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In: Forman AM, Fischman SH, Woodville L, eds. New horizons in midwifery: proceedings of the Sixteenth Triennial Congress of the International Confederation of Midwives, October 28-November 3, 1972, Washington, D.C. London, International Confederation of Midwives and New York, American College of Nurse-Midwives, 1973. 188-90.New demands are being made on midwives to broaden their duties, assume greater responsibility in planning and organization and implementation of maternal and child health care. In the future, increasing numbers of people will receive health care services, thus legislation will have to provide for expanded midwife services with a focus on family health care including family planning. Laws requiring continuous education must be legislated to insure a high level of competance. For greater utilization of available health manpower personnel, laws will have to aim at restructuring existing patterns to provide for improved midwifery resources. It is believed that the midwife or nurse-midwife constitutes a major link between family and an increasing complex health care system.
San Francisco, San Francisco Press, 1974. 292 p.Despite its high effectiveness, lack of side effects, ease of use, and low cost, condom utilization has declined in the U.S. from 30% of contracepting couples in 1955 to 15% in 1970. The present status of the condom, actions needed to facilitate its increased availability and acceptance, and research required to improve understanding of factors affecting its use are reviewed in the proceedings of a conference on the condom sponsored by the Battelle Population Study Center in 1973. It is concluded that condom use in the U.S. is not meeting its potential. Factors affecting its underutilization include negative attitudes among the medical and family planning professions; state laws restricting sales outlets, display, and advertising; inapplicable testing standards; the National Association of Broadcasters' ban on contraceptive advertising; media's reluctance to carry condom ads; manufacturer's hesitancy to widen the range of products and use aggressive marketing techniques; and physical properties of the condom itself. Further, the condom has an image problem, tending to be associated with venereal disease and prostitution and regarded as a hassle to use and an impediment to sexual sensation. Innovative, broad-based marketing and sales through a variety of outlets have been key to effective widespread condom usage in England, Japan, and Sweden. Such campaigns could be directed toward couples who cannot or will not use other methods and teenagers whose unplanned, sporadic sexual activity lends itself to condom use. Other means of increasing U.S. condom utilization include repealing state and local laws restricting condom sales to pharmacies and limiting open display; removing the ban on contraceptive advertising and changing the attitude of the media; using educational programs to correct erroneous images; and developing support for condom distribution in family planning programs. Also possible is modifying the extreme stringency of condom standards. Thinner condoms could increase usage without significantly affecting failure rates. More research is needed on condom use-effectiveness in potential user populations and in preventing venereal disease transmission; the effects of condom shape, thickness, and lubrication on consumer acceptance; reactions to condom advertising; and the point at which an acceptable level of utilization has been achieved.