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PubMedDate not supplied

First premarital contraceptive use: United States, 1960-82.

This study shows the first national estimates of trends and differentials in first contraceptive use for a national sample of all women. Only 47 percent of women aged 15-44 in 1982 (or their partners) used a method at first premarital intercourse. The leading method at first intercourse was the condom, followed by the pill and withdrawal. The percentage using a method increased from the early 1960s to the late 1970s, because of increases in use of the pill and withdrawal. However, in the early 1980s, use at first intercourse increased sharply because of an increase in use of the condom. The proportion who used a method at first intercourse varied from 22 percent among Hispanic women to 74 percent among Jewish women; it was higher among white than black women, and higher in higher socioeconomic categories. After first intercourse, contraceptive use did not vary significantly by socioeconomic characteristics. While the condom was the leading method at first intercourse, women who practiced contraception for the first time after first intercourse typically used the pill.

Adolescent↗
PubMedDate not supplied

Assessing the role of family planning in reducing maternal mortality.

It is widely believed that family planning has important benefits for both maternal and child health. Despite this, little work has been done to quantify the potential effect of family planning in reducing maternal mortality. This paper assesses the impact of family planning in averting maternal deaths, and discusses the overall ability of risk strategies to address the bulk of maternal mortality. The practical difficulties of providing effective contraception to populations with high maternal mortality are addressed, and the need for maternal health care services as an adjunct to useful family planning programs is emphasized. Although family planning cannot by itself cause a substantial reduction in risk of pregnancy, the combined strategies of general fertility reduction, abortion services, and family planning for high-risk groups might effectively address about half of all maternal mortality in the developing world. Pregnancy and delivery care have the potential for saving large numbers of lives with appropriate interventions. It is concluded that reproductive risks can be reduced only by preventing unwanted pregnancies and protecting maternal health during wanted ones.

Abortion, Legal↗
PubMedDate not supplied

Use of contraceptives for birth spacing in a Nigerian city.

This paper examines the use of contraceptives among women aged 15-35 in the urban area of Ilorin, Nigeria, with particular focus on use for the purpose of spacing births. Approximately 19 percent of ever-married women in the sample had used contraceptives at some time and approximately 6 percent were using at the time of the survey. Results suggest that some women have used or are using contraceptives as a substitute for prolonged periods of postpartum sexual abstinence. Whereas all groups of women in the study prefer to maintain an interval of two years between births, less traditional women no longer prefer to observe long periods of postpartum sexual abstinence. For some women, therefore, there is a wide gap between the length of preferred birth interval and the length of preferred abstinence. The magnitude of this gap is significantly associated with both ever use and current use of contraceptives. Other variables found to have a significant independent effect on contraceptive use were total number of children desired, maternal age, and maternal education.

Adolescent↗
PubMedDate not supplied

Contraceptive use and the need for family planning in Puerto Rico.

In 1982, 69 percent of Puerto Rican women in union were practicing contraception. Forty-five percent relied on contraceptive sterilization (40 percent, female, and five percent, male), eight percent were using the pill, four percent each, the IUD and the condom, five percent relied on rhythm, and three percent were using other methods. Thus, sterilization is the dominant form of fertility regulation in Puerto Rico, and there is relatively little use of reversible methods for childspacing. Reliance on female sterilization peaks among women in union in the age-group 35-44 (54 percent), whereas pill use is highest among those aged 15-24 (approximately 23 percent). Overall, eight percent of all women aged 15-49 are at risk of unintended pregnancy because they are fecund, sexually active, not pregnant or seeking pregnancy and not using any kind of contraceptive method. However, among women in union, this risk ranges from nine percent among those aged 30-39 to 22 percent among women aged 15-19. Reliance on sterilization rather than reversible methods of contraception is strongly influenced by socio-demographic variables. Women with less than a high school education, the wives of blue-collar workers, women living outside of the major cities and those born in Puerto Rico depend upon sterilization more than do women with a college education, the wives of white-collar employees, women living in cities and those born outside of the country. These findings point to the need for improved availability of reversible family planning services, especially for young women, and those whose childbearing is incomplete.

Adolescent↗
PubMedDate not supplied

Contraceptive failure in the United States: estimates from the 1982 National Survey of Family Growth.

A multivariate life-table analysis of national survey data from 1982 indicates that among currently married women, the pill and IUD have the lowest use-failure rates. During the first year of use, about three percent of pill users and six percent of IUD users experience an unintended pregnancy. Failure rates for the remaining methods range from 14 percent for the condom to 22 percent for spermicides; between these lie rhythm and natural family planning (16 percent), the diaphragm (17 percent) and other methods, mainly withdrawal, douche and abstinence. Married women using no contraceptive method experience an unintended pregnancy rate of 40 percent during the first year of unprotected intercourse. A woman's age, pregnancy intention (either to delay or to prevent births), parity and income all have significant effects on the risk of unintended pregnancy. The risk generally declines with age, except for women attempting to prevent an unwanted pregnancy, among whom women under 20 have lower failure rates than do those 20-29 years of age. As expected, women attempting to prevent an unwanted pregnancy have lower failure rates than do those seeking to delay a wanted pregnancy, with the difference being greatest for women under 20 years of age and smallest for 20-29-year-olds. Use-failure rates among low-income women are higher than those among women with larger family incomes, while low-parity women have lower failure rates than do women of higher parity. On average, standardized use-failure rates for single women are lower than those for married women, probably because of a lower average level of intercourse among single women. In addition, these rates are understated because of the substantial underreporting of abortion among single women; if abortion reporting were complete, failure rates would be about 1.4 times as high as they appear here, and thus would be close to those of married women. Differences in the risk of unintended pregnancy among single women show a number of similarities with those seen among married women: Use of the pill and IUD is associated with the lowest failure rates, reliance on the condom is associated with intermediate failure rates, and use of spermicides is linked with the highest failure rates. However, while rhythm and the diaphragm exhibit use-failure rates that are among the highest found for single women, failure rates for these methods are at intermediate levels among married women.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMedDate not supplied

Determinants of breastfeeding in developing countries: overview and policy implications.

Breastfeeding can play a major role in fertility regulation in developing countries. The effect of breastfeeding is enhanced when the incidence of breastfeeding is high and the duration extended. These factors are more likely to occur when suckling at the breast is frequent. Sociological and behavioral factors can also influence a woman's decision to initiate and terminate breastfeeding. The effects of urbanization, maternal education, and socioeconomic status act through the intervening variables of sociocultural factors, health services, employment status of women, and availability of breastmilk substitutes. Strategies to alter these intervening variables include educational campaigns and support groups for lactating women, changes in health services, availability of child care facilities near employment centers, and enforcement of the international code of marketing of breastmilk substitutes.

Breast Feeding↗
PubMedDate not supplied

Attitudes toward the rhythm method in the Philippines.

Two sets of focus group discussions on the advantages and disadvantages of the rhythm method were carried out in the Philippines in 1980 and 1981. The first discussions were held among 30 women and nine men 21-40 years of age, and the second among eight women 25-35 years of age who had voluntary pregnancy terminations after the method had failed. Among the perceived advantages of rhythm were that it permits spontaneous intercourse on the safe days and has no bad side effects. Among the perceived disadvantages were that it is ineffective, especially for women with irregular periods, and it requires abstinence. The women who had had voluntary pregnancy terminations discussed their motivations and rationales and the methods that they had used. The information obtained from the discussions formed the basis for support materials that are now used throughout the country.

Abortion, Spontaneous↗
PubMedDate not supplied

Contraceptive patterns of religious and racial groups in the United States, 1955-76: convergence and distinctiveness.

A number of studies have reported data on contraceptive use among white Protestant and white Catholic couples in the United States, but this paper is the first to study a large sample of couples with other or no religious affiliation, as well as black couples by religion, using multivariate controls. Using a nationally representative sample of 14,000 married women aged 15-44, we find convergence among white Protestant, Catholic, and Jewish couples in contraceptive patterns between 1955 and the mid-1970s, but large differences remained at the latter date, even after multivariate controls. Among black couples, differences by religious affiliation are smaller, but differences between white and black couples within religion categories are substantial. We conclude that religious differences are not artifacts of an incomplete demographic transition, and that religious affiliation is an indispensable datum for understanding contraceptive choice in the United States.

Black or African American↗
PubMed1981

A prospective multicentre trial of the ovulation method of natural family planning. I. The teaching phase.

The percentage of 869 women in five countries capable of being taught to recognize the periovulatory cervical mucus symptom of the fertile period was determined in a prospective multicentre trial of the ovulation method of natural family planning. The women were ovulating, of proven fertility, represented a spectrum of cultures and socioeconomic levels, and ranged from illiteracy to having postgraduate education. In the first of three standard teaching cycles, 93% recorded on interpretable ovulatory mucus pattern. Eighty-eight per cent of subjects successfully completed the teaching phase; 7% discontinued for reasons other than pregnancy, including 1.3% who failed to learn the method. Forty-five subjects (5%) became pregnant during the average 3.1-cycle teaching phase. The average number of days of abstinence required by the rules of the method was 17 in the third teaching cycle (58.2% of the average cycle length). To what extent the findings of this study can be extended to other couples remains to be demonstrated.

Adult↗