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[Contraception in children and adolescents].

It is discussed how the adult type contraception fits the divergent needs of the youngsters. Oral contraceptives are suitable from the 16th year of life. Vaginal globuli and foams have also proved to be an effective means of contraception over that period of life. For anatomical reasons pessaries are not recommended, insertion of intrauterine devices is contraindicated because of their possible adverse effects. Experiences with university students taking d-Norgestrel as "morning-after-pill" have been favorable. The therapeutic abortion is regarded as an emergency measure to be employed only if anticonception failed. Adaequate education at the proper age and the importance of preventive measures are stressed.

Abortion, Spontaneous↗

Contraception.

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Cervix Mucus↗

A prospective multicentre trial of the ovulation method of natural family planning. III. Characteristics of the menstrual cycle and of the fertile phase.

Seven hundred twenty-five women of proven fertility recorded the presence of cervical mucus at the vulva in 7514 menstrual cycles. The mean cycle length of the 6472 "normal" cycles was 28.5 days (standard deviation +/- 3.18). The peak day of mucus discharge was the last day of slippery, raw-egg-white-like mucus and occurred on average on day 15 (+/- 2.6). The fertile period was defined as any day on which mucus was reported before the peak day until 3 days after the peak. Its mean length was 9.6 (+/- 2.6) days. The probability of pregnancy was maximal on the peak day and declined on the days before and after the peak.

Adult↗

Mortality associated with fertility and fertility control: 1983.

This analysis demonstrates that levels of mortality associated with all major methods of fertility control (tubal sterilization, the pill, IUD, condom, diaphragm, spermicides, rhythm and abortion) are low in comparison with the risk of death associated with childbirth and ectopic pregnancy when no fertility control method is used. The exceptions are the risks associated with pill use after the age of 40 for women who do not smoke, and with pill use after the age of 35 for smokers. The safest approach to fertility control is to use the condom and to back it up by abortion in case of method failure. Except for the lowest-risk method of fertility control (condom and abortion) and the highest (pill use by a smoker), most strategies of fertility control result in a similar risk of mortality until the woman reaches 35 years of age. At that point, risk from pill use rises more sharply than risk associated with other methods. The above conclusions are based on the lowest contraceptive failure rates reported by Schirm and his colleagues for married American women. If, instead, the highest failure rates are employed, use of the pill by a nonsmoker or the IUD clearly is safer than reliance on barrier methods or rhythm. As noted earlier, there are few women who make their contraceptive choices solely on the basis of perceived risk of mortality. Very few, for example, would consider abortion as a primary method of birth control; and for many, abortion would not be acceptable even as a backup for failed contraception. Although the risk of mortality resulting from use of the IUD is low, many women who have not yet had children might not want to face the increased risk of infertility problems from pelvic inflammatory disease that have been associated with use of this method.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗

The costs of contraception.

The cost of contraception is one factor that affects the choice of a birth control method. An analysis of the first-year costs for the various methods, based on fees charged by private physicians and supplies purchased at drugstores, shows that the cost can be considerable and that there are large differences in cost between methods. Prescription contraceptives--the pill, IUD and diaphragm--are by far the most expensive of the reversible methods because they require medical supervision, but supplies alone are also more expensive for prescription methods than for nonprescription methods. First-year cost is highest for the pill-$172, compared with $160 for the diaphragm and $131 for the IUD. The mean of $154 for these three prescription methods is almost four times the mean first-year cost of $40 for condoms and foam. Sterilization necessitates the largest initial expenditure, and the cost of tubal ligation-$1,180-is almost five times the cost of vasectomy-$241. However, sterilization represents a one-time cost, while the other methods involve recurring expenses that may add up to more than the cost of sterilization over time. The methods that are associated with the lowest failure rates-sterilization, the pill and the IUD-are among the most expensive. To offset the costs of contraception, 4.6 million American women obtained low-cost care from subsidized family planning clinics in 1980.

Contraception↗

[Contraception].

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Contraception↗

Contraception.

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Abortion, Induced↗