Family planning perspectives
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Ever since induced abortion was legalized in the United States, there has been a running controversy over whether induced abortion affects subsequent childbearing; for example, it has been claimed that women who terminate a pregnancy are at a greater risk of miscarrying a subsequent pregnancy or of having a low-birth-weight baby. Ten studies of the later impact of first-trimester induced abortion by vacuum aspiration (the dominant method in the United States) are examined here; they find that compared with women who carry their first pregnancy to term, women whose first pregnancy ends in induced abortion have no greater risk of bearing low-birth-weight babies, delivering prematurely or suffering spontaneous abortions in subsequent pregnancies. ⋯ In addition, some evidence from other studies links dilatation and curettage (D&C) procedures with later infertility, but most studies have found no such association. No definite conclusions can be reached about the impact of multiple induced abortions, since the results of 13 different epidemiologic studies are almost evenly divided between those that show no effect and those reporting related reproductive problems.
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In 1979, 50 percent of women aged 15-19 and 70 percent of men aged 17-21 living in metropolitan areas of the United States reported that they had ever had sexual intercourse. The average age at which young women had their first sexual experience was 16.2, compared with 15.7 among the men; women tended to have their first intercourse with a partner nearly three years older than themselves, whereas men had their first intercourse with a partner less than one year older. Blacks generally experienced first coitus at a younger age than did whites. ⋯ In contrast, fewer than four in 10 young men said that they had been engaged to or going steady with their first partner, and more than one in three said that they and their first partner had been friends. Young men were more than twice as likely as young women to have had first intercourse with someone they had only recently met. Seventeen percent of the young women and 25 percent of the young men surveyed said that they had planned their first intercourse; women who had been going steady with their first partner were most likely to have planned intercourse, while the young men who had met their first partner shortly before intercourse took place were the most likely to have planned the act.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Mortality associated with fertility and fertility control: 1983.
This analysis demonstrates that levels of mortality associated with all major methods of fertility control (tubal sterilization, the pill, IUD, condom, diaphragm, spermicides, rhythm and abortion) are low in comparison with the risk of death associated with childbirth and ectopic pregnancy when no fertility control method is used. The exceptions are the risks associated with pill use after the age of 40 for women who do not smoke, and with pill use after the age of 35 for smokers. The safest approach to fertility control is to use the condom and to back it up by abortion in case of method failure. ⋯ As noted earlier, there are few women who make their contraceptive choices solely on the basis of perceived risk of mortality. Very few, for example, would consider abortion as a primary method of birth control; and for many, abortion would not be acceptable even as a backup for failed contraception. Although the risk of mortality resulting from use of the IUD is low, many women who have not yet had children might not want to face the increased risk of infertility problems from pelvic inflammatory disease that have been associated with use of this method.(ABSTRACT TRUNCATED AT 250 WORDS)
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An analysis of the characteristics of women who obtained abortions in 1980 indicates that as in previous years, they were mainly young, white and unmarried. Thirty percent were under age 20 and one percent were under 15; 70 percent were white; 79 percent were unmarried; 58 percent were childless; and 67 percent had had no previous abortions. Ninety-one percent of abortions occurred within the first 12 weeks of gestation, and fewer than one percent occurred past 20 weeks. ⋯ In spite of their higher abortion rate, nonwhites have a fertility rate 37 percent higher than that of whites. Although hospital abortions are usually more expensive and less convenient than abortions performed in clinics and physician's offices, and the proportion of abortions performed in hospitals has declined, hospitals are still an important source of abortion services for nonwhite women and women with little education, particularly in states which pay for Medicaid abortions. In these states, a large proportion of hospitals offer abortion services, and many low-income women utilize these services.(ABSTRACT TRUNCATED AT 400 WORDS)