Studies in family planning
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Recent demographic surveys have incorporated a month-by-month calendar for the five-year reference period before the survey for the recording of fertility-related events (sexual unions, contraceptive use, pregnancies, and breastfeeding). In the 1986 survey of Maternal and Child Health and Family Planning in Costa Rica, approximately one-half of the 3,527 women interviewed were administered a questionnaire with traditional fertility and family planning questions; the other half were asked virtually the same questions, but the women's responses were entered in a month-by-month calendar. ⋯ Comparisons of the number of events (live births, pregnancy losses, and contraceptive use) showed that more events were recorded among the women in the calendar group. Significantly less erroneous superposition of events (contraceptive use in the last trimester of pregnancy and hormonal contraceptive use in the first month postpartum) was noted when the calendar was used.
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This study evaluates the effect of a nurse training program in family planning counseling skills on the quality of service delivery at the clinic level, as well as its impact on client compliance with prearranged appointments. The study used a quasi-experimental design to compare certified nurses who received six weeks of family planning technical training with certified nurses who, in addition to the technical training course, received a three-day course in counseling skills. ⋯ The likelihood that clients will attend follow-up visits was also found to improve when they were attended by trained professionals. Short-term counseling training can significantly improve the quality of care provided by family planning workers, as well as client compliance with follow-up appointments.
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Historical Article
Abortion in Europe, 1920-91: a public health perspective.
This article grew out of a keynote address prepared for the conference, "From Abortion to Contraception: Public Health Approaches to Reducing Unwanted Pregnancy and Abortion Through Improved Family Planning Services," held in Tbilisi, Georgia, USSR in October 1990. The article reviews the legal, religious, and medical situation of induced abortion in Europe in historical perspective, and considers access to abortion services, attitudes of health professionals, abortion incidence, morbidity and mortality, the new antiprogestins, the characteristics of abortion seekers, late abortions, postabortion psychological reactions, effects of denied abortion, and repeat abortion. ⋯ Abortion is a social reality that can no more be legislated out of existence than the controversy surrounding it can be stilled. No matter how effective family planning services and practices become, there will always be a need for access to safe abortion services.
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This article presents results from a population-based study of the magnitude and causes of maternal mortality in the Giza governorate of Egypt in 1985-86. Deaths to women in the reproductive ages were identified through the death registration system. Family members of the deceased were interviewed using the "verbal autopsy" approach. ⋯ An average of 2.3 causes per maternal death were reported; the most common causes were postpartum hemorrhage (31 percent of cases) and hypertensive diseases of pregnancy, such as toxemia and eclampsia (28 percent of cases). Women experiencing hemorrhage, hypertensive diseases of pregnancy, or other serious complications must have easy access to hospital and maternity centers equipped for handling these conditions. Since most deliveries occur at home, many with the help of traditional birth attendants, TBAs will need training in early diagnosis, treatment, and/or effective referral of problem pregnancies.
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In 1988, the USSR Ministry of Public Health published official statistics on abortion for the first time in 60 years. Using the official data published in 1988 and unofficial statistics from a variety of independent sources, this report attempts to describe some of the basic features of fertility regulation in the USSR. ⋯ The official data leave much to be desired in the way of accuracy, reliability, and completeness. However, it is clear that the level of induced abortion is higher in the USSR than in any other country in the world.