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PubMed1995

Missouri's parental consent law and teen pregnancy outcomes.

The Supreme Court decision of July 1989 upholding state regulation of abortion has led to numerous attempts to impose parental consent and/or parental notification legislation for females under the age of 18 seeking abortions. The effect of such legislation on teen pregnancy outcomes is hotly debated. Missouri vital statistics data from 1980 through 1992 are examined for the effect of such a law on pregnancy resolution choices among teens. The Missouri data suggest that since the enforcement of the parental consent statute in 1985 there has been a decrease in the selection of abortion as a pregnancy outcome, particularly among white teens. In addition there has been an increase in the percent of abortions among teens taking place in other states and an irregular but steady trend toward later abortions. The increasing number of births to unmarried mothers under the age of 18 suggest the need for specific services to help these young mothers cope.

Abortion, Induced↗
PubMed1978

Liberalized abortion in Oregon: effects on fertility, prematurity, fetal death, and infant death.

An analysis of Oregon Vital Statistics data from 1965 to 1975 was conducted to assess the impact of Oregon's 1969 abortion legislation, which substantially increased the number of reported medically induced abortions. This increase was associated with a slight increase in the age-adjusted 1970 fertility rate and there was no decrease in births to women in the age groups obtaining proportionately the most abortions. A significant and persistent 11 per cent reduction in premature births to women over age 20 (p less than .001) and a 22 per cent reduction in spontaneous fetal deaths (p less than .05) were associated with liberalized abortion. Decreases in neonatal and postneonatal infant mortality were observed, but were indistinguishable from an ongoing trend toward improved infant health. A gradual 25 per cent decline in the age-adjusted fertility rate occurred between 1969 and 1975, but the increase in the number of reported abortions could account for only one-fourth of this decrease. A seven-fold increase in the use of family planning clinics between 1970 and 1973 and more liberalized laws regarding provision of family planning service appeared to account for a much higher proportion of the decreased fertility than did liberalized abortion.

Abortion, Legal↗
PubMed1988

Estimates of pregnancies and pregnancy rates for the United States, 1976-85.

After increasing by 9 per cent in the period 1976-80 in the United States, pregnancy rates declined by 4 per cent between 1980 and 1984 (from 111.9 to 107.3 pregnancies per 1,000 women aged 15-44 years). Between 1984 and 1985, the rate rose by less than 1 per cent to 108.2. More detailed data by age and race, available only through 1983, indicate that the decline in the 1980-83 period was not shared by all age groups. For example, pregnancy rates continued to increase for women in their thirties, and teenage pregnancy remained substantially the same. In 1983, 61 per cent of all pregnancies ended in live birth, 26 per cent in induced abortion, and 13 per cent in fetal loss. Pregnancy rates in that year were two-thirds higher for women of races other than White than for White women, and pregnancies of other-than-White women were more likely to terminate as an induced abortion or fetal loss. However, White teenagers and teenagers of other races were about equally likely to have their pregnancy end in induced abortion or fetal loss.

Abortion, Induced↗
PubMed1992

The untold story: how the health care systems in developing countries contribute to maternal mortality.

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.

Abortion, Legal↗
PubMed1982

Single extra-amniotic injection of prostaglandin E2 in Tylose gel to induce first trimester abortion in young nullipara.

A single extra-amniotic injection of 2 or 4 mg of prostaglandin E2 in Tylose gel was administered to 30 primigravidae between the ages of 14 and 20 years to induce first-trimester abortion. Twenty-three patients (76.7%) aborted, though incompletely, within 9 hours, with a mean induction-abortion interval of 6.3 hours. In the remaining 7 (23.3%) the cervical os was found to be open and no mechanical dilatation was required at the time of vacuum aspiration. The only side effect was vomiting, which occurred in 2 patients. The method was shown to be safe and effective and may be employed in young primigravidae, thus eliminating the cervical complications attending vacuum aspiration.

Abortion, Induced↗
PubMed1983

Outcome of delivery subsequent to vacuum-aspiration abortion in nulliparous women.

Altogether 4719 women who had had a legally induced abortion in Uppsala County during 1970-75 were followed by means of computerized record linkage, and deliveries during 1970-78 after abortion were noted. Out of 1 364 deliveries traced, 670 were to primiparas who had had a previous vacuum-aspiration (VA) abortion. The outcome of the delivery for the 670 women was compared with that of matched controls, 622 primiparas and 626 secundiparas. Confounding variables were checked for by multiple regression analysis using the infant's birthweight and gestational duration as dependent variables. This analysis showed that the abortion did not have a statistically significant effect on the outcome. Low birth weight infants and preterm delivery did not occur more often after a previous VA abortion.

Abortion, Induced↗
PubMed1987

Early complications after induced first-trimester abortion.

Complications subsequent to 5,851 consecutively induced first-trimester abortions during the period 1980-85 were analysed. Three hundred and fifty-six abortions (6.1%) led to complications requiring hospital admission. According to bivariable analysis, women below 25 years of age, women with parity 0, women with no spontaneous and with no induced abortions, and women in gestational week 8 had significantly higher postabortal complication rates than women 25 years of age and older (p less than 0.001), women with previous births (p less than 0.0001), women with spontaneous abortions (p less than 0.005), women with induced abortions (p less than 0.005), and women in other gestational age groups (p less than 0.0005). The mean stay in hospital per complicated abortion was 5.3 days. It was discussed whether the administration of prophylactic antibiotics to women with a history of pelvic inflammatory disease and young women completing their first pregnancy could reduce the complication rate.

Abortion, Induced↗
PubMed1991

Sexual experience, abortion and sexually transmitted diseases among young women at a contraceptive clinic.

All visitors who during one year visited a contraceptive clinic in the Solna district of Stockholm County and were below the age of 26 were asked to fill in a questionnaire and offered a test for C. trachomatis. Three hundred and six women (97%) participated. Ninety percent had at some time used oral contraceptives and 91% had experience of condom use. One-fifth of the whole group had undergone one or more legal abortions, and one fourth had experience of a sexually transmitted disease (STD). The most common STD experienced was chlamydia, followed by condyloma. The actual prevalence of chlamydia in the group was 6%. Sexual contacts were often made early in on-going steady relations. Forty-two percent admitted casual sex, but the number of life-time partners was five or less among the majority.

Abortion, Legal↗
PubMed1992

Effect of predilatation of the uterine cervix by laminaria tent on activity of the placenta.

Serum concentrations of hCG were determined in blood samples taken 18-20 h and immediately before vacuum aspiration in 45 women in gestational weeks 7-9, admitted for legal abortion. In 35 of the women, a laminaria tent was inserted for cervical dilatation immediately after the first blood sampling. Serum hCG values decreased significantly in the women pretreated with laminaria tent, but were unchanged in the untreated women. This finding may indicate that pretreatment with a laminaria tent induces a partial placental detachment.

Abortion, Legal↗
PubMed1994

Induced abortion. Effects of marital status, age and parity on choice of pregnancy termination.

OBJECTIVE: To study the impact of marital status, age and parity on the decision regarding pregnancy termination over time among pregnant Norwegian women. DESIGN: National surveillance data of induced abortions and births. MATERIAL: All women terminating their pregnancies (n = 174,590) as registered in the Abortion File in the Central Bureau of Statistics and all women giving birth (n = 639,551) as registered in the Medical Birth Registry of Norway between January 1, 1979 and December 31, 1990 were eligible for the study. Included in the analysis of pregnancy outcome were records with complete information on marital status, age and parity, which comprise 93.8% (n = 163,826) of all women having had an induced abortion and 99.0% (n = 633,542) of all women giving birth during the time period. OUTCOME MEASURE: The proportion of pregnancies terminated as induced abortions and the relative risk of pregnant women choosing abortion in strata of marital status, age and parity. STATISTICAL METHODS: Trend analysis of the proportion of pregnancies terminated as induced abortions in different time periods in categories of marital status, age and parity. RESULTS AND CONCLUSION: From the first three-year period 1979-81 to the last three-year period 1988-90 there was a decreasing tendency to choose abortion among unmarried pregnant women above 20 years of age and married women with two or more children. In the other strata of marital status, age and parity there were no changes over the time period, except for married women 20-24 years of age which was the only group that showed an increasing abortion tendency over the time period. The prospect of single parenthood was the strongest determinant for choosing abortion independent of age and parity. Within all age groups of married women the abortion tendency increased more with parity than age. Cohabiting women chose abortion significantly more often than married women did. However, the true estimate of choosing abortion among cohabiting women was closer to married women than to single women. In order to find out the importance of other social factors and attitudes in the decision making process regarding pregnancy outcome, adjustments must be made for marital status, age and parity.

Abortion, Induced↗
PubMed1996

Towards regional equality in family planning: teenage pregnancies and abortions in Finland from 1976 to 1993.

BACKGROUND: A major goal of Finnish family planning policy since the 1970s has been to minimize unintended pregnancies by providing equal contraception and abortion services throughout the country. This report looks at how this policy has succeeded among teenagers. METHODS: The data on childbirths, induced abortions and mean populations were collected from the national abortion and population registers. Regional and age-specific rates were calculated for fertility, abortions and pregnancies in girls aged 15-19. RESULTS: In 1993, the teenage pregnancy rate was 20/1000 and the abortion rate 9.5/1000 in the whole country. Although the pregnancy rate had dropped by half since the 1970s, the regional differences were still there: the lowest rate was 18/1000 and the highest 29/1000 (in Lapland) in 1991-93. The abortion rate ranged from 8/1000 to 14/1000. Childbirths decreased, particularly at the beginning of the study period, while abortions declined sharply towards the end of the period. In 1986-88, the abortion ratio exceeded 100 in all provinces except two. In the 1990s, it dropped below 100 again except in the capital province. In 16-17 year-olds, the trends were quite equal in different provinces. In 18-19 year-olds, pregnancies remained more frequent in the north and were more often carried to term, while the choice of abortion was more likely in the south. CONCLUSIONS: Equally declining trends in pregnancies in all provinces suggest that teenage family planning services have a comprehensive coverage. However, regional differences still remain and imply a detailed analysis of their reasons.

Abortion, Induced↗
PubMed1996

Induced abortions and childbirths: trends in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine during 1970 to 1994.

BACKGROUND: To analyse trends in childbirth, induced abortions and maternal morbidity from 1970 to 1994 in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine. METHODS: Official health statistics from the six countries were compiled and analysed. RESULTS: High abortion rates (up to 142 per 1000 women of fertile ages and years) were seen in all countries analysed, but since 1980 a continuing decrease is noted for Estonia, Latvia and Kalimingrad with a lowest rate of 50 abortions/1000 women/year in Latvia in 1994. Teenage abortions and childbirths are increasing. Maternal mortality, including complications of abortions, is still a reality in all the countries studied. CONCLUSION: The high abortion frequencies in all countries studied here indicate that national abortion prevention programs are needed. Such programs should focus on education, both of medical professionals, teenagers, fertile women and males. Concomitantly, the availability of cheap and modern contraceptives must increase, especially to defined risk groups.

Abortion, Induced↗