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PubMedDate not supplied

Reproductive health in Romania: reversing the Ceausescu legacy.

As a result of the restrictive reproductive health policies enforced under the 25-year Ceausescu dictatorship, Romania ended the 1980s with the highest recorded maternal mortality of any country in Europe--159 deaths per 100,000 live births in 1989. An estimated 87 percent of these maternal deaths were caused by illegal and unsafe abortion. Under the Ceausescu regime, all contraceptive methods were forbidden and induced abortion was available only for women who met extremely narrow criteria. Immediately after the December 1989 revolution that overthrew Ceausescu, the new government removed restrictions on contraceptive use and legalized abortion. This legislative change has had beneficial effects on women's health, seen in the drop in maternal mortality in 1990 to 83 deaths per 100,000 live births--almost half the ratio in 1989. In addition, changes instituted since the revolution have led to the improved availability of reproductive health services and to the creation of new educational and training opportunities related to reproductive health services and to the creation of new educational and training opportunities related to reproductive health. The newly created contraceptive and abortion services have presented health system managers and policymakers with many challenges as they work to expand the availability of high-quality, comprehensive reproductive health care in a setting of economic hardship, political unrest, insufficient infrastructure, and outdated medical knowledge and practice.

Abortion, Legal↗
PubMed1991

Adolescent sexuality in Kenya.

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya.

Adolescent↗
PubMedDate not supplied

Characteristics of U.S. women having abortions, 1987.

In 1987, as in earlier years, women having abortions were predominantly white (65 percent), younger than 25 (59 percent), and unmarried (82 percent). A majority had no previous live births (53 percent), and most had no previous abortions (58 percent). About half the abortions were performed before nine weeks of gestation, and 97 percent were curettage procedures, usually suction curettage. Comparisons with 1980 data reveal a six percent decline in the U.S. abortion rate after changes in age, race and marital status within the population are controlled for; however, the decline occurred only among the white population and not among minority races. Among teenagers aged 15-19, the abortion rate declined slightly for whites and increased for minorities. The rate also increased among women younger than age 15.

Abortion Applicants↗
PubMedDate not supplied

Trends in rates of live births and abortions following state restrictions on public funding of abortion.

Abortion rates rose following the expanded legalization of abortion by the Supreme Court decision in Roe v. Wade. As a result, the impact of the restriction on Federal funding of abortions under the Hyde Amendment in 1977 was not clear. However, abortion rates had plateaued by 1985, when State funding of Medicaid abortions was restricted in Colorado, North Carolina, and Pennsylvania. Analysis of statewide data from the three States indicated that following restrictions on State funding of abortions, the proportion of reported pregnancies resulting in births, rather than in abortions, increased in all three States. In 1985, the first year of State restrictions on the use of public funds for abortion, Colorado, North Carolina, and Pennsylvania recorded 1.9 to 2.4 percent increases in the proportion of reported pregnancies resulting in live births, after years of declining rates. With adjustments for underreporting of abortion, there was an overall 1.2 percent rise in the proportion of pregnancies resulting in live births in those States. Nationally the proportion rose only 0.4 percent. By 1987, the three States had experienced increases above 1984 levels of 1.6 to 5.9 percent in the proportion of reported pregnancies resulting in live births. The experiences of the three States can be used in projecting an expected increase in the proportions of reported pregnancies resulting in live births, rather than in abortions, for similar States. A projection for California, for example, showed that an increase could be expected in the first year of restrictions on the use of public funds for abortion of at least 4,000 births, which could be expected largely to affect women of low income.

Abortion, Legal↗
PubMed1990

Abortion-related deaths in Ile-Ife, Nigeria: a 12-year review.

Cases of death due to abortions at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, between January 1977 and September 1988 were reviewed. Abortion accounted for 12.5% of the maternal deaths and the majority (88.9%) were from illegal abortions. The majority (92.6%) of the patients were of low educational status. Both married women and single girls were involved. Instrumentation was employed in 81.5% of the abortions and unqualified personnel were involved in 74.1% of cases of such intervention. Seventeen (63%) of the pregnancies were terminated within the first trimester. Most (96.3%) of the patients were admitted in poor clinical state and 51.8% of them died within 48 h of admission. Sepsis was the commonest cause of death.

Abortion, Illegal↗
PubMed1990

[Analysis of the structure of the urban and rural populations of the central portion of Krasnodar Krai].

The structure of the populations in Korenovsk and Ust-Labinsk districts--sexual, age, family and migrant is described Reproduction is low in these populations. The after-reproduction age class in rural populations prevailed, which affects the ratio of recessive and dominant forms in hereditary pathology of these populations. Family planning in towns accounts for small size of the families and decrease of the role of natural selection. Gametic and endogamy indexes for these populations indicate that intensive migrant processes take place in populations studied, as shown by the level of recessive pathology. The results obtained can be used in the medical-genetic studies for this territory.

Age Factors↗
PubMed1990

[Fertility and reproduction in women working in beet growing and animal breeding (1943-1982)].

The article contains formulae for real fertility rate (RFR), functional and calendar-related pregnancy intervals. RFR is proposed as the criteria in the assessment of occupational factors' influence on the reproduction function in couples not using contraceptives. The simultaneous reproduction assessment with two indices involved (real fertility and birthrate) made it possible to evaluate the role of the occupational and social factors in human reproduction in the region. The agricultural female workers surveys showed that RFR remained stable at the time of examinations and births, taking account of the age, in women engaged in beet raising, cattle breeding and employees, who had been working in different labour conditions for 40 years. Within the same period of time, birth rates in the beet-raisers were markedly higher as compared with the employees.

Adolescent↗
PubMedDate not supplied

Fertility conditions in Gondar, northwestern Ethiopia: an appraisal of current status.

In order to study current fertility conditions, this study examines the sociocultural, economic, and demographic characteristics of 734 women aged 15-55 in the Gondar administrative region of northwestern Ethiopia. Women over age 45 in the sample were found to have, on average, 7.27 pregnancies, 0.88 abortions, 6.39 children ever-born, 1.51 child deaths, and 4.88 live offspring. The total infertility rate was 8.5 percent, and the subfertility rate was 12.7 percent. Fertility levels in the region were relatively high, compared to other developing countries. Contraceptive use was estimated at 3.6 per 1,000 women (for ages 15-49). The need for more effective family planning services is strongly indicated. The study suggests that, among other goals, policy efforts should focus on the reduction of unintended conception and unwanted fertility.

Adolescent↗
PubMed1990

Maternal mortality in New York City, 1981-1983.

The maternal mortality ratio in New York City during the 3-year period of 1981-1983 was 36.1 deaths per 100,000 live births. Eight (7%) of 120 deaths occurred more than 42 days after termination of the pregnancy. Eighteen (15%) of the cases involved white, non-Hispanic women, 66 (55%) were black, and 32 (27%) were Hispanic. Fifty-seven deaths were associated with cesarean delivery, although most of these could not be attributed to the mode of delivery. Sixty-six (55%) of the deaths were classified as direct maternal deaths. The age ranged from 16-44 years, with 83 (69%) of the women aged 20-34, 11 (9%) 19 or less, and 26 (22%) aged 35 or older. Increasing age and parity were associated with greater maternal mortality ratios. The leading causes of pregnancy-associated mortality were found to be ectopic pregnancy, pulmonary embolism, anesthetic complications, amniotic fluid embolism, intracranial hemorrhage, hypertensive diseases of pregnancy, infection, and cardiac disease. Abortion-related mortality was about nine times less than the maternal mortality ratio, and the cesarean death-to-case rates could be considered roughly comparable to overall maternal mortality.

Adolescent↗
PubMedDate not supplied

The contribution of previous induced abortion to tubal ectopic pregnancy.

Data from a one year prospective study of thirty-one tubal ectopic pregnancies and ninety-three matched controls is presented. Compared with the controls, a history of induced abortion, was not only statistically significantly more frequent amongst the subjects (P less than 001) but was the Penultimate cyesis in 41.9% of ectopic cases as against 3.2% of the controls (P less than 001). Non-physicians provided 51.6% and 3.3% of induced abortions in the study and control groups respectively. Complications occurred in 51.6% of study population and 6.5% of controls. It is concluded that induced abortions created the predispotion to tubal implantation in the study population and therefore a reduction in the incidence of illegally induced abortion in the community can reduce the incidence of ectopic tubal gestation and tubal infertility.

Abortion, Illegal↗
PubMed1989

[Chlamydia trachomatis in at-risk groups in legal abortion in the first trimester].

Examination for the presence of C. Trachomatis in the cervix and urethra and bacteriological examination of the cervix were performed in a material of 224 patients for legal abortion in the first trimester of pregnancy. Chlamydia was demonstrated in 8.9% of the patients, Neisseria gonorrhoeae in 0.5% and, in 41%, growth of Gardnerella vaginalis predominated. It proved possible to define a group at risk for the presence of Chlamydia consisting of all the patients under the age of 25 years and nulliparae aged 25-29 years. 17% in this group had positive Chlamydia tests as compared with 1.7% in the patients in other groups. Patients in the above mentioned risk group should be examined for C. trachomatis in cases of legal termination of pregnancy so that appropriate treatment can be administered prior to evacuation.

Abortion, Induced↗
PubMedDate not supplied

Collecting data on pregnancy loss: a review of evidence from the World Fertility Survey.

Estimates of levels and differentials of pregnancy loss are presented for 40 developing countries participating in the World Fertility Survey (WFS) program. Judged against agreed-upon levels of spontaneous loss in human populations, WFS surveys measured from 50 to 80 percent of recognizable losses. The coverage of induced abortions appears to be much worse. Consistent with data from other sources and settings, the probability of loss is strongly correlated with maternal demographic characteristics: age, pregnancy order, pregnancy spacing, and pregnancy loss history. Despite incomplete coverage, the WFS data on pregnancy loss provide considerable, and largely unexploited, insight on the dynamics of the reproductive career.

Data Collection↗