appropriate to the United States or any other country during a time period when use of abortion has been changing. It also focuses attention on the fact that births averted reflect only part of the program's impact and that much of the program's effect is on averting abortions. During the decade, an estimated 5,434,000 unintended pregnancies were averted by enrollment in the family planning program. In 1979, 4,486,000 women were enrolled in family planning clinics. An estimated 792,000 unintended pregnancies were averted as a direct result, 1 for every 5.7 patients. The 274,000 averted births would have increased the number of births in 1980 in the U.S. from 3,598,000 to 3,872,000, an increase of 8%. The estimated 420,000 abortions averted would have increased abortions in the U.S. about 25% higher, to about 2,000,000.

Abortion, Legal↗
PubMedDate not supplied

American women's sexual behavior and exposure to risk of sexually transmitted diseases.

According to nationally representative data from the 1988 National Survey of Family Growth and the 1988 and 1989 General Social Surveys, 67% of all women aged 15-44 who have ever had intercourse have had more than one partner, 41% have had four or more, 23% six or more and 8% more than 10; 71% have had one or more nonmarital partners. Fewer than 1% of currently married women report having had more than one partner in the previous three months, compared with 13% of formerly married women and 9% of single women who are sexually active. For the most part, women with multiple partners do not have characteristics that set them apart from other women; women in all age-groups and racial or ethnic groups appear equally likely to have multiple partners while unmarried. Fifty-seven percent of women who report multiple partners have never been married, and another one-quarter are currently divorced. Twenty-one percent are teenagers, 46% are aged 20-29 and 24% are in their 30s. Between 27% and 39% of all sexually active women aged 18-44 are estimated to have had direct or indirect contact with more than one sexual partner during the preceding 12 months (including women with only one partner whose partner had multiple partners). About 20% of currently sexually active women reported using the condom, but one in five condom users had not used one at last intercourse. Once social and demographic factors are controlled, condom users with multiple partners are less likely than other condom users to have used a condom at last intercourse.

Adolescent↗
PubMedDate not supplied

Contraceptive failure rates based on the 1988 NSFG.

Analysis of data from the 1988 National Survey of Family Growth--corrected for the underreporting of abortion--reveals that contraceptive failure during the first year of use remains a serious problem in the United States, contributing substantially to unintended pregnancy. The pill continues to be the most effective reversible method for which data were available (8% of users accidentally became pregnant during the first year of use), followed by the condom (15%). Periodic abstinence is the method most likely to fail (26%), but accidental pregnancy is also relatively common among women using spermicides (25%). Failure rates vary more by user characteristics such as age, marital status and poverty status than by method, suggesting the extent to which failure results from improper and irregular use rather than from the inherent limitations of the method.

Abortion, Induced↗