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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Sixty percent of women and 52 percent of men now in their 20s took a sex education course by age 19, according to the 1984 National Longitudinal Survey of Work Experience of Youth. Whites are more likely than either blacks or Hispanics to have had a course by that age--57 percent compared with 53 percent and 48 percent, respectively. The survey also shows that large proportions of teenagers initiate coitus before they have taken a sex education course. ⋯ Among the strongest determinants of first coitus at those ages are infrequent church attendance, parental education of fewer than 12 years and black race. Older sexually active girls who have previously had a course are significantly more likely to use an effective contraceptive method (73 percent) than are those who have never taken a course (64 percent). This relationship may offset any effect that a sex education course may have in raising the likelihood of early first coitus, since no significant association can be found between taking a sex education course and subsequently becoming premaritally pregnant before age 20.