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Public Law 100-202, Joint Resolution making further continuing appropriations for the fiscal year 1988, and for other purposes, 22 December 1987.

This US Act provides the following with respect to universal access to child immunization: "The Congress calls upon the President to direct the Agency for International Development, working through the Centers for Disease Control and other appropriate Federal agencies, to work in a global effort to provide enhanced support towards achieving the goal of universal access to childhood immunization by 1990 by 1) assisting in the delivery, distribution, and use of vaccines, including a) the building of locally sustainable systems and technical capacities in developing countries to reach, by the appropriate age, not less than 80% of their annually projected target population with the full schedule of required immunizations and b) the development of a sufficient network of indigenous professionals and institutions with responsibility for developing, monitoring, and assessing immunization program and continually adapting strategies to reach the goal of preventing immunizable diseases and 2) performing, supporting, and encouraging research and development activities, in both the public and the private sector, that will be targeted at developing new vaccines and at modifying and improving existing vaccines to make them more appropriate for use in developing countries. In support of this global effort, the President should appeal to the people of the US and the US private sector to support public and private efforts to provide the resources necessary to achieve universal access to childhood immunization by 1990." The Act also does the following with respect to various forms of bilateral assistance: 1) prohibits the use of funds for an organization or program that supports coercive abortion or involuntary sterilization; 2) prohibits the use of funds for the performance of abortion as a method of family planning (FP); 3) provides that in awarding grants for natural FP under section 104 of the Foreign Assistance Act no applicant shall be discriminated against because of such applicant's religious or conscientious commitment to offer only natural FP. In addition, the Act stipulates that with respect to appropriations for the Department of Health and Human Services no funds will be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term.

Abortion, Induced↗

The impact of restricting Medicaid financing for abortion.

If all states observed the Hyde Amendment restrictions, many thousands of Medicaid-eligible women who would have obtained abortions under the 1977 funding policy would not receive them--in addition to the 133,000 who could not get Medicaid-funded abortions in the year preceding the restrictions.

Abortion Applicants↗

Postconceptional prostaglandin therapy.

392 cases of prostaglandin abortions were analyzed for efficacy, clinical acceptability and complications. It was repeatedly emphasised that the clinical administration of PGs are not without risks and serious drawbacks. The vaginal suppositories seem to be vary promising. It is suggested that new lines of research should be pursued in order to improve our understanding of the effect of PGs and to develop better dose schedules as demanded by clinical and professional excellence.

Abortion, Induced↗

Outcome following therapeutic abortion.

Psychological outcome of abortion was studied in 102 patients, measuring multiple variables over four time intervals. Five measured affects--anxiety, depression, anger, guilt, and shame-were significantly lower six months after the preabortion period. The following variables describe subgroups of patients with significant variations in patterns of responses as indicated by changes in affects: marital status, personality diagnosis, character of object relations, past psychopathologic factors, relationship to husband or lover, relationship to mother, ambivalence about abortion, religion, and previous parity. A complex multivariate model, based on conflict and conflict resolution, is appropriate to conceptualize, the unwanted pregnancy and abortion experience. Data suggest that women most vulnerable to conflict are those who are single and nulliparous, those with previous history of serious emotional problems, conflictual relationships to lovers, past negative relationships to mother, strong ambivalence toward abortion, or negative religious or cultural attitudes about abortion.

Abortion, Therapeutic↗

Arthrogryposis associated with unsuccessful attempts at termination of pregnancy.

We report three cases of failed termination of pregnancy in which the children were subsequently born with arthrogryposis (AMC) (multiple congenital contractures). Arthrogryposis is a sign with many causes. We suggest that the multiple congenital contractures seen in these children are due to vascular compromise during the attempted termination with secondary loss of functional neurons leading to fetal akinesia and subsequent contractures. Two of the children have additional evidence of intrauterine vascular compromise. Limitation of movement secondary to the rupture of the fetal membranes and continuous leakage of amniotic fluid after the attempted termination may have compounded the contractures in two of the children.

Abortion, Incomplete↗

Psychological factors that predict reaction to abortion.

Investigated demographic and psychological factors related to positive or negative reactions to legal abortions performed during the first trimester of pregnancy in 62 females in an urban southern community. Results suggest that the social context and the degree of support from a series of significant persons rather than demographic variables were most predictive of a positive reaction.

Abortion, Induced↗

Community leaders' attitudes toward family planning.

Four separate samples of lawyers, businessmen, ministers, and physicians were requested to complete four separate non-overlapping attitude questionnaires in an effort to assess their attitudes toward sterilization, individual responsibility for contraception, family size, social responsibility, overpopulation, and contraception in the lower class. The data indicated that the four professional groups differed in their attitudes and those differences provided the impetus for suggestions focused on developing and maintaining a positive relationship between the influential members of the community and the family planning clinic.

Community Health Centers↗

Vaginal spermicides and miscarriage seen primarily in the emergency room.

Among 813 women who had obtained a vaginal spermicide within 48 weeks of the estimated date of fertilization (EDF), 47 (5.8%) had an early miscarriage. Among women who had obtained oral contraceptives, 35/1,127 (3.1%) miscarried, and among women who obtained neither, 140/4,231 (3.3%) miscarried. The risk ratio estimate comparing spermicide users with nonusers was 1.8 (90% confidence interval 1.4, 2.3). The association was strongest among women who had obtained a spermicide within 12 weeks of the EDF. Examination of abortus material revealed that the association with spermicides was strongest among those where an abnormal fetus was present.

Abnormalities, Drug-Induced↗

Selective termination of multiple gestations.

Twenty-two selective terminations in multiple gestations were performed by a number of different methods. In 17 dichorionic pregnancies there was a successful delivery in surviving singletons or twins. In five monochorionic pregnancies undergoing selective termination there was a successful delivery in only one and a pregnancy loss in the other four. Six of the 18 delivered pregnancies were complicated by premature labor and delivery. Among the several methods used for selective termination, intracardiac potassium chloride injection appears to be the procedure of choice in dichorionic pregnancies.

Abortion, Induced↗