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PubMedDate not supplied

Family planning clinic services in the United States, 1983.

Almost five million women were enrolled in family planning clinics in the United States in 1983, eight percent more than in 1981. The number of family planning provider agencies declined slightly, from 2,504 to 2,462, but the number of clinic sites that could be identified increased slightly, from 5,124 to 5,174. Family planning clinics operate in three-quarters of U.S. counties; in 1975, the last time county coverage was checked, four-fifths of the counties had clinics. About one in 20 women who are exposed to the risk of unintended pregnancy and live in unserved counties are teenagers or low-income women. Nonmetropolitan counties are more likely to be without clinics than are metropolitan counties. Overall, there are 417,000 low-income women and 249,000 teenagers at risk of unintended pregnancy living in counties where there are no family planning clinics. In 1983, health departments constituted six in 10 of all family planning agencies and served two-fifths of all family planning clinic patients; Planned Parenthood affiliates accounted for fewer than one in 10 agencies and served more than one-quarter of all patients. Hospitals and all other agencies served about one-third of the total 1983 caseload. These patterns were similar to those reported for 1981. Family planning clinics continue to serve primarily low-income women: Four-fifths of the nearly five million clinic patients in 1983 had family incomes below 150 percent of the federally defined poverty level. About 1.6 million women aged 19 and younger were served, representing one-third of all clinic patients in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Menstrual history and fecundity of women exposed and unexposed in utero to diethylstilbestrol.

Sequential examination and interview of diethylstilbestrol-exposed (DES-exposed) and -unexposed women verified that DES exposure has no effect on age at menarche and indicated no differences in the age at first coitus, pregnancy and live birth. Analysis of variance indicated that there is an age-related increase in oligomenorrhea in DES-exposed women as compared to unexposed women that disappears as the patients reach their late 20s. Prospective data collection is required to substantiate this finding. There appears to be no substantial effect of in utero exposure to DES on women's ability to conceive.

Abortion, Induced↗
PubMedDate not supplied

Family planning clinic services in the United States, 1981.

In the first 13 years after the federal government initiated support for family planning clinic services, there was a fivefold increase in the number of U.S. women obtaining these services from organized programs, from about 860,000 in 1968 to 4.6 million in 1981. This increase was due to the growth in the number of service providers and in the average number of clients served by each agency. Between 1968 and 1981, the number of provider agencies rose from about 1,400 separate agencies operating 1,800 clinics to 2,500 agencies administering 5,000 clinics. The average number of patients served by each agency increased from 600 to 1,800. Family planning clinics have continued to serve primarily low-income women; in 1981, four-fifths of the women served, or 3.7 million, had low incomes. In addition, an estimated 1.8 million low-income women obtained family planning services from private physicians. Thus, about 58 percent of the 9.5 million low-income women who were exposed to the risk of having an unintended pregnancy in 1981 made a contraceptive visit in that year; 39 percent went to clinics and 19 percent visited private physicians. Five million women 19 years of age or younger were at risk of unintended pregnancy in 1981; of these, 2.9 million (57 percent) obtained medically supervised family planning services--30 percent from organized programs and 27 percent from private physicians. Family planning clinic patients obtained contraceptive care from a variety of public and private health agencies in 1981.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

Factors affecting the selection of a reversible or an irreversible contraceptive method in a developing country.

OBJECTIVES: To evaluate the factors that may affect the selection of a reversible or an irreversible contraceptive method. METHODS: In an urban area of a developing country, demographic characteristics, educational and income levels, and previously used contraceptive methods were retrospectively reviewed for 3 years from the files of women who had chosen reversible or irreversible contraceptive methods. Student's t test and the chi2 test were used to analyze the data obtained from the two groups of women. RESULTS: Out of a total of 8078 women, 595 (7.4%) selected surgical sterilization, while 7483 (92.6%) preferred reversible methods such as intrauterine devices (38.1%), combined oral contraceptives (13.9%), condoms (40%) and Norplant (0.6%). Compared to those who preferred reversible methods, the women with surgical sterilization had a higher mean age (33.9 +/- 4.2 years versus 29.6 +/- 3.9 years), mean gravidity (3.8 +/- 0.9 versus 2.3 +/- 1.2) and mean number of living children (2.6 +/- 0.8 versus 2.1 +/- 1.1) (p < 0.01). These women had also higher rates of high-school education (37.3% versus 30.1%) and previous modern contraceptive use (78.1% versus 71.2%) (p < 0.01). None of the women with surgical sterilization, but 1770 (33.0%) of those who chose reversible methods, had fewer than two living children. CONCLUSIONS: These data suggest that irreversible contraceptive methods tend to be chosen by older women with higher educational levels, who have decided that their family is complete and who have at least two children.

Adult↗
PubMed1994

The use of levonorgestrel implants (Norplant) for contraception in adolescent mothers.

BACKGROUND: Although levonorgestrel implants (Norplant) would appear to be a good contraceptive option for adolescent mothers, there is little information about the use of Norplant in this population. METHODS: We studied 100 postpartum adolescents who chose a contraceptive method at an urban teaching hospital between September 1991 and July 1992. Structured interviews were conducted and medical records were reviewed soon after delivery and at a mean (+/- SD) of 15.5 +/- 2.9 months post partum. RESULTS: Forty-eight of the adolescent mothers chose Norplant, 50 chose oral contraceptives, and 2 (not further studied) chose barrier methods of contraception. The factors significantly associated with the choice of Norplant were older age (16.7 years among those who chose Norplant, vs. 16.2 years among those who chose oral contraceptives), multiparity (24 subjects vs. 6 subjects), and previous use of oral contraceptives (34 subjects vs. 21 subjects). During follow-up, there were no differences between the Norplant group and the oral-contraceptive group in the frequency of clinic visits (an average of 2.3 visits per subject in each group), failure to return after the postpartum visit (9 subjects vs. 11 subjects), or the incidence of sexually transmitted diseases (42 percent vs. 36 percent). At follow-up, 95 percent of the subjects in the Norplant group and 33 percent of those in the oral-contraceptive group were still using the method they had chosen (P < 0.001). During the first postpartum year 1 subject in the Norplant group and 19 in the oral-contraceptive group became pregnant (P < 0.001). Norplant users did not differ from all other adolescents studied with regard to sexual activity or condom use. CONCLUSIONS: The selection of Norplant by adolescent mothers as a method of contraception is associated with higher rates of continued use and lower rates of new pregnancy than the selection of oral contraceptives and does not affect the use of health care services, sexual activity, condom use, or the rate of sexually transmitted diseases.

Adolescent↗
PubMed2001

The effectiveness of preabortion contraception counseling.

OBJECTIVE: To demonstrate the impact of preabortion counseling followed by immediate postabortal provision of the chosen method on postabortion contraceptive use. METHODS: Three hundred and forty-two women undergoing voluntary termination of pregnancy at less than 10 weeks gestation were enrolled at the Woman and Child Health Training and Research Clinic, Medical School of Istanbul. Clinic visits and telephone surveys were performed to measure contraceptive use at 6 months following abortion. RESULT: Two hundred and thirty-six women either visited the clinic or responded to the telephone survey. Eighty percent of the respondents reported use of a modern contraceptive as compared to less than 40% prevalence found in the national survey. CONCLUSION: Preabortion counseling combined with immediate postabortal provision of contraceptives may significantly increase contraceptive use at 6 months postprocedure.

Abortion, Induced↗
PubMed1997

Contraceptive continuation and its determinants in Benin.

To understand better the rates of continuation of different contraceptive methods, a study in 12 family planning centers in Cotonou and Porto Novo, the two largest cities in Benin, was conducted. From January 1 to December 31, 1993, 944 questionnaires completed by new women acceptors of one of three methods of contraception (oral contraceptive, injection, or IUD) were analyzed. For all methods of contraception, the average length of follow-up was 9.5 months. From the start of the analysis, 44.4% (n = 419) of the women were regularly followed, 49.5% (n = 467) were not regularly followed, and 6.1% (n = 58) reported discontinuation of the method. One year after beginning the use of contraception, the cumulative proportion of women at risk of becoming pregnant, for all the methods together, was 42.0% (38.6-45.4%). Age was associated with the probability of abandoning oral contraception (p = 0.01). Three months after the start, the cumulative proportion of drop-out women having chosen oral contraceptive was 37.2% (22.8-51.6%) of the less than 20-year-olds, 19.0% (14.3-23.7%) of the 20- to 30-year-olds, and 23.4% (15.6-31.2%) of the over 30-year-olds. In contrast, drop-out was not associated with age for women using injection (p = 0.96) or the IUD (p = 0.47). Our results indicate a relatively high and rapid rate of discontinuation for modern contraceptive methods, particularly for young women having chosen oral contraceptive. This finding should incite the family planning educators to give more emphasis to the counseling programs, especially during the first three months.

Adolescent↗