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Honolulu, Hawaii. 1974. n.p.A series of charts produced by Hawaii Planned Parenthood, Inc., provide statistical data on the numbers of minors given contraceptive assistance and counseling by 15 Planned Parenthood clinics. Information provided by the charts includes: 1) Patient characteristics; 2) Method of contact preferred by the patients; 3) Contraceptive methods, past and present; 4) Levels of education; 5) Family size and income of patients; 6) Numbers of fetal deaths and live births; 7) Patients' marital status; 8) Clinic medical services; 9) Patient load by clinic, age, and length of residence in Hawaii; 10) Welfare status of patients; and 11) Reasons given by patients for and against the practice of contraception.
In: Diczfalusy, E. and Borel, U., eds. Control of human fertility. Proceedings of the Fifteenth Nobel Symposium, Sodergarn, Lidingo, Sweden, May 27-29, 1970. New York, Wiley, 1971. 39-51.A drug delivery system providing for a controlled release of progestogen and affecting ovulation and steroidogenesis minimally would deal effectively with some of the problems associated with contraception. 2 systems being developed which fit these criteria are the primary topics of discourse in this article. In 1 system an implant consists of a polymer membrane of polydimethylsiloxane (PDS) and contains the progestogen in crystalline form. Major problems with the PDS implants include a lack of intraindividual constance of release and interindividual variation in the slope of the decay in release. In the second system the implant consists of a lipid-steroid membrane containing a steroid. In this implant the concentration of the steroid in the membrane and the nature of the lipid phase may be important in determining the pattern of release. In vivo metabolic studies with lipid-steroid pellets are limited, but the patterns of output may be similar to those seen with PDS implants. Because of rate problems, a shorter regime slow-release implant seems more feasible than a longer lasting system. Surgical difficulties associated with the implantation and removal of the PDS implant make the choice of a lipid-steroid micropellet preparation more feasible for a short-term regimen. The discussion, following the main body of the article, focuses primarily on problems associated with implants.
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 22 p. (IESA/P/ICP. 1984/EG.I/8)The World Health Organization (WHO) has been studying several national surveys with regard to certain health related aspects of fertility. The primary purpose of these studies was to stimulate the use of data by the national health authorities for an improved care system for maternal and child health, including family planning. Some preliminary results are reported in this discussion, in particular those relating to contraception, the reproductive health of adolescents, infertility and subfecundity, and breastfeeding. The national surveys concerned are those of Bangladesh, Indonesia, the Republic of Korea, the Philippines, and Sri Lanka. The methods of analysis were simple and traditional, except for 2 points: some of the data had to be obtained by additional tabulation of the raw data tapes and/or the recode tapes since the standard tabulations of the First Country Reports did not include the needed information; and Correspondence Analysis was used in an effort to stimulate and facilitate the use of the findings for improvements of national health programs. Methods of contraception vary widely, from 1 country to another and by age, parity, and socioeconomic grouping. The younger women tend to choose more effective modern methods, such as oral contraception (OC); the older women, i.e., those over age 35, tend to seek sterilization, if available. It is evident that the historical development of family planning methods has greatly influenced the current "mix" of methods and so has the current supply situation and the capacity of the health care system (particularly in regard to IUD insertions and sterilizations. Use of contraception among adolescents to postpone the 1st birth was practically unknown. The risk of complications at pregnancy and childbirth, including maternal and infant death, is known to be particularly high for young mothers, and the results clearly showed that the infant mortality rate is highest for the youngest mothers. All the women who suffer from infertility do not recognize their condition, but the limited data still point to the need to consider the health needs of women who suffer from unwanted fecundity impairments. This may require medical intervention to cure infections or the offer of relevant sexual counseling. Some infecundity may require the improvement of nutritional and personal hygienic levels before meaningful achievements are made. The prevalence of breastfeeding has declined in some population groups, and the consequences can be expected to be deleterious and to involve serious increases in specific morbidity and mortality.
Contraception. 1982 Mar; 25(3):231-41.A randomized, controlled, clinical trial comparing 6 combined oral contraceptives (OCs) with 50 mcg or less of ethinyl estradiol was undertaken in 10 WHO Collaborating Centers for Clinical Research in Human Reproduction. A total of 2430 women entered the trial and were observed for 28,077 woman-cycles. All low-dose combined OCs demonstrated equivalent efficacy with 1-year pregnancy rates of 1-6%. However, discontinuation rates for medical reasons differed significantly between the treatment groups with the preparation containing 20 mcg ethinyl estradiol and that containing 400 mcg norethisterone acetate being associated with higher discontinuation rates due to bleeding disturbances. Even among the preparations which did not differ in discontinuation rates, the reasons for discontinuation did differ. Women receiving norethisterone preparations tended to discontinue because of bleeding disturbances while those receiving the levonorgestrel-containing preparations tended to discontinue because of complaints of nausea and vomiting. (author's)