A method for calculating rates of induced abortion

Accurate measurement of induced abortion is necessary for understanding the fertility dynamics of a population and for making projections about the future. Changes in abortion rates can amplify or dampen the impact of changes in contraception. This paper presents a methodology for calculating marital induced abortion rates from observed marital fertility and contraceptive prevalence and for modeling the impact of substituting contraception for abortion on future fertility. The methodology is validated against observed abortion complications in three populations, and the impact of substituting contraception for abortion on expected fertility is demonstrated.     

Abortion and family building models: Fertility limitation in Hungary

This paper demonstrates how family-building models can be used for checking the quality of abortion data. A family-building model, called FERMODA, is presented and used to check whether the available data on abortion for Hungary are consistent with Hungarian data on other aspects of family building. Model cohorts are generated, using in FERMODA the proportions of women married and the birth and abortion rates of two selected Hungarian cohorts. The estimates obtained from the simulated cohorts concerning use of contraception are compared with the information available on contraception, and, on the basis of this comparison, a judgment is made about the quality of abortion data for Hungary.     

Abortion in amsterdam

Abstract Mortality from abortion is low in the Netherlands to-day, and approximately equal to mortality at delivery. Calculations suggest that about 4,000 abortions occur in Amsterdam every year, of which about 2,100 are induced. The abortion rate shows a very gradual decline after the Second World War. An investigation of the social background of women with induced abortion showed no relationship between occupational group and the incidence of abortion, but a strong negative correlation between religion and abortion. Abortion was more common among women with disturbed relationships in their own or parental families. Induced abortion usually occurred in pregnancies resulting from failure of contraception; these failures were caused not by lack of knowledge of good contraceptives, but by ineffective practice of contraception. The inability to use contraceptive methods in an effective way is related to a lack of communication between the two partners, and to a negative attitude of the women towards sex. An attempt has been made to formulate a theory of the causes of induced abortion among the women interviewed in Amsterdam.     

Japan's fertility: effects of contraception and induced abortion after World War II

This report studies the effects of contraception and abortion on crude birth rate (CBR) and total fertility rate (TFR) in Japan from 1947-1980. The CBR declined from 34.3 in 1947 to 17.3 in 1957, and the TFR from 4.5 to 2.0 in the same period. Both stabilized (CBR in the range of 17.0 to 19.0 and TFR at 2.0 to 2.1) between 1957 and 1973. This dramatic decline in fertility was initiated under the serious socioeconomic difficulties of post-World War II Japan. At the onset of the postwar fertility decline, fertility within marriage was controlled most strongly by induced abortion, and to a lesser extent, lactation and contraception. During the period of stable low fertility (1960-1980) the effect of abortion decreased and the effect of contraception increased. KAP surveys show that in the late 1970's more than 75% of contraceptive users in Japan employed the condom, while condom use in other Asian countries is generally very low. A shift from traditional to modern methods of contraception is unlikely to alter the already low level of fertility in Japan but would have considerable social, medical, and economic impact.     

Education,employment, and fertility in Kinshasa and prospects for changes in reproductive behavior

This paper examines fertility behavior of women in Kinshasa, Zaire's capital city with a population of roughly four million. We look at relationships linking women's education, employment, and fertility behavior (children ever born, age at first marriage, contraception, abortion, breastfeeding, and postpartum abstinence), using data from a 1990 survey of reproductive-age women. Other things equal, there are significant differences by educational attainment and by modern sector employment in lifetime fertility and in most of the proximate determinants as well. The results suggest that modern contraception and abortion are alternative fertility control strategies in Kinshasa, with abortion appearing to play an important role in contributing to the observed fertility differentials by education and employment. The dramatic increases that have taken place in women's access to secondary and higher education are likely to reduce fertility in the future, while the effects of Zaire's current economic and political crisis are uncertain. Our findings are consistent with some of the arguments of Caldwell et al. (1992) on a new type of fertility transition in sub-Saharan Africa. If Zaire seeks to lower fertility, policy efforts should be made to soften the impact of economic crisis on school enrollments and enhance opportunities for young women to remain in school, at least well into the secondary level. Policy should also seek to promote more effective marketing and delivery of modern family planning services, so as to induce women to substitute modern contraception for abortion as a means of controlling their fertility.     

Risk-taking and contraceptive behavior among unmarried college students

The contraceptive behavior of sexually active, never-married college women was examined using multiple regression analyses. Use of an effective method of contraception was highly situation-specific: length of relationship and frequency of intercourse were the variables most highly correlated with use of effective contraception, followed by method of contraception used at first coitus and knowledge of reproduction. Failure to use effective contraception was not associated with low estimates of pregnancy risk, nor with high utility of pregnancy, nor with uniquely high willingness to seek abortion. The results of the present study suggest that use or non-use of effective contraception is mediated by the predictability of sexual intercourse.We would like to thank Ira H. Bernstein for his assistance with computer programming and data analysis. Reprints are available from Ms. Irene Steeger, Center for Population and Family Health, Columbia Unviersity, New York.     

Notes on abortion and birth control in Germany

In this paper the author discusses the legislation regarding abortion and contraception which applies in the western zones of Germany to-day. He states that a number of regulations made under the National Socialist regime are still enforced and discusses the consequences of this state of affairs.     

A vital statistics-based procedure for estimating conception rates

A method for estimating conception rates, using vital statistics data, is developed and applied to data on five-year age groups of California women for 1971. The approach is deterministic and allocates total exposure time to the known pregnancy outcomes of live birth, spontaneous abortion, and induced abortion. The population at risk is defined to exclude women who are known to be sterile or sexually inactive. Early fetal loss, premarital conception, and contraceptive use are taken into account. Estimates are made of the fecundability which would obtain ifno contraception were used.     

The Decline of marital fertility in Japan

Summary Studies concerning the demographic history of Tokuwara and Meiji Japan suggest that fertility rose substantially before declining during the twentieth century. Were the motivations and circumstances which held down natality during the feudal period similar to those which account for the modern fertility decline and the low birth rate obtaining in the Japan of to-day? The thesis of this paper is that the pre-modern situation was fundamentally different from the modern one. During the Tokugawa era infanticide and abortion were used, independently of parity, to eliminate weak offspring whose chances of survival were deemed poor. Desired natality generally exceeded natural fertility. With the rise of income per head during the Meiji period the population's need for these desparate practices vanished. To-day parity-specific control characterizes fertility. Parityspecific control was diffused throughout Japan in response to declining desired fertility. Desired fertility fell significantly below natural fertility sometime during the late nineteenth or early twentieth century and the wish to reduce actual fertility to the desired level stimulated the adoption of parity-specific control. The speed of decline in marital fertility was partially governed by official policies toward contraception and abortion, contraception and abortion.     

Abortion,Family Planning,and Population Policy: Prospects for the Common‐Ground Approach

For the past several decades those engaged in shaping the Program of Action documents at international conferences on population have muted their voices when the topic of abortion has been raised. In a desire to side‐step entanglement in a bitter debate over the morality of abortion, great care has been taken to define “family planning” in ways that explicitly exclude abortion. The “common‐ground” approach to treating abortion can be summarized in two directives found in all contemporary international population documents: “in no case should abortion be promoted as a method of family planning”; and all governments should work “to reduce the recourse to abortion through expanded and improved family‐planning services.” This article has three goals: first, to examine the appropriateness of these directives with respect to what is currently known about the relationship between abortion, family planning, and population policy; second, to trace how this “contraception‐only” definition of family planning became de rigueur at international population conferences; and third, to discuss the prospects for the emergence of a more appropriate “common‐ground” approach to abortion and population policy.     

Brief

This brief article discusses population dynamics, contraception, and abortion in Shanghai, China. China's policy of rapidly developing medium and small cities and towns is coming to fruition. China now has 666 cities, of which 75 are megacities, 192 are medium-sized cities, and 399 are small cities. It is expected that there will be about 800 cities by the year 2000. Population movement of the floating population has increased. During 1990-95 the domestic migrant population was 3.02% of total population. 24.44 million (67.1%) were floating population who moved within provinces, and 11.98 million floated between provinces. Population is affected by declines in the supply of water. The Yellow River spans 5400 km and passes through nine provinces, including the two most populous provinces of Henan and Shandong. The Yellow River empties into the Yellow Sea, when the river is flowing. Since 1972, stretches of the Yellow River have run dry for as many as 683 km. The driest stretch of the river tends to be from Kaifeng City in Henan Province to its mouth at the Yellow Sea. The river bed has been dry for as many as 136 days. The lack of water from the Yellow River impacts on the millions who live along its banks near the Yellow Sea. The Shanghai Population Information Center reports that married women's abortion rate has declined and unmarried women's abortion rate has increased. An information program on contraception and contraceptive services for unmarried women is planned for completion by Spring 1998. It is hoped that the family planning program will be as successful in decreasing abortion rates among the unmarried as among the married. In the community of Pengpu New Village, Zabei District, a new family planning program was established which promotes the concept of family planning among nongovernmental organizations, the unemployed, and the floating population.     

Birth control and abortion in France since 1939

This paper describes developments in French policy on contraception and abortion during the occupation and since the liberation. It includes an account of the relevant legislation and the resulting medical, judicial and police activity, as well as some information regarding abortees and abortionists. The latter, of necessity, relates only to cases which have come to the attention of the authorities or the public.     

Age-old methods of contraception

Folk methods of contraception have been used in Philippines from immemorial times, especially in the rural areas. Some methods seem to be practical while others are mystical. The popularity of methods are due to their low cost and the trust women in the community feel for the traditional healer. Herbs are the most commonly method used. For external application, pounded and heated leaves are placed inside a bag. Traditional practitioners believe that when the "charm" is worn during intercourse, the semen will "dropout" of the vagina. For internal application a beverage is prepared with seeds of the plant and drunk before sexual intercourse. For contraceptive purposes other herbs used in rural communities could induce abortion, which is illegal in Philippines. A projected study by the University of the Philippines' College of Medicine will try to establish the pharmacological effectiveness of local plants to determine the validity of some methods of family planning reported by medical students who have talked to rural herbalists and patients. The one which seems most relevant for this study is the herb Kibatalia Gitingesis, which is supposed to contain "progesteronal-like principles." Other methods of contraception are abdominal massage, which involves manual manipulation of the uterus, chemicals, like asoge (mercury), salt, and tablets, and the use of inanimate objects, such as the bato-balani or magnetic stone. If herbs and other folk methods of contraception are proven to be effective, the possibility to have them incorporated into the National Population Program has to be considered. The untrained hilots (nurse midwives) could become trained program workers, and because of their influence in the community the number of acceptors would increase.     

Eastern Europe: pronatalist policies and private behavior

Fertility trends in the 9 Eastern European socialist countries (Albania, Bulgaria, Czechoslovakia, German Democratic Republic, Hungary, Poland, Romania, USSR, Yugoslavia) are reviewed. Official policy in all these countries but Yugoslavia is explicitly pronatalist to varying degrees. Attention is directed to the following areas: similarities and differences; fertility trends (historical trends, post World War 2 trends, and family size); abortion trends (abortion legislation history, current legislation, abortion data, impact on birth rates, abortion seekers, health risks, and psychological aftereffects); contraceptive availability and practice; pronatal economic incentives (impact on fertility); women's position; and marriage, divorce, and sexual attitudes. The fact that fertility was generally higher in the Eastern European socialist countries than in Western Europe in the mid-1970s is credited to pronatalist measures undertaken when fertility fell or threatened to fall below replacement level (2.1 births/woman) after abortion was liberalized in all countries but Albania, following the lead of the USSR in 1955. Fertility increased where access to abortion was again restricted (mildly in Bulgaria, Czechoslovakia, and Hungary at various times, and severely in Romania in 1966) and/or economic incentives such as birth grants, paid maternity leave, family and child care allowances, and low interest loans to newlyweds were substantially increased (Bulgaria, Czechoslovakia, Hungary, and Poland to some extent, in the late 1960s and early 1970s, and the German Democratic Republic in 1976). Subsequent declines in Bulgaria, Czechoslovakia, Hungary, and Romania suggest that policy induced increases in fertility are short-lived. Couples respond to abortion restrictions by practicing more efficient contraception or resorting to illegal abortion. It is evident that the region's low birth rate is realized mainly with abortion, for withdrawal remains the primary contraceptive method in all countries but Hungary and the German Democratic Republic. It seems that cash incentives have advanced the timing of 1st and 2nd births without substantially increasing the 3rd births required to keep national fertility above replacement level. Demographic factors alone will most likely keep birth rates low in several Eastern European countries during the 1980s and the 1990s. Due to the low birth rates in the 1960s, there will be fewer women in the prime childbearing ages of 20-29 in at least Poland, Czechoslovakia, Bulgaria, and Hungary. It becomes clear that policy efforts to influence private reproductive behavior can only be moderately successful if the living conditions are such that women are determined not to have more than 1 or 2 children.     

Contraceptive acceptance and pregnancy: a matrix approach to the analysis of competing risks

Abstract This paper represents an initial attempt to formalize the relationships among post-partum sterility, fecundability, and contraceptive acceptance in terms of absorbing Markov chains. Acceptance of contraception offered by family planning programmes is analyzed as a possible event in time for a cohort of recently delivered women as they pass through phases of temporary sterility and fecundability towards another possible pregnancy. The results of the study indicate that once a woman leaves the post-partum anovulatory stage, the probability of her becoming pregnant again is large compared to the competing rates of contraceptive acceptance currently in force. Unless highly fecund non-contracepting women are approached by family planning programmes shortly after a pregnancy has been terminated (by childbirth or abortion), they will quickly become ineligible to accept either the pill or IUD because of once again being 'currently pregnant'.     

Contraception,attitude-practice,and fertility differentials among US Hispanic,African–American and white women

Hispanic fertility (primarily among nationals from Mexico, Central and South America in the US) is higher today than it is in Mexico and the other nations of origin (Frank and Heuveline 2005). It persists into the second and third generations, with only moderate signs of declining to replacement. Meanwhile, the fertility rates of African–Americans, American Indians Cubans, and Puerto Ricans have all declined to replacement, only slightly above the non-Hispanic white population. This study attempts to clarify the question why African–American fertility has declined to replacement, but Hispanic fertility has not. The data used are from Cycle 6 of the National Survey of Family Growth (NSFG) of 2002. Differences in physiological or marital-status factors are found not to explain these fertility differences; however, there are significant differences in the practice of contraception during early childbearing years. Slightly less effective methods if contraception is used, and less recourse to abortion if a pregnancy is undesired, all imply higher fertility for Hispanic women. Underlying contraceptive behaviour are sets of attitudes and motives that favour, permit, or seek childbearing. A much higher percentage of Hispanic than African–American women report that they wanted their last birth and intend to have another in the future. Hispanic women of all socio-economic statuses are considerably more pronatal in their attitudes, particularly with respect to the births of first and second children.     

Fertility transition in Communist Albania, 1950-90

In 1945, at the end of the Second World War, Albania had the highest fertility in Europe with an average of more than six live births per woman. However when Albania emerged from behind the 'olive curtain' in 1990, fertility had fallen to three children per woman, despite a pro-natalist environment and in the virtual absence of contraception and abortion. Nevertheless, after five decades, Albania's position at the top of the European fertility league remains unchanged. This paper documents the fertility transition in Albania during the period 1950-90 and places the demographic results in the context of recent socioeconomic and cultural change.     

The spread of anti-natal knowledge and practice in Nigeria

Abstract In March/April 1969 the Demographic Training and Research Unit, University of Ife, surveyed 8,400 respondents of both sexes to investigate their knowledge and use of anti-natal practices and the sources of that knowledge. The area sampled was a stratified cross-section of Nigeria extending inland 500 miles from Lagos. Data are analysed by age cohorts of respondents and by the date of change in knowledge or practice. It is shown that anti-natal knowledge and practice decline with distance from Lagos, that contraception is widely practised amongst the richer towns and those with a higher proportion of educated people, and to a smaller extent among farmers than restricted knowledge or means would alone indicate. Recently the spread of both knowledge and practice has been faster than could be explained by socio-economic change and has largely resulted from changing attitudes to anti-natal practice and increased discussion of the subject in the world as a whole. Within Nigeria this has been helped by rising levels of urbanization and education, which are the two major determinants of anti-natal knowledge and practice in the country. The spread of such practice has led to an increased employment of traditional anti-natal methods, but this increase is small compared with the much greater resort now being made to modern contraception and induced abortion. The mass media have been of particular importance in introducing new knowledge, while the spread of such knowledge has owed most to discussions between friends of the same sex.     

Adolescent pregnancy and childbearing - growing concerns for Americans

The negative impact of the increase in sexual activity among teen-agers and the health and life chances of those involved are examined. The barriers to effective contraception by teen-agers, racial differences, and the U.S. experience in relation to that of other countries are discussed. Some of the major topics discussed are: 1) overall fertility rates among teen-agers, 2) legitimate and illegitimate births, 3) marriage among teen-agers, 4) adoption, 5) abortion as an outlet, 6) sexual activity, 7) patterns in conceptions, and 8) patterns of contraceptive practice. Also discussed are: 1) teen-agers and clinical services, 2) health consequences of adolescent childbearing, 3) teen-agers health and sex, 4) child development, 5) life chances for a t een-age mother, 6) consequences for society, and 7) international comparisons. 6 figures and 11 tables are included.     

New zodiacal influences on chinese family formation: Taiwan, 1976

Although Chinese folklore holds that the Dragon Year is an auspicious time to have a birth, notable increases in Chinese fertility in Dragon Years did not occur before 1976. Demographic explanations for the belated occurrence of this phenomenon rely on the notion of natural fertility: that is, couples’ lack of modem contraception had kept such decisions outside the realm of choice. The decomposition performed in this article, however, shows that the bulk of the 1976 Dragon Year baby boom on Taiwan was due to strategies that had always been available: marriage timing, abortion, and coital behavior. The natural fertility paradigm thus is insufficient in explaining the motivation for this behavior and should be complemented by institutional approaches.