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Biomedical subjects

H P David

Publications and source records attributed to H P David.

At least 19 recordsLinked to original sources
PubMed1999

Coping with cancer. A personal odyssey.

Building on personal experience, the psychological impact of cancer is reviewed. The subspecialty of psycho-oncology is a recent development within oncology, reflecting the increased interest in behavioral, psychological, and social factors in cancer prevention, treatment, and in improving the quality of life of patients with cancer at all stages through counseling and educational programs. Early identification of patients who are coping poorly is important for compliance with treatment and control of distress. It is equally important to recognize and diagnose common psychological disorders, primarily anxiety and depressive symptoms, which can occur. Referral for counseling to a mental health professional familiar with the care of patients with cancer may be indicated. My successful confrontation with cancer led to emotional growth. For those who cannot be sanguine about their experience, there may still be ways to reduce its, at times, devastating psychological impact. Hopefully, the days in which cancer patients had to suffer alone, in secrecy, and in fearful silence, are disappearing.

Adaptation, Psychological↗
PubMed1997

Multiple induced abortions: Danish experience.

Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family considerations). Though similar to first and second time aborters in their life situations and greater contraceptive risk-taking, third timers seemed to become pregnant more readily. They were also less willing to be interviewed. Related studies and suggestions for postabortion counseling are discussed.

Abortion, Induced↗
PubMed1996

Women's health and reproductive rights: Romanian experience.

One of the most dramatic chapters in the history of women's reproductive rights ended in Romania in 1989. For over 23 years, Romania had pursued a rigidly enforced pronatalist policy, banning the importation of contraceptives, strictly prohibiting most abortions, and imposing a tax on childless couples. The aim of this study was to explore, through individual in-depth interviews, psychosocial antecedents and consequences of the Romanian policy. The study group consisted of 50 women, aged between 18 and 55 years, with diverse sociodemographic and educational characteristics. The interviews focused on sexuality education, sexual experiences, reproductive events, and partner relations. The results show that women's private behavior and efforts to regulate their fertility prevailed over public policies, regardless of personal risks or costs to health. Concluding observations summarize major findings, results from a 1993 national household survey on reproductive health, and a commentary on the need for ongoing sexuality and contraceptive education and counseling.

Adolescent↗
PubMed1995

Children from unwanted pregnancies in Prague, Czech Republic revisited at age thirty.

The results of the fourth wave of the Prague Study of subjects born of unwanted pregnancies (UP) are reported. Of these young adults, 190 were examined at age 30 together with pair-matched control subjects born of accepted pregnancies (AP). Siblings of both UP and AP subjects were also examined. As in the previous data waves the UP subjects manifest less favorable psychosocial development on average than their AP controls, although the differences have narrowed. In some respects the siblings of the UP subjects share the latter's less favorable characteristics. However, there is a gender specific nonshared late effect of unwanted pregnancy: the UP females are more frequently emotionally disturbed than their AP female controls, whereas no such difference occurs between the female siblings of the UP and AP subjects.

Adult↗
PubMed1994

Reproductive rights and reproductive behavior. Clash or convergence of private values and public policies?

Using a rational scientific approach upholding public health values, this article notes experience gained from 25 years of cooperative transnational research on reproductive behavior. An overview of world population trends is followed by discussions of reproductive rights as a human right, the utility of acceptability studies of modern methods of fertility regulation, and findings from research on psychological responses to abortion, long-term developmental effects of compulsory pregnancy, and the use of incentives and disincentives to influence family size. There is also consideration of the clash between private values and public policy on reproductive behavior in the United States and the convergence achieved in Denmark and the Netherlands, where rates of unintended pregnancy are among the world's lowest.

Abortion, Legal↗
PubMed1992

A randomized clinical trial of mifepristone (RU486) for induction of delayed menses: efficacy and acceptability.

Mifepristone (RU486) should be useful for inducing menstrual bleeding in women with menses delayed up to 10 days. We evaluated this potential use for "menstrual regulation" in a randomized clinical trial with 16 women, half of whom received a single 600 mg dose and half of whom received a placebo. Four of eight women in each treatment group proved to be pregnant. Seven of eight who received mifepristone were not pregnant at two-week follow-up, in contrast to four of eight who received the placebo (p = 0.15). Mifepristone may hold promise for "menstrual regulation" for women who do not have access to medical confirmation of pregnancy or who choose not to have this determination made.

Abortion, Induced↗
PubMed1992

Psychological factors in abortion. A review.

Psychological research is increasingly involved in debates regarding abortion. While recognizing the diversity of ethical and moral issues intertwined with abortion, the American Psychological Association (APA) has focused its involvement on psychological factors, most recently by appointing an expert panel to review the literature on psychological effects. This article notes the history of APA involvement and reports on the panel's conclusions. It presents evidence that abortion is not likely to be followed by severe psychological responses and that psychological aspects can best be understood within a framework of normal stress and coping rather than a model of psychopathology. Correlates of more negative responses following abortion are also discussed.

Abortion, Induced↗
PubMed1992

Blurred edges to population policies.

Fertility is now below replacement level in most European countries, especially the industrialized ones. In the last 20 years, several countries have developed or improved pronatalist programs containing incentives that are designed to motivate couples to have a 2nd and especially a 3rd child, to maintain a stable population. The WHO Sexuality and Family Planning Unit called a short consultation on this subject last October. What actually constitutes a pronatalist population program and the connections between public policies and private reproductive behavior were not very clear. Nor is it easy to assess the longer--term demographic effects of pronatalist policies or what influences their effectiveness. The outcome usually reflects the country's history, cultural and religious traditions, changes in lifestyle, and the value given to the family and children. Incentives are defined as monetary or nonmonetary inducements to voluntary reproductive behavior that conforms to specified population policies. They may be small or large, in cash or kind, parity-specific or income-linked, immediate or developed, one-time or incremental, or any combination of these. Disincentives are negative sanctions that are either incurred or thought likely as a result of violating the policy. But both incentives and disincentives are difficult to define. Pronatalist policies designed to encourage early marriage and larger families, thereby raising the future total fertility rate should not be confused with traditional social welfare policies designed simply to ease the burden of childbearing. Some policies have both demographic and social welfare aims. Strong pronatalist policies may be linked with restrictions on contraceptive availability and legal abortion. Moreover, other public policies affecting social security, education, employment, housing, regional planning and the emancipation of women may unintentionally influence demographic behavior. Population policies are the product of politics. Often written in ambiguous language and intended to affect society as a whole, they still depend for their outcome on microlevel changes in a couple's perceptions of the costs and benefits of having children. In theory, they can be carried out in many ways but in practice such policies are severely limited by administrative, political, technological, economic, and ethical constraints. One difficulty is that governments is rarely enunciate precise goals. Their approach may range from noninterference in private reproductive behavior to total coercion using controls ranging from traditional cultural influences to imposition of fertility regulations. In some countries, fertility rates have increased briefly (in terms of period rates) following introduction of pronatalist policies. However, it is not clear how the rates were influenced, particularly in the case of parities 1, 2, and 3. A forthcoming report will describe experiences in Bulgaria, France, Germany, Sweden, and Norway.

Developed Countries↗
PubMed1990

Psychological responses after abortion.

A review of methodologically sound studies of the psychological responses of U.S. women after they obtained legal, nonrestrictive abortions indicates that distress is generally greatest before the abortion and that the incidence of severe negative responses is low. Factors associated with increased risk of negative response are consistent with those reported in research on other stressful life events.

Abortion, Induced↗
PubMed1990

Family planning for the mentally disordered and retarded.

Increasing perception of healthy reproductive functioning and conception prevention has been accompanied by greater recognition of the needs for emotional and sexual fulfillment of individuals with mental disorder or retardation. Although family planning services have burgeoned in the United States and many other countries and the special concerns of mentally disordered and retarded persons have been well documented, organized efforts to include counseling on fertility regulation in mental health and in training programs have, with few exceptions, been sparse. Recent trends are discussed in terms of reported experience from the United States and Denmark. It is recommended that women of childbearing age in psychiatric facilities be given an opportunity to participate in programs offering screening for and treatment of gynecological conditions, as well as family planning counseling, before going on home leave or discharge. Such counseling should be adapted to a woman's emotional functioning, consider possible contraindications of specific contraceptive methods, and, to the extent possible, involve the partner. Ethical aspects need to be considered to avoid even the appearance of coercion. Similar opportunities should be provided for retarded persons seeking to achieve a satisfying sexual life. Surgical contraception and abortion are discussed within the context of patient rights, competence, and the desirability of avoiding unintended conceptions and reducing unwanted births that may engender further stress and psychosocial difficulties for the woman, the child, and society. The experience of former patients might well be useful in restructuring current service programs and priorities.

Family Planning Services↗
PubMed1990

Illegal abortion in Mexico: client perceptions.

An exploratory study of the perceptions of 156 abortion clients in Mexico suggests that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. "Too young" was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on average, equivalent to three to four weeks minimum wage; physicians' charges were about three times higher than those of nonphysicians.

Abortion Applicants↗
PubMed1990

Family planning services delivery. Danish experience.

The purpose of this article is to give an overview of the Danish family planning services delivery based on a description of the country, the people, and their opinions. All laws and regulations about contraceptive services, including abortion and sterilization, are described in historical perspectives. It is concluded that the system has been developed on the basis of the health care system of the country to such a degree that it broadly covers the prevailing general attitudes of the population and that the expectations of the population to the system are reasonably met. What remains unsatisfactory is a relatively high proportion of induced abortions. Future possibilities for solving this problem could be: to improve the education of physicians, health nurses, midwives, teachers, and social workers with regard to family planning and sexuality; to revise teacher's guidelines on sex education and intensified sex education in the schools; to intensify information to risk groups such as teenagers and single women; and to accomplish general organisation of school class visits to family planning clinics.

Abortion, Legal↗
PubMed1989

Pronatalist experience in Europe.

Pronatalist programs and their effects in Europe are reviewed from the 1930s to the present, with individual attention given to France, West Germany, and Romania. The author finds that "where there are low levels of fertility, pronatalist incentives result primarily in accelerating the birth of the second child to an earlier time, especially among younger couples. Average completed family size tends to change little, with usually only a slight increase in the proportion of women giving birth to a third child."

Birth Intervals↗
PubMed1985

Post-abortion and post-partum psychiatric hospitalization.

Confusion persists regarding relative psychological risks associated with term deliveries and induced abortions. One reason for the scarcity of comparative findings is the lack of epidemiological data on post-abortion and post-partum admissions to psychiatric hospital. While such admissions are not separately tracked in United States health statistics, they are measurable events, reflective of severe psychological stress associated in time with delivery and abortion, and probably less subject to diverse interpretation than are individual consultations with clinical practitioners in their offices. The paper reviews what is known from published international research about post-abortion and post-partum admissions to psychiatric hospitals and discusses comparative findings obtained from computer linkages of Danish national registers. Admissions to psychiatric hospital were tracked for a three-month period after either delivery or abortion for all women under age 50 and then compared with the three-month admission rate to psychiatric hospitals for all Danish women of similar age. The major finding is that for never-married and currently married women, the post-pregnancy-related risk of admission is about the same-around 12 per 10 000 abortions or deliveries. Higher psychiatric admission rates were noted for separated, divorced and widowed women having abortions or carrying to term.

Abortion, Induced↗