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Journal of Family Planning and Reproductive Health Care. 2006 Oct; 32(4):249-252.Both the Delphi method and nominal group technique offer structured, transparent and replicable ways of synthesising individual judgements and have been used extensively for priority setting and guideline development in health-related research including reproductive health. Within evidence-based practice they provide a means of collating expert opinion where little evidence exists. They are distinct from many other methods because they incorporate both qualitative and quantitative approaches. Both methods are inherently flexible; this article also discusses other strengths and weaknesses of these methods. (excerpt)
Family Coordinator. 1970 Apr; 19(2):159-164.Spurned as a subject unfit for even private conversation, let alone the pages of a magazine, in the early twentieth century, birth control is now discussed openly in every kind of communications medium. In the early years of the birth control movement, however, only journals which enjoyed some kind of financial security would dare include such an inflammatory subject. As Americans encountered economic difficulties in the 1930s and adopted a more enlightened view of sexual relations, birth control became an acceptable topic, even to those who opposed the practice. Public acceptance of and interest in the issue has been reflected in periodical coverage of the subject. (author's)
ANNUAL REVIEW OF POPULATION LAW. 1988; 15:6.This Hubei, China, Circular, issued near the end of 1988, provides the following: "The population growth situation in our country is grim. Since 1986, the natural population growth rate has risen continuously. To draw the prompt attention of the whole party and the entire people to the issue of our population, all localities must seriously unfold the activities of publicizing family planning (FP) this winter and next spring, in coordination with education in current affairs. It is necessary to publicize FP in an all-around way and with accuracy, and the activities of publicizing must be carried out effectively in a solid and deep-going way. In the rural areas, stress must be placed on areas where FP work is not carried out well and where there is a prevailing tendency toward early marriage, early child-bearing, and extra-budgetary births. In cities, publicity and education must be conducted especially among the transient population, individual households, and jobless households. During the period of publicity, large-scale street-corner publicity activities must be carried out in cities and towns so as to create strong public opinion and to combine the endeavor to publicize current affairs and policies with the effort to popularize knowledge about contraception and birth-control, to execute measures of contraception and birth control, and to establish FP associations in the countryside." (full text)
Plano, Texas, Instructional Aides, 1984. 78 p. (A Guide on Current Topics)This document provides readers with a review of the history of the controversy regarding abortion, a summary of the major positions on both sides of this debate, and an assessment of public opinion regarding abortion. It draws heavily on research materials from the Centers for Disease Control, the Alan Guttmacher Institute, and the Population Council. Chapter 1 sets the abortion issue in historical perspective. Chapter 2 focuses on US Supreme Court decisions, while Chapter 3 discusses Congressional activities. Chapter 4 presents statistical data on the abortion rate in the US, demographic characteristics of abortion seekers, abortion techniques, and abortion-related mortality. Chapter 5 surveys the status of abortion around the world. Chapter 6 presents survey results on public attitudes toward abortion. Chapters 7 and 8 include statements from national leaders who believe abortion should not and should, respectively, be outlawed, while Chapters 9 and 10 present statements on both side of the debate as to whether the moment human life begins can be determined. Appendix I presents excerpts from Vatican position papers on abortion. Appendix II summarizes US laws, state by state, that limit access to abortion. Appendix III cites federal laws restricting abortion funding. Appendix IV presents proposed abortion legislation. And finally, Appendix V lists addresses of organizations that support abortion, organizations that oppose abortion, and institutions that maintain statistics on abortions in the US. Instructional Aides provides similar documents on a number of social issues, including aging, health, immigration, minorities, and women.
[Promoting family planning in Romania. Phase one of qualitative research with detailed group interviews, Bucharest, February 1992] Promouvoir la planification familiale en Roumanie. Premiere phase de recherche qualitative, entretiens de groupes approfondis, Bucarest, Fevrier 1992.
Bucharest, Romania, Societatea de Educate Contraceptive Si Sexualita, 1992.  p.This paper reports upon the first phase of qualitative research into the development of family planning in Romania. The research is based upon 8 in-depth group interviews conducted in Bucharest during February 1992. A total 24 focus group sessions will eventually be held. Research was conducted to better understand the population’s opinions, attitudes, and knowledge about family planning and contraception; to identify rumors, taboos, and false ideas about such subjects; and to identify relevant content and strategies appropriate to diverse subpopulations. Choice of moderator, training, group meeting preparation, and the meeting guide are discussed as elements of research methodology.
Islamic precepts and family planning: the perceptions of Jordanian religious leaders and their constituents.
International Family Planning Perspectives. 2000 Sep; 26(3):110-7, 136.Two nationally representative surveys, one of 1000 married women aged 15-49 and the other of 1000 men married to women aged 15-49, and a census of all Muslim religious leaders in Jordan collected information on knowledge, attitudes and beliefs regarding family planning, and sources of information about it. 80% of men, 86% of women, 82% of male religious leaders and 98% of female religious leaders believe that family planning is in keeping with the tenets of Islam. Among religious leaders, 36% reported that they had preached about family planning in the year preceding the survey. 75% of women and 62% of men in the general public said that they had spoken about family planning with their spouse, and 9% and 17%, respectively, reported having spoken with a religious leader. On a scale of 0-10 measuring agreement with statements regarding the benefits of family planning (with 10 being in complete agreement), women averaged 9.4 and men 8.8, while male religious leaders averaged 6.5 and female religious leaders 7.2. Among the general public, 74% of women and 58% of men said that deciding to practice contraception is a joint decision between husband and wife. About 90% of religious leaders agreed or agreed strongly with the statement that contraceptive decisions should be made jointly by husband and wife. Women were significantly more likely than men to believe that specific contraceptive methods are permitted under Islam, and male religious leaders were more likely than were men in the general population to find specific methods acceptable. Only 26% of men cited interpersonal communication as a source of family planning information, compared with 66% of women, 73% of male religious leaders and 89% of female religious leaders. Almost three-quarters of men and women said they want to know more about family planning. Although Islamic religious leaders in Jordan cite different reasons than the general public to justify the use of contraceptives, they are as likely as others in the population to approve of family planning. (author's, modified)
[Family planning expansion project in Burkina Faso: initial community study, 1992. Preliminary report] Projet d'expansion de la planification familiale au Burkina Faso: etude communautaire initiale 1992. Rapport preliminaire.
[Ouagadougou, Burkina Faso], Ministere de la Sante et de l'Action Sociale, Direction de la Sante Familiale, 1992. , xv, 48,  p.This report describes and presents preliminary results from an initial community study for a family planning (FP) expansion project in Burkina Faso. The study was conducted during May 1992 in 4 of 15 provinces retained for information, education, and communication (IEC) activities, with the goal of obtaining preliminary data on the knowledge, attitudes, and practices (KAP) of the target population with regard to FP, their contact and understanding of the logo on population issues, and their opinion of health agents and social workers. 494 men and 506 women were interviewed by questionnaire. 40% of the study respondents were from Kadiogo, 30% from Yatenga, 20% from Kossi, and 10% from Namentenga. 73% were married and 26% were single. 64% were Muslim and 27% were Catholic. About half of the respondents had received no formal education, while 15% had attained a secondary school education. Recommendations are made with regard to increasing FP awareness among some target groups, inadequate FP knowledge and use in Yatenga, the limited knowledge about FP methods other than the oral pill and the condom, partner communication about FP, ideal family size, knowledge and use of modern contraceptives, intentions to practice FP in the future, the less than universal use of IEC by health agents and social workers, respondents doubts about the abilities and intentions of social workers, and the inability of many respondents to clearly associate the national FP logo with FP.
SEXUAL HEALTH EXCHANGE. 1998; (3):4.Two decades of Family Planning Association of Hong Kong (FPAHK) advocacy of husband-wife communication and cooperation in family planning led Hong Kong's population to finally accept the notion of male responsibility in family planning. Recent surveys have documented high rates of male contraceptive use. The FPAHK established its first clinic to provide men with birth control advice and services in 1960, then set up a vasectomy clinic and installed condom vending machines. Working against prevailing traditional beliefs that childbearing is the exclusive domain of women and that vasectomy harms one's health, the FPAHK began campaigns to motivate men to take a positive and active role in family planning and to correct misinformation on vasectomy. Successful FPAHK efforts to stimulate male support for family planning include the 1977 "Mr. Family Planning" campaign, the 1982 "Family Planning - Male Responsibilities" campaign, and the 1986-87 "Mr. Able" campaign. Although these campaigns ended in the 1980s, men may now be counseled on contraception at 3 of the 8 FPAHK-run birth control clinics.
New Delhi, India, Indian Institute of Mass Communication, 1993.  p.This study examined the family welfare program, Mahila Swasthya Sangh (MSS), which was fully implemented in Karnataka and Gujarat states; Uttar Pradesh (UP) and West Bengal with low implementation; Assam with targeted implementation in villages with over 1000 persons; and Punjab with implementation in every village. Interviews were conducted during 1991. Most respondents were aware of the family welfare programs. The main sources of information were the radio and posters. Most were aware of MSS in their villages, with the exception of UP. Just over 50% made visits to MSS members about their health problems. Almost 33% of MSS members made weekly or monthly visits to residents. Most respondents were familiar with oral rehydration solution and immunization, with the exception of those in UP. Except in UP, most favored a stop to childbearing. The most frequently used methods were the pill, Copper T IUD, and tubectomy. Almost 50% knew the legal age of marriage for men and women. Lower levels of knowledge about marriage age occurred in UP, West Bengal, Assam, and Karnataka. Almost 75% favored marriage for women over age 18 and men over age 21. UP and West Bengal had lower levels of approval at these ages. Most knew that MSS provided maternal and child health care, immunization, and diarrheal and seasonal diseases. Most were unaware of the song, drama, and cultural shows, and 50% knew about the wall paintings. Over 75% were not aware of well-baby shows. 24% knew about school child health programs. Over 66% approved of contraceptive and medicine distribution.
Perceptions of family planning and reproductive health issues: focus group discussions in Kazakhstan, Turkmenistan, Kyrgyzstan, and Uzbekistan.
Baltimore, Maryland, Johns Hopkins School of Public Health, Center for Communication Programs, 1997 Aug. xiii, 80 p. (Field Report No. 10)In preparation for a planned expansion of reproductive health services in Kazakhstan, Kyrgyzstan, Turkmenistan, and Uzbekistan, focus groups were conducted to gain an understanding of contraceptive knowledge, attitudes, and practices of the audience targeted for contraceptive promotion. The field work began with a pilot project involving 103 married men and women in 12 focus group sessions in and around Tashkent, Uzbekistan in December 1993. This pilot study led to development of a discussion guide adapted for use in all four countries, and 96 focus groups discussions involving 888 married men and women were held in three different regions of each country. Additional focus group sessions in each country involved participants specifically targeted by the new program. The results revealed differences among the countries but could be generalized to develop a regional IEC (information, education, communication) approach. This report opens with an introduction describing background information on the region and the study methodology. The next four chapters present results and conclusions for each country in terms of the following topics that were discussed: perceptions on age at first marriage, fertility preference and family size, attitudes towards family planning (FP), knowledge and awareness of FP methods, FP communication between husbands and wives, available sources of FP information, and additional perspectives. Chapter 6 covers the following issues that can be used to plan a regional approach to reproductive health: the quality of family life, male responsibility, abortion, communication about side effects, provider knowledge and skills, the role of religion, and the symbolic environment.
Washington, D.C., Communications Consortium Media Center, 1996. , 128,  p.This guidebook for news reporters and editors provides quick access to basic information on the historical events, political acts, and policy decisions shaping current family planning (FP) and abortion issues as well as references to further resources for in-depth research and reporting. The first part of the guide contains an overview of who has abortions and why, how FP services are implemented in the US (including information on where abortions are performed, teenage contraception and abortion, sex education, and school-based clinics), political factors, public opinion as expressed in the polls, the actions of all three branches of the federal government which had a reproductive health impact, and a rundown of abortion laws and activity in the states as of early 1996. The second part of the guide deals with policy issues such as 1) abortion restrictions and their impacts, 2) the impact of research and development (RU-486, Norplant, Depo-Provera, other abortifacients, and fetal tissue research), 3) reproductive health and the Christian Right, and 4) international issues pertaining to developing countries (world abortion laws; abortion in developing countries; population stabilization, FP, and US foreign policy; and the impact of US domestic politics on foreign population assistance). The book ends with a quick reference which includes a listing of abortion rights advocates and opponents, a glossary of terms, references, an index, and a foldout which illustrates FP history at a glance.
PEOPLE COUNT. 1992 Aug; 2(7):1-3.Some results are provided from the 1991 Social Weather Survey conducted in 1991 for the Legislators' Committee on Population and Development. The sample included both males and females (84% Roman Catholic, 7% other indigenous Christians, 7% Protestants, 1.2% Muslims, 0.2% without a religion, and 0.1% Buddhists). Surprising findings are that the public does not feel restricted from using family planning methods due to religious rules, schooling teachings, or a physician's advice. Most people hold that politicians generally support family planning. Only 19% are reported to believe that governors are against family planning, and 16% report that their mayors are against family planning. According to stated voting intentions, incumbent government officials perceived to be anti-family planning risk not being reelected. 96% of the survey respondents believe that it is important to have control over one's fertility. Awareness of family planning methods is directly related to socioeconomic class, education, and urban location. 21% say that their religion forbids tubal ligation and 26% say that ligation should never be practiced. 22% say that their religion allows ligation. Among people who believe that religion bans ligation, 10% approve of ligation at any time and 44% stipulate that there are times when it may be practiced. Another interesting finding was that school teaching had more influence on beliefs than religion. When schools said that rhythm was not allowed, 40% agreed. When religion taught that rhythm was not allowed, only 21% agreed. 9% of persons who were sectarian educated and 5% among non-sectarian educated persons believed that ligation should not be practiced.
NIDI/CBGS PUBLICATION. 1994; (30):51-71.The main aim of the present paper is to present data about the impact of increased genetic risk upon reproductive decision-making....The first part of this paper summarizes the results of a number of large follow-up studies evaluating the effect of genetic counseling on family planning decisions. The second part of the paper focuses on prenatal testing for congenital handicaps. After a theoretical discussion of this controversial and rapidly changing topic, the results of a recent study in Flanders [Belgium] are summarized, evaluating community attitudes towards prenatal testing. (EXCERPT)
BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE. 1991 Jan-Feb; 67(1):30-4.The rate of teenage pregnancy in the US is significantly higher than in any other industrialized nation. Studies have shown the teenagers in other countries are not more sexually active. The biggest difference between US and the rest of the industrialized world is the US failure to make contraceptives easily available to teenagers. There are only 2 ways to prevent teenage pregnancy: 1) get them to shop having sex, or 2) get them to use contraceptives. When forming policy it is important to know which method will be more successful. Policymakers, educators, and health professionals are all guilty of rationalizing why option 1 will work better than option 2, even though their is little or no research or anecdotal evidence to support their claim. The facts are clear: in other industrialized countries the more freely available contraceptives are to teenagers, the lower the pregnancy rate. In New York City, 840 condoms were distributed in just 4 months upon request to participants in a male responsibility discussion group. Nationwide 2000 teenage boys were sent a coupon for free condoms by mail and 6% returned their coupons (the normal rate of return would be 3%). A 1988 study revealed that condom usage between 1979-88 among 17-19 year old males in metropolitan areas doubled. A 1987 Harris poll found that 60% of all adults favored condom advertising on television. A 1989 follow-up study revealed that 89% of parents of adolescents favored condom advertising on television. The most common reason given for not increasing access to contraceptives is that teenagers will receive the wrong message. Another fear is that parents will complain, yet in the 2000 condom coupon example, less than 1/3 of 1% of the parents complained. Is the rest of the industrialized world giving their teenagers the wrong message by making contraceptives easily available? Clearly, US policy against contraceptive access for teenagers is giving the worst message and the high teenage pregnancy rate is the best evidence.
[Unpublished] 1988 Nov. ii, 23 p. (USAID Contract No. DPE-3028-C-00-4079-00)Associated with sexually transmitted diseases and illicit sex, condoms suffer poor images as family planning methods in some countries. Research was therefore conducted to examine the effect of AIDS communications programs upon condom use in family planning in Mexico. Reaching samples of 1300 males and 1300 females aged 15-60 years in 36 Mexican cities, 5 questions regarding attitudes toward and knowledge of condoms were included in 6 waves of omnibus surveys over the course of 1988. The surveys were conducted concurrently with a governmental AIDS information campaign, and aimed to measure attitudinal changes over the period. Unprompted knowledge of condoms' use in protecting against HIV infection increased from baseline levels of 14% to a high of 37% in the 5th survey wave, while unprompted knowledge of condoms for both family planning and AIDS prevention grew to 32% from an initial 11%. Knowledge targeted for increase by the campaign, therefore, significantly increased over the campaign and survey period. The image of condoms has not been tarnished, and may have, in fact, been bolstered by the campaign and related media attention. These results suggest that AIDS information campaigns are likely to lead to increased demand for condoms.
WOMEN'S GLOBAL NETWORK FOR REPRODUCTIVE RIGHTS NEWSLETTER. 1991 Jul-Sep; (36):10-1.Many female adolescents die each year in Ghana from abortions or related complications. They and their infants face greater risk of dying in childbirth than that posed to women aged 20-35 and their infants. Moreover, the proportion of teenage pregnancies has increased to currently account for 30% of all pregnancies compared to 20% 5 years ago. Attitudes increasingly favor educating youths on sex and reproduction, and making contraceptives more available for them. Lacking adequate background information and specific recommendations for program development, however, 3 studies were commissioned by the Ministry of Health. Held in 9 secondary schools, 1 study found boys to initiate sex at the average age of 15 years, and girls at age 16. As a group, adolescents desire accurate and complete information on sex and reproduction, yet presently possess only inaccurate knowledge. Additionally, they hope for the development of family life programs designed to increase parents' awareness of adolescents' sociocultural milieu. The study found teachers, peers, magazines, and mothers for females to be their most significant sources of information. Family life education programs have, therefore, been recommended for schools, and sociocultural and religious groups. Audiovisual materials are also recommended for development. A national adolescent reproductive health policy is being drafted which will focus heavily on education. Career counseling and guidance in basic hygiene, child care, nutrition, and how to manage personal changes in adolescence are expected, along with the creation of youth advisory centers.
AMERICAN MEDICAL NEWS. 1990 Oct 19; 7-8.The mission of the Media Project of the Center for Population Options is to encourage the entertainment industry to provide adolescents with positive and realistic message about sexuality and family planning. The project has specifically targeted television as a way to reach teens because they not only watch TV but what they see influences their behavior. According to the project's director, "they emulate their favorite characters." A 1986 Louis Harris poll found that teen-agers ranked TV as the 4th most important source of information, out of 11 choices, on sex and birth control. A study of the 1986 prime-time television season discovered a tremendous amount of sexual references and innuendo in the programs. They found touching behaviors (24.5 times/hour); suggestions and innuendo (16.5 times/hour); sexual intercourse (implied 25 times/hour); and socially taboo behaviors such as sadomasochism and masturbation (intimated 6.2 times/hour). In contrast, education information was only given 1.6 times/hour. There are few references to birth control or responsible conversations about sexual intimacy. The Los Angeles-based media project has 3 program components. These components include a media advisory service that provides creative and technical assistance, an information series designed for consciousness raising, and an awards program. The advisory service sends out background sheets on health-related issues and provides story and script consultation. The information series has inspired industry professionals to integrate messages about teenage sexuality and responsible sex into the TV dramas. The project received 380 requests for information during 1990. The project has also sponsored an annual media awards program since 1983. The awards program is a forum where producers get positive attention for a job well done.
[Unpublished] 1989 Oct. , 15 p.A preliminary investigation revealed a large gap between knowledge and practice in the area of family planning in Egypt. Informal opinion leaders have a lot of power and influence in the social system. This study examines the role that informal opinion leaders play in shaping the behavior of rural citizens in Egypt. Communication habits, awareness of the population problem, and how individuals make decisions concerning family planning are also explored. The study employed the use of 50 question interview schedule and 6 questionnaires designed to gather information about the socio-economic characteristics of the respondents. It was intended to be representative of the entire country; 400 respondents from 15 different governorates were interviewed, 50% were males and 50% were females. The majority of the respondents were in the 20-40 age group (81.7%), while 3.9% were between 15 and 20 years and 14.4% were 45 years and above. 47% of the respondents were illiterate, 16.5% could read and write, 26.4% has intermediate certificates, and 65 were university graduates. Many of the respondents were housewives, government employees, and farmers. 71.1% of the sample was married. The findings of the study are organized into 6 sections. Section 1 examines communication behavior; exposure to mass media; preferences in radio, TV, journals, and magazines; and attendance at public family planning meetings. Section 2 explores level and sources of family planning information. The third section briefly discusses the priority concerns of the Egyptian public. Religion and family planning is the focus of section 4 and sources of informal consultation in matters of religion, health, and agriculture are reviewed in the fifth section. The last section of the findings examines the credibility of sources of information. The 2 tables in this section list the perceptions of respondents regarding who they consult and the characteristics of these sources. The findings generated several recommendations. It is suggested that communication messages intended to promote family planning should relate the positive effects that family planning has on the standard of living. The consequences of not practicing family in regard to standard of living should also be communicated. It is also recommended that directors of the information, education, and communication centers in the governorates develop a strong liaison relationship with local opinion leaders. A partnership between directors and leaders would give credibility to the messages being delivered by the center. Community meetings should also be organized to encourage discussion about population issues and give support to family planning activities. Finally, training courses for the opinion leaders was suggested.
MEDICINE AND LAW. 1989 Jan; 7(5):483-503.South African law, as many other law systems do, has exercised a strong measure of control over the fertility of its citizens via the sanction of illegitimacy and the prohibition of marriage (and thus legitimate children) between certain individuals (those who are among the prohibited). Until last year, when the Mixed Marriages Act was abolished, marriage across the color line was prohibited in South Africa. The requirement of a valid consent by both prospective spouses in order to enter into the marriage further excludes certain categories of people from procreating legitimate children (the insane, the mentally feeble), while the requirement of consummation will exclude certain categories of paraplegics from solemnizing a valid marriage. Age restrictions on marriages and the requirements of parental consent for minors are further factors limiting the individual's freedom to procreate. These restrictions have a well-established historical basis extending over a long period of time. They can be categorized as attempting to preserve the family unit. The above provisions were formulated at a time when the law never contemplated the amazing advances in human biology which have produced conception artificially; e.g., AID, IVF, and surrogacy. The legislature, both in South Africa and elsewhere, adopted a neutral approach to this fertility revolution at first and watched the legal system struggle to adapt outmoded principles to the new technology. Legislation relating to AID and IVF eventually appeared in many jurisdictions and as a result of its delayed introduction, public opinion has now been educated to accept these new techniques and the legislation looks favorably on these new techniques. This is not the case insofar as surrogacy is concerned. South Africa, England, and Australia have produced essentially negative legislation. Certain American states, however, have adopted progressive legislation which acknowledges and accepts surrogacy. The merits of this are discussed and it is felt that it should be condoned by the South African legislature under certain conditions, as it can now be considered as furthering the interests of the family unit. (author's modified)
PEOPLE. 1991; 18(1):7-8.This article attributes Sub-Saharan national population policy change to the attendance at the 2nd African Population Conference (APC) in Arusha in 1984, preliminary to attendance at the World Population Conference (WPC) in Mexico City in 1984, and the socioeconomic crises which precipitated the disparity between population growth and resources. Demographics are better understood. Family planning is now seen as reflecting traditional African values of birth spacing. Consequently countries have developed specific national policy statements. Liberia, Nigeria, Senegal in 1988, Zambia in 1989, and the Sudan in 1990, have developed comprehensive population policies in addition to those already established in Kenya and Ghana. Zaire and Zambia policies are in the process of endorsement; others formulating policy are Botswana, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, Niger, Tanzania, Togo, and Zimbabwe. Policies are based on APC and WPC documents as well as the N'Djamena Plan of Action (1989). These guidelines tend to include detailed action and implementation plans, including targets for fertility reduction. Approaches to fertility reduction among specialists are still being debated. The significance of national population policy is as a public endorsement in addition to providing an analytical framework.
The cultural meaning of AIDS and condoms for stable heterosexual relations in Africa: recent evidence from the local print media.
[Unpublished] 1989 Mar. Paper presented at the Seminar on Population Policy in Subsaharan Africa: Drawing on International Experience, sponsored by the International Union for the Scientific Study of Population (IUSSP), Committee on Population and Policy, with the collaboration of Departement de Demographie de l'Universite de Kinshasa, Commission Nationale de la Population du Zaire (CONAPO), Secretariat au Plan du Zaire, held at the Hotel Okapi, Kinshasa, Zaire, 27 February to 2 March 1989. 27 p.This paper draws on the authors previous research experience in Liberia and Sierra Leone, and articles in local newspapers and journals from Central, Eastern and Western Africa. To research the AIDS epidemic in terms of: 1) problems for fertility that condoms pose 2) the association of condoms with promiscuity 3) economic pressures that induce women to contract lovers and men to enter polygamous relationships 4) the importance of fertility and 5) the association of AIDS with promiscuity. There is great concern for the uninfected children of parents who die of AIDS. Women are generally being blamed for spreading the HIV virus to their partners and being promiscuous making all her children suspicious as products of illicit unions. The father and his kin often repudiate these offspring. Questions are raised as to where these children will go and, what is the economic and social effect of their geographical mobility? Young women, school girls in particular, now comprise one of the groups at high risk for contracting the HIV virus because private schools expose girls to older, wealthier, married men. Parents may begin growing reluctant to send their daughters to school to avoid the AIDS virus, while encouraging them to marry early, leading to higher fertility rates and low interest in contraception. Yet secondary schools are the best arenas to introduce condoms and AIDS education because the girls are highly motivated. The use of condoms in Africa is controversial because they prevent fertility and suggest promiscuity. 2 major philosophies are common among health manpower: 1) minimizing the demographic impact of AIDS in light of continued high fertility rates, or 2) emphasizing the crisis brought on by death and destruction. Government efforts to publicize the AIDS epidemic and the utility of condoms as a prophylactic are doing the greatest service to women and society by providing them with credible elements of ambiguity and deniability.
BMJ. British Medical Journal. 1989 May 6; 298(6682):1231-4.The effects of the 1967 Abortion Act, legislation which extends to women living in England, Wales, and Scotland, are reviewed. The Act was not backed by any specific allocation of money for facilities or staff within the National Health Service and the service provided has varied from district to district. Yet, the number of abortions increased rapidly in the late 1960s and early 1970s. This process had slowed down by 1974, when the number of abortions dropped for the 1st time. The introduction of free contraception seems to have had an important effect; the number of abortions declined by nearly 9000 from 1973-76, and the abortion rate fell from 11.4 to 10.5/1000 women aged 15-44. The number increased in 1977 and 1978, possibly because of adverse publicity about the side effects of oral contraception (OC). The rate of abortion in Scotland, although lower than the rate in England and Wales, has risen steadily since 1969. An important effect of the 1967 Act has been to reduce the number of deaths due to illegal abortions. In the 1st decade of legal abortion, the proportion of all maternal deaths that were due to abortion dropped from 25% to 7%. The number of recorded deaths due to abortion declined from 160 during 1961-63 to 9 during 1982-84. There were 7 deaths after legal abortions during 1982-84 and 4 during 1985-87. 21 years after the passage of the Act half of all women having legal abortions pay for them. The regional differences in the provision of abortion services have persisted since 1968. The proportion of abortions performed in the 1st trimester increased from 66% in 1969 to 86% in 1987, yet the proportions of early abortions in Britain still compare poorly with other countries. In the US, women have been able to request abortion in the 1st trimester since 1974; by 1977 this led to 91% of abortions being performed in this period. Regional differences in the surgical methods persist, and there may be considerable delays between a woman asking for an abortion and the procedure being performed. A Marplan poll conducted in 1988 reported that 80% of those surveyed thought that women should have the right to choose an abortion in the 1st few months of pregnancy; 15% disagreed, and 5% did not know or did not respond. The number of women coming to Britain for abortions peaked in 1973, when 56,000 came. The rate of abortion per 1000 women in England and Wales is 14.8, a moderate figure when compared to other nations -- rates range from 5.6 in the Netherlands to 181 in the USSR.
BMJ. British Medical Journal. 1988 Mar 5; 296(6623):715.All families in a rural physician's practice were polled regarding the prevalence of genetic disorders and the value of genetic counseling and therapeutic termination of pregnancy for fetal abnormality. 1900 questionnaires were distributed in Barnard Castle, England in 1986 and 1987, with a response rate of less than 50%. During this time, a public debate occurred about a bill prohibiting abortions after 18 weeks' gestation. The results of the poll revealed that 82% of the respondents were in favor of termination for fetal abnormality. 685 people were strongly in favor of a genetics advisory service, 229 were generally in favor, 37 were undecided, 10 were not in favor, and 3 were strongly opposed. An even greater proportion were in favor or regional genetics counseling services. Moral or religious background, gender, or handicapped status of the respondents was not determined. While the majority of people felt there was a sound argument for lowering the gestational age limit for therapeutic termination, such termination should not be at the expense of prenatal diagnostic services. Parental choice and the limits of current diagnostic techniques must be considered when establishing gestational age limits for therapeutic termination of pregnancy. Chorionic villus sampling to detect fetal abnormality is an option for women over 35, but the technique involves a high miscarriage risk. The technique may not be available and many women will refuse to accept the uncertainty of fetal normality and request termination before 17 weeks. More than 99% of those terminated fetuses would have been normal. A law mandating a universal standard for late abortions could kill more fetuses than it saves.
SOCIOLOGICAL REVIEW. 1987 Feb; 35(1):123-49.The activities of 2 main pressure groups in the decade of the 1970s--the Society for the Protection of the Unborn Child (SPUC) and the LIFE organization--and the evidence they submitted to the Lane Committee, established in 1971 to examine the working of the Abortion Act, and the Select Committee, formed to discuss James White's Amendment Bill in 174, are reviewed. Official campaign literature, public statements on the part of leading anti-abortion activists, national press reports, and parliamentary debates on the issues have helped to provide some insight into the ideological stance of the anti-abortion movement in England and Wales during the 1970s. Fieldwork was undertaken which included nonparticipant observation at local branch meetings of SPUC and LIFE, the completion of a self-administered questionnaire by 64 group members, and semi-structured interviews with 25 local campaign leaders and group activists. The subsequent analysis presents anti-abortion protest as an example of moral crusade by focusing on Gusfield's notion of cultural fundamentalism and his analytical distinction between assimilative and coercive reform. Some participants in the anti-abortion campaign accept that a small number of abortions may need to be performed for genuine medical reasons and do not adopt the extreme position that abortion should be prohibited. This group does demand a change in the law to prevent mass abortion on demand. Both LIFE and SPUC have a clearly recognizable moral reform dimension. The analysis of the campaign literature and the study of a small sample of campaign activists revealed that pressure group members share a common concern about the erosion of moral standards. To adopt the terminology of Gusfield, the anti-abortion movement can be construed, in part, as a movement of cultural fundamentalism, which favors the reestablishment of traditional values and seeking an end to the moral uncertainty endemic in modern society. As the anti-abortion movement is primarily concerned about amending existing legislation, a coercive strategy of reform prevails. The analysis makes it evident that the anti-abortionists in their emphasis on fundamental values seek to promote a traditional sexual morality but also are trying to establish what they believe to be the moral superiority of the traditional nuclear family. Due to the fact that no abortion amendment bills have been proposed on which to focus their campaign, in recent years the anti-abortionists have increasingly focused on the enforcement of existing legislation in an effort to reduce the number of abortions and publicize their moral stance.
NEW REPUBLIC. 1986 Jan 27; 13-5.RU-486, a new drug which enables women to perform abortions privately at home, could transform, if not end, the abortion debate. This steroid compound, developed by the French drug company Roussel-Uclaf, blocks the cells in the lining of the uterus from receiving progesterone. Deprived of progesterone, the wall of the uterus breaks down. The ovum breaks off from the uterine wall and is discharged in a period. Unlike the "morning after" pill, RU-486 does not contain massive dosages of estrogen, which causes unhealthy side effects and thus limits its use to rape cases and other emergencies. At least 5 years away from the commercial market, RU-486 is being tested in Paris, Stockholm and the University of Southern California as a chemical alternative to surgical abortions and as a post-coital contraceptive to replace current methods like the IUD and oral contraceptives (OCs). Used instead of OC and the IUD, a woman could take the drug on the last 3 days of each cycle. If fertilization had occurred, RU-486 would prevent the ovum from implanting; if not, the drug would merely bring on her monthly period within 48 hours. Dr. Daniel Mishell of the University of California reports that his trials have revealed that 100 milligram doses of RU-486 have induced complete abortions in the first 6 weeks of pregnancy for 80% of the women who have taken it. Swedish tests have been 90% successful when RU-486 is supplemented with prostaglandins, which induce mild contractions of the uterus. Several women bled seriously in early tests, but Mishell states that fewer women have hemorrhaged in more recent trials with lower doses. He predicts the drug will prove to be safer and more effective when an optimal dose is found and tested in earlier pregnancies. If RU-486 became the abortion method of choice in the US, the abortion debate would be over for many who now consider it an open question. Polls show that the pro-life movement has failed to increase the number of Americans who support a legal ban on abortions. They have succeeded in making Americans uncomfortable about abortion generally. This soft support is vulnerable to RU-486 because polls also show that Americans oppose early abortions less fervently and in fewer numbers than late abortions. It is also likely that if RU-486 becomes the preferred method of abortion, abortion clinics in the US would close, replaced by 24-hour clinics to treat potential complications. And, if RU-486 is used monthly, pro-lifers would have a difficult time convincing the public that the drug isn't just another contraceptive. Although RU-486 erases much ambiguity in the abortion debate, it will create some. Women could take RU-486 without ever knowing whether they are pregnant.