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Changes in fertility and the acceptability of pregnancies in northern Finland during the last 20 years.

The acceptability of pregnancies was studied in two birth cohorts in Northern Finland which represent 96% of all births in the region in 1966 (12,068 births) and 99% (9362 births) in 1985-1986. The numbers of women of fertile age in the area during these years were 148,000 and 158,000, so that fertility may be said to have fallen from 81 to 59 per 1000. The pregnancy was wanted in 63.0% of cases and unwanted in 12.2% in 1966, the rest being classified as accepted later. The corresponding figures in 1985-1986 were 91.8% and 1.0%. The latter figures changed very little when maternal age, parity and social class were standardized to the 1966 levels. Acceptability was connected with age, in that the age groups in which childbearing was most frequent, 20-25 years in 1966 and 26-30 years in 1985-1986, had the highest incidence of desired pregnancies. In spite of the fact that there were 1.4 times as many births per woman aged 15-49 years in the former cohort, more wanted children were born to the age group 25-34 years in the latter cohort. The percentage of wanted pregnancies also varied with the woman's parity, social class and marital status. The children in the 1966 cohort were followed until the age of 14 and the incidences of cerebral palsy (CP) and mental retardation (IQ less than 71) were 3.2 times higher among the unwanted children than among the wanted ones.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗

Fertility in myotonic dystrophy in Saguenay-Lac-St-Jean: a historical perspective.

Myotonic dystrophy (MD) is an autosomal dominant disorder that has a high prevalence in Saguenay-Lac-St-Jean. A case-control study, based on a population register, of 373 MD patients who married in this region between 1855 and 1971 was conducted to determine whether their fertility was affected by the disorder. Six demographic parameters, that is the number of children, the age at marriage, the ages at the time of birth of the first and the last child, the interval between the marriage and the birth of the first child, and the interval between consecutive births, were analyzed. The mean number of children born to MD and control individuals was not different (P > 0.05). However, MD males had more children than MD females although they have started delaying their marriage since 1921. Fertility fell significantly in both the MD and control groups during the period of observation. This change reflects the decline in fertility of French Canadians in general during this period, but mainly after 1940.

Adult↗

Patterns and change in Canadian fertility 1971-1988: first births after age 30.

An analysis of Canada's changing pattern of births during the period 1971-1988 suggests that the tempo and timing of fertility has changed. Between 1971 and 1988, the number and rates of first births to women in their 30s increased rapidly, and rates for women younger than 25 declined. The rate of first births (first births per 1,000 women) for women 30-34 increased from 11.5 in 1971 to 17.1 in 1981 and to 22.3 in 1988--a 94% increase over the 17 years. The rate for women 35-39 also rose from 3.0 in 1971 to 3.6 in 1981 and 5.9 in 1988--a 97% increase occurring mostly in the 1980s.

Adolescent↗

Changing sex ratio of mortality in the Semai Senoi, 1969-1987.

An excess of male over female deaths is characteristic of modern national populations, whereas in some high-mortality societies female mortality exceeds that of males. Among the Semai Senoi, a Malaysian Orang Asli ("aboriginal") population, women experienced higher mortality than males in the decades before 1969. This differential occurred in all age classes older than 15 years so that the sex ratio progressively increased with age. A recent (1987) restudy of the Semai population found that sex-specific differential mortality is much reduced. A comparison of the 1969 and 1987 life tables shows a sharp shift in the sex ratios of mortality for the post-15-year-old age classes (the geometric means of age classes 15-44 were 0.768 in 1969 and 0.997 in 1987) so that male and female expectations of further life at age 15 are now nearly identical. In contrast to the best-known cases of high female mortality (mostly in South Asia), Semai sex differential mortality does not include the childhood ages. The Semai have traditionally been relatively sexually egalitarian, and sex bias in care has not occurred. Analysis of sex-specific causes of death for the pre-1969 population suggests that maternal mortality is the major cause of the excess female deaths. The reduced number of maternal deaths seems largely due to better health care, particularly the availability of hospital services. Interestingly, the reduction in female mortality has occurred simultaneously with increased fertility, and overall mortality has continued at relatively high levels (eO less than 36). Thus, rather than forming a component of a unitary demographic transition, declining sex differences in mortality can be accounted for by a specific factor, better maternal care.

Adolescent↗

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↗

Contraceptive knowledge and practices in Ilorin, Nigeria: 1983-88.

This report describes changes in knowledge and use of contraceptives in Ilorin, Nigeria between 1983 and 1988, a period marked both by dramatic changes in Nigeria's economic climate, as a result of the decline in the value of oil exports, and by considerable increases in public programs aimed at promoting the use of family planning and reducing fertility. The report is based on the analysis of two surveys of married women aged 15-35 years who lived in the city of Ilorin. By 1988, knowledge of modern methods of contraception had become virtually universal in Ilorin, even among women with no education and among those living in the poorest areas of the city. Current use of contraceptives had also increased considerably since 1983, reaching prevalence rates of 15 percent among women with primary education, 20 percent among those with secondary education, and 40 percent among those with postsecondary education. Each of these groups of women experienced at least a doubling of contraceptive prevalence between 1983 and 1988. Although use among uneducated women was still low in absolute terms (prevalence of 4.5 percent), these women also experienced a substantial relative increase in use.

Adolescent↗

The determinants of sexuality among adolescent school girls in Kenya.

One thousand seven hundred and fifty one Secondary school girls aged 12 to 19 years were interviewed by means of a self-administered questionnaire. 416 (23.8%), of them reported to have been sexually experienced at the time of the study. 4.1% of the sexually experienced girls had started sex below the age of 10 years, some of whom had been raped. The low and middle class private schools in the city centre had higher incidence of sexually experienced girls. The same was observed in those girls staying away from their parents. Majority of the sexually experienced girls had started coitus within one to two years of attaining menarche or having a boyfriend. Some of these girls may have been forced to indulge in sex by the men/boys or circumstances. Lack of factual knowledge, parental guidance and lust for material gains are some of the factors the girls felt may be responsible for the upsurge in adolescent sexual behaviour. The role played by these factors in adolescent sexuality is discussed, and possible remedial measures are suggested.

Adolescent↗

Contraceptive use and fertility decline in Chogoria, Kenya.

This article describes the results pertaining to fertility and family planning from a 1985 survey conducted in the catchment area of Chogoria Hospital in central Kenya. Current contraceptive prevalence was found to be quite high, 43 percent as opposed to 17 percent for Kenya as a whole. The total fertility rate of 5.2 births per woman was 2.5 births lower than the national rate. Very few women reported wanting to have large numbers of children or thinking that fate or God should determine family size. Although these data cannot conclusively demonstrate that the family planning program operating in the area has been responsible for reduced fertility there, they do provide some support for this hypothesis.

Adolescent↗

Is the Asian family planning program model suited to Africa?

This paper examines four Asian countries where fertility declines between the early 1960s and early 1980s ranged from 29 to 57 percent and contrasts their situations with seven African countries where fertility either remained constant or rose. It is shown that the difference is not explained by the African countries being at an earlier stage of socioeconomic development nor by the failure to provide family planning programs. The explanation is a lack of African demand for limiting family size, the result of family structures and economies quite different from Asia, and of essentially religious attitudes toward fertility that have an impact both on family economics and the acceptability of various forms of fertility control. These attitudes, together with the nature of the African state, mean that governments could not implement the forceful family planning policies that have at times characterized the programs of China, India, and Indonesia.

Africa↗

Trends in family size preferences and contraceptive use in Matlab, Bangladesh.

In the nearly ten years of its existence, the Matlab Family Planning and Health Services Project has been characterized by a remarkable rise in contraceptive use and a corresponding decline in fertility. This study examines available evidence on trends in family size preferences in the Matlab area from 1977 to 1984 and their relationship to contraceptive use. Within the Matlab treatment area, the most significant factor behind the increase in contraceptive use has been a sharp rise in the practice of contraception for spacing births. There also appears to have been a more modest increase in the proportion of women wanting no additional children. Family size preferences in the treatment and comparison areas were roughly comparable, suggesting--to the extent that such preferences have changed over time--change may have occurred throughout the Matlab study area. The findings are evaluated in terms of their implications for the current debate on the contribution of family planning programs to fertility decline in developing countries.

Adult↗