Family planning perspectives
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The majority (72 percent) of U. S. residency programs in obstetrics and gynecology include first-trimester abortion techniques in their training. Programs affiliated with public hospitals or with private non-Catholic institutions are the most likely to provide such training, while Catholic-affiliated training programs and those at military hospitals are the least likely to do so. ⋯ Nine percent of programs report that all residents participate in first-trimester abortion training, and another 56 percent report that at least half of their residents do so. The participation rate is linked to the expectations of the program: Approximately 88 percent of programs that routinely incorporate abortion techniques in their training report that from one-half to all their residents participate, compared with about 55 percent of programs that offer the training as an option. Approximately 82 percent of programs teach abortion techniques up to at least 20 weeks' gestation.(ABSTRACT TRUNCATED AT 250 WORDS)
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In 1982 and 1983, as in previous years, the majority of abortions in the United States were obtained by young women (62 percent), white women (70 percent) and unmarried women (81 percent). Half of all abortions were performed eight or fewer weeks after the last menstrual period, and 91 percent, at 12 weeks or earlier. The proportion of abortions that were repeat procedures continued to rise, to 37 percent in 1982 and 39 percent in 1983. ⋯ Teenage nonwhites and whites have about the same abortion ratios. After rising during the 1970s, the adolescent pregnancy rate peaked around 1980-1981 and fell slightly in 1982-1983. The relative differentials between the pregnancy, birth and abortion rates of nonwhite and white teenagers narrowed somewhat between 1978 and 1981, but then widened slightly between 1981 and 1983.
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Rates of teenage pregnancy, birth and abortion vary greatly among states. Because states that have high birthrates tend to have low abortion rates, pregnancy levels vary much less than do the birth and abortion measures. The role of unintended pregnancy is highlighted by the fact that in states that have very high pregnancy rates, the adolescent abortion rate is higher than the birthrate and the abortion rate combined in states that have the lowest pregnancy rates. ⋯ Increased spending on education is associated with relatively high abortion rates (and, therefore, pregnancy rates). The higher the teacher-student ratio, the lower the adolescent birthrate and the more likely the pregnant teenager is to have an abortion. Welfare payments to teenage mothers are negatively associated with both black and white teenage birthrates, and higher maximum payments are associated with relatively high abortion levels.(ABSTRACT TRUNCATED AT 400 WORDS)
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A multivariate life-table analysis of national survey data from 1982 indicates that among currently married women, the pill and IUD have the lowest use-failure rates. During the first year of use, about three percent of pill users and six percent of IUD users experience an unintended pregnancy. Failure rates for the remaining methods range from 14 percent for the condom to 22 percent for spermicides; between these lie rhythm and natural family planning (16 percent), the diaphragm (17 percent) and other methods, mainly withdrawal, douche and abstinence. ⋯ In addition, these rates are understated because of the substantial underreporting of abortion among single women; if abortion reporting were complete, failure rates would be about 1.4 times as high as they appear here, and thus would be close to those of married women. Differences in the risk of unintended pregnancy among single women show a number of similarities with those seen among married women: Use of the pill and IUD is associated with the lowest failure rates, reliance on the condom is associated with intermediate failure rates, and use of spermicides is linked with the highest failure rates. However, while rhythm and the diaphragm exhibit use-failure rates that are among the highest found for single women, failure rates for these methods are at intermediate levels among married women.(ABSTRACT TRUNCATED AT 400 WORDS)
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In 1982, 69 percent of Puerto Rican women in union were practicing contraception. Forty-five percent relied on contraceptive sterilization (40 percent, female, and five percent, male), eight percent were using the pill, four percent each, the IUD and the condom, five percent relied on rhythm, and three percent were using other methods. Thus, sterilization is the dominant form of fertility regulation in Puerto Rico, and there is relatively little use of reversible methods for childspacing. ⋯ Reliance on sterilization rather than reversible methods of contraception is strongly influenced by socio-demographic variables. Women with less than a high school education, the wives of blue-collar workers, women living outside of the major cities and those born in Puerto Rico depend upon sterilization more than do women with a college education, the wives of white-collar employees, women living in cities and those born outside of the country. These findings point to the need for improved availability of reversible family planning services, especially for young women, and those whose childbearing is incomplete.