Main results of recent Hungarian family planning studies.
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From the mid-1960s to the mid-1970s, when fertility was declining in Thailand as a whole, especially rapid declines occurred in Northern Thailand, but they did not occur uniformly in all the region's provinces. The Northern Thailand Fertility Study, initiated in 1975 to study the reported fertility changes, gathered data in two provinces: Chiang Mai, where fertility decline has been quite rapid, and Chiang Rai, which experienced relatively little decline until 1974. This preliminary report discusses fertility levels and trends in the two provinces, fertility experience and expectations of respondents, attitudes toward and knowledge of family planning, and contraceptive practice. The results suggest that most of the difference in fertility decline is related to the different level of family planning program activity in the two provinces.
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In recent years the United States has made considerable progress in providing family planning services for those in need. This does not mean, however, that the problems posed by unwanted pregnancies and unwanted births have been completely overcome. Estimates of the number of low-income women needing and receiving family planning services indicate that roughly 3.6 million women at risk of an unwanted pregnancy were receiving family planning services in 1973. This represented almost two-thirds of those in need at the time. Many programs are also seeking to meet the teenage need demonstrated by very high rates of out-of-wedlock births, premarital conceptions, obstetric problems, and legal abortion demands of women 15 to 19 years of age. As of 1973, it appeared that between 1.3 and 2.2 million never-married teenagers were in need of organized family planning services, and that of these, services were being received by between 25 and 42 per cent.
The world has reached the present position of unprecedentedly rapid population growth not by achieving uniquely high fertility but by bringing about extraordinarily low mortality. The high growth rate and the built-in momentum of the age structure are obstacles to achievement of an acceptable standard of living for most of the world's population. Although government population programs have the potential to curb this growth rate, this potential has not been realized, and such programs are too often perceived both by their administrators and the population concerned as an end in themselves rather than a means toward a better standard of living. It is in this latter perspective, and in the context of the total development process, that population programs should be implemented.
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To aid in achieving demographic goals, since 1968 the government of Singapore has passed a series of laws designed to limit family size. Policies were instituted in 1968 to discourage couples from having more than three children; policies introduced in 1973 discouraged having more than two. Trends in fertility rates and in the numbers of abortions and sterilizations in recent years are consistent with the intent of these social policies. Decline in third and subsequent births was the most important factor in fertility decline after 1972, and the numbers of abortions and sterilizations undergone by higher parity women have increased substantially sin"e 1970. Although other factors have affected fertility in Singapore, the data suggest that the disincentives have played a role in continued fertility decline in recent years.
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A survey of abortion providers in Seoul in late 1977 reveals a threefold increase in the rate of abortion and a greater than threefold rise in the ratio of abortions to live births since 1970. The survey findings also show that the overwhelming proportion of these abortions are performed in private clinics, by obstetrician-gynecologists, during the first trimester. The Seoul figures, which are similar to those of Romania and are higher than those of Japan in the early 1960s, indicate that abortion has contributed substantially to Korea's reduced fertility.
There were 1.32 million legal abortions in the United States in 1977 and a projected 1.37 million in 1978, an increase of four percent between 1977 and 1978 compared with one of 12 percent between 1976 and 1977. In 1978, 29 percent of pregnant women chose to terminate their pregnancies by abortion. Almost three percent of U.S. women of reproductive age obtained an abortion in 1978. From 1967 through 1978, approximately six million women obtained almost eight million legal abortions; about one in eight U.S. women of reproductive age has had a legal abortion. The number of hospitals reporting that they provided abortion services dropped slightly from 1,695 in 1976 to 1,661 in 1977, but the number of nonhospital abortion clinics increased from 448 to 522, and the number of physicians who reported performing abortions in their offices grew from 424 to 533. Between 1976 and 1977, the average number of abortions per hospital facility decreased from 246 to 237, while the average number per nonhospital provider increased from 875 to 879. The percentage of abortions performed in hospitals declined from 35 in 1976 to 30 in 1977, while the percentage reported by free-standing clinics increased from 61 to 66; the percentage performed in physicians' offices remained at four. Ninety-five percent of abortions in 1977 occurred in metropolitan areas, where 75 percent of the women in need of abortion services live. In 1977, there were identified abortion providers in only 23 percent of U.S. counties. Nine percent (more than 118,000) of the women who obtained abortions in 1977 had to travel to another state for services, and many traveled to other, often distant, counties in their home states. One in three abortions in 1977 were obtained by teenagers, and three in four were obtained by unmarried women. Twenty-eight percent of the women estimated to be in need of abortion services in 1977, and 26 percent in 1978, were unable to obtain them. In FY 1977, before Hyde amendment restrictions on government financing of abortions for poor women, 133,000 of the estimated 427,000 Medicaid-eligible women in need of publicly funded abortion services were unable to obtain them.(ABSTRACT TRUNCATED AT 400 WORDS)
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