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INTEGRATION. 1991 Sep; (29):8-15.This article describes the urgent need for modern family planning (FP) services and supplies in the Soviet Union, and presents the nation's high induced abortion rate as one of its most serious medical and social problems. With more than 6 million legal abortions per year, and another estimated 6 million performed illegally, the problem of induced abortion is placed on par with heart disease and cancer in the Soviet Union. Induced abortion is the primary method of birth control, responsible for terminating 2 out of 3 pregnancies. Many abortion seekers, especially those employing illegal services, suffer complications resulting in loss of ability to work or even death. The maternal mortality rate for 1988 was 43.0/10,000. Efforts to decrease the level of abortion have increased during reconstruction, and have been witness to a decline in the number of abortions by 866,000 over the period 1985-1988. Contributory factors behind this decline, as well as the decrease of the abortion ratio, are an increased contraceptive prevalence level totalling 13.7% of reproductive-age women, stabilization of the birth rate at a low level, a smaller proportion of reproductive-age women in the population, and rate reporting changes. Nonetheless, inadequate family planning services prevail in the Soviet Union. Instead of focusing upon abortion and contraception, services focus upon diagnosing and treating infertility, and offer neither FP information nor services for premarital youths. Moreover, contraceptive supplies suffer serious, ongoing shortages. Research is needed on the social, demographic, medical, and biological aspects of reproductive behavior in the Soviet Union. Regional differences, abortion law, public opinion on illegitimate pregnancy, abortion methods, health personnel training, and maternal and child health are also discussed.
Lexington, Kentucky, University of Kentucky, Center for Developmental Change, 1985 Jun. vii, 141 p. (CDC Development Papers No. 21)An interdisciplinary study, which incorporates a community-based and multimethod approach in a rural, historically high fertility community of Southern Appalachia, was conducted to describe the current pattern of fertility regulation behavior among the study population and to discern the most significant factors associated with such regulation in this contemporary rural-mountain community. A 3-phase research design was used, combining an inventory of local public opinion about birth control and family planning services with a social survey and related ethnographic field studies on the fertility regulation behavior of individuals and specifically married couples living in the community. In addition, the research team conducted a county-wide survey consisting of interviews with 407 married women of childbearing age (15-45) in intact conjugal units and a follow-up study involving indepth interviews with 107 of the 407 women. The county community hospital and health department have played a major role in the provision and delivery of family planning services to community residents since at least the early to mid-1960s. There is general agreement among community leaders, health professionals, and survey respondents that family planning services are now widely available and accessible to individuals and families throughout the county. There is general community support for smaller families and the decision of young married couples to use birth control and to postpone childbearing for a period of time following their marriage. Also there is general community support for educational activities in secondary schools. Family has declined for several reasons since the 1970s, including a tendency to think of childbearing in terms of socioeconomic conditions and to consider the costs of raising and educating children. Active fertility management practices among married couples appear to be rooted primarily in biological, economic, and family considerations as well as increased knowledge of wives and husbands about birth control and greater availability and accessibility of modern contraceptive methods. 8 out of 10 couples with wives who are not currently pregnant are using a method of fertility management. About half of these couples have chosen sterilization. Almost 2/3 of the wives among couples who were sterilized were either pregnant or just had a baby when the couple first considered sterilization. It is concluded that the contemporary patterns of fertility regulation among married couples in the study community are strikingly similar to those found among most other American couples today.
Ottawa, Canada, International Development Research Centre, 1973. 30 p. (IDRC-009e)This paper evaluates the progress of a Latin American population through stages in family planning adoption. The focus is on changes in knowledge of contraception, attitudes, and practices which occurred over 5 years (1964-69) of widespread public discussion concerning family planning and of program activity in Bogota, Colombia. Data from 2 surveys, 1 in 1964 and the other in 1969, permit the 1st temporal analysis of family planning adoption for a major metropolitan city in Latin America. Additional data on rural and small urban areas of Colombia from the 2nd survey permit a limited assessment of diffusion of family planning from the city to the nation as a whole. The 1st survey in Bogota revealed moderate to high levels of knowledge of contraceptive methods and generally favorable attitudes to birth limitation. However, at this time many women had never spoken to their husbands about the number of children they wanted, nor tried a contraceptive method at any time. The 2nd survey showed substantial changes in this picture. The proportion of currently mated women who had spoken to their husbands about family size preference changed from 43 to 62% for an increase of 71%. Fertility fell appreciably over this period, especially among younger women. Family planning program services had a significant direct contribution to the adoption process, since 36% of mated women had been to a clinic by 1969. The most modern methods of birth control -- the anovulatory pill and the intrauterine device -- which were scarcely known in 1964 were widely known in 1969, and contributed most to the observed increase in current contraceptive practice. However, among the previously known methods, the simplest method of all, withdrawal (coitus interruptus), showed the greatest increase in current practice and remained the most commonly used method. These findings suggest that favorable attitudes and knowledge tend to become rather widespread before levels of husband-wife discussion of family size preferences and levels of contraceptive trial increase appreciably. The results also indicate that contraceptive knowledge and favorable family planning attitudes are spreading rapidly outward from the cities into the rural areas, but that contraceptive practice is still predominantly restricted to urban populations. (author's)