Contraception survey: Denmark 1988

In 1988 a survey** was conducted in 1,033 women living in Denmark, whose ages ranged from 15 to 44 years. The main aims of the study were to identify the influence, if any, of demographic and socioeconomic factors on contraceptive use and to assess the women's knowledge of selected facts concerning their own fertility. The study's additional objectives were to gain insight into factors influencing communication on the subject of contraception, such as advice obtained from professional counsellors, general information dissemination and discussion between partners, and to investigate women's attitudes and opinions regarding contraceptive methods and their use. The results are discussed in relation to the findings of other studies on the use of contraceptives both worldwide and in a number of European countries. The Danish findings are also examined in the context of possible action to reduce the relatively high rate of legally induced abortions in Denmark.

Efficacy of three variations of periodic abstinence for family planning in Indonesia

A prospective study to determine the efficacy of three alternative guidelines for the practice of periodic abstinence (PA) for family planning was conducted in Indonesia. The three methods studied were the Billings ovulation method, the Dorairaj modified mucus method, and a local version of the mucus method. For each method, the study encompassed a three-month learning phase and an additional 12-month effectiveness phase. Data from a total of 850 acceptors showed that, despite some variations in the sociodemographic characteristics of the acceptors, the Billings ovulation method had the lowest (10.4 per 100 women) and the local mucus method had the highest (26.5 per 100 women) overall life-table discontinuation rates in the effectiveness phase. One-year life-table unplanned pregnancy rates ranged from 2.5 per 100 women for the Billings method to a high of 11.5 per 100 women for the local method acceptors. Unplanned pregnancy was the main reason for termination.

Pregnancy resolution and family formation. Understanding gender differences in adolescents' preferences and beliefs

This article examines gender differences in adolescents' personal views about pregnancy resolution and family formation as they relate to a vignette describing their involvement in an unplanned pregnancy within the context of an ongoing, stable relationship. We use a sample of 577 White and Black high school students from a metropolitan, midwestern city to contrast males' and females' preferences and beliefs about pregnancy resolution and family formation. Although similar percentages of males and females preferred abortion and adoption as strategies for handling their own pregnancy, females were more likely than males to select arrangements that involved living with their children, and they were more likely than males to choose single custodial parenting as their first preference. For those young people choosing some form of parental rearing, observed gender differences in the preference for forming a two-parent household were explained by adolescents' beliefs about their parents' and friends' expectations and their personal concerns about having their educational career adversely affected.

The sexual and reproductive behavior of American women, 1982-1988

Comparison of 1988 data from the National Survey of Family Growth with 1982 data reveals that the proportion of U.S. women who have had sexual intercourse rose slightly, from 86 percent to 89 percent. Among teenagers, the proportion sexually active rose from 47 percent to 53 percent; most of the change is attributable to increases occurring among white and nonpoor teenagers, thus narrowing racial and income differences. Among women aged 15-44 in 1988 who have ever had intercourse, 67 percent reported that they had had two or more sexual partners in their lifetime. The proportion was highest among women aged 20-34 (about 70 percent), but 58 percent of sexually active teenage women reported having had two or more sexual partners. About 67 percent of women of reproductive age in 1988 were exposed to the risk of unintended pregnancy, up from 63 percent in 1982. Among these women, 35 percent rely on contraceptive sterilization to prevent pregnancy and 55 percent use reversible methods, while 10 percent use no method. Poor women are much more likely than nonpoor women to be using no method of contraception (15 vs. eight percent); among poor teenagers, this proportion reaches 25 percent. The level of contraceptive use at first intercourse among teenage women improved substantially between 1982 and 1988, however, rising from 48 percent to 65 percent. During 1984-1988, almost four in 10 births and almost six in 10 pregnancies among American women were unintended; most of these were mistimed, but 12 percent of births were unwanted ever.(ABSTRACT TRUNCATED AT 250 WORDS)

[Contraception in Austria]

952 sexual active women between 15 and 44 years were investigated for their contraceptive behaviour. In 42% the pill was the first choice followed by the condom in 16%. 18% of all sexual active women in this age group did not use any contraceptives. Therefore the rate of unplanned pregnancies was very high: 34% reported about such unplanned pregnancies in their history. The main sources for informations in contraception are the gynecologist and the partner, but not the parents or the newspapers. Nearly half of all women did not know how the pill really works and quite a lot has still the opinion that there are really harmful side effects of oral contraceptives.

The impact of public-sector expenditures for contraceptive services in California

A methodology previously used to calculate the number of unintended pregnancies averted nationally through publicly funded contraceptive services has been adapted for a state-level analysis in California. An estimated 136,800 unintended pregnancies--which would result in approximately 36,000 births, 85,100 abortions and 15,700 miscarriages--are averted each year because publicly funded contraceptive care is available from clinics and private physicians in California. Federal and state expenditures of $46 million for contraceptive services in California in FY 1989 resulted in an estimated savings of $232-$509 million in public costs for abortions, for prenatal and maternity care and for medical care, welfare and supplementary nutritional programs during the first two years after a birth. These savings represent an average of $7.70 saved for each dollar spent to provide contraceptive services. This savings/cost ratio is 75 percent higher than that previously estimated for the United States as a whole.

The incidence of unplanned and unwanted pregnancies among live births from health visitor records

A survey of health visitor records has indicated that approximately one-third of pregnancies resulting in live births are unplanned. The data further revealed an association between planning of pregnancies and socio-demographic variables and use of preventive health care for infants.

Contraceptive choice in Lagos, Nigeria

Among 1266 contraceptive acceptors (median age 30 years, median parity 4.5) attending a family planning clinic, mostly after referral from the post-natal clinic, two thirds chose the intrauterine device, almost all the remainder choosing oral contraception. Oral contraception was, however, the main choice among women parity 0 or 1. A definite intention to have no more children was given by none of the women of parity 3 or under, and only by 15% of those of parity 8 or more, so that child spacing was the main reason for accepting contraception. By 12 months, the discontinuation rate among oral contraceptive users was 17% (IUD 11%) of which 11% (IUD 6%) was for personal reasons or to plan pregnancy, 4% (IUD 5%) through adverse effects and 0.6% (IUD 0.8%) through accidental pregnancy.

Use of contraceptives by women of upper socioeconomic status

This was a descriptive correlational study of the contraceptive knowledge, methods, and consistency of contraceptive use by women of upper socioeconomic class. Socioeconomic class was determined using Hollingshead's Four-Factor Index of Social Status (1975) and was based on the woman's own educational and occupational status. The mean socioeconomic score for participants in this study (N = 83) was high in the second of five socioeconomic classes. Study participants were found to be consistent users of their contraceptive method and had fewer unplanned pregnancies in their history than the general population. They were more knowledgeable about contraceptives and reproduction than others tested with the same contraceptive knowledge instrument. They used barrier methods predominantly, with the use of less theoretically effective methods correlating significantly with a greater number of contraceptive methods used in the past.

Contraceptive failure in the United States: an update

This report provides an update of the authors' previous estimates of first-year probabilities of contraceptive failure for all methods of contraception. Estimates are provided of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct use at every act of intercourse). The difference between these two probabilities provides a measure of how forgiving of imperfect use each method is. These revisions are prompted by recent studies that provide the first estimates of failure during perfect use for periodic abstinence and the cervical cap, by more complete evaluations of implants, and by the appearance of the Copper T 380A and disappearance of other IUDs from the US market. Also provided is a more complete explanation of how the previous estimate of the probability of becoming pregnant while relying solely on chance should be interpreted, and this estimate is revised slightly downward.

A study of the vaginal contraceptive sponge used with and without the fertility awareness method

The actual effectiveness rates of natural and barrier methods of family planning are lower than the theoretical ones. If couples accurately defined the limits of the fertile phase and used barriers at that time, then actual effectiveness might increase. A randomized, controlled clinical trial was initiated to determine the effectiveness of the contraceptive sponge used only during the fertile time and to compare this with sponge use at every intercourse. Recruitment problems and discontinuation forced the early termination of this study, but qualitative information about compliance and acceptability was collected. Common sponge problems were reported as were misuses of the sponge, but problems and misuse were not related. Determination of the fertile phase was reportedly easy, but complaints of and discontinuation for inconvenience occurred. For unplanned pregnancies, contraceptive behaviors around the time of conception are presented.

Contraceptive practice of Irish married and single first-time mothers

This study surveys 100 married and 100 unmarried primiparous mothers, attending the National Maternity Hospital, Dublin, with regard to their contraceptive practice, their planning of their pregnancy and the timing of their first antenatal visit. Nineteen per cent of the married women, but 64% of the unmarried women, had never used any contraceptive method. The contraceptive pill was the most popular method for both groups, but while three in five of the married women had at some time used the pill, only a little more than one in five of the unmarried women had ever used it. One quarter of the women who had used contraception reported that their pregnancy was the result of a failure in their contraceptive method. Eighty-nine per cent of the single group and 20% of the married had not planned their pregnancy. None of the married women, but almost a quarter of the single, delayed their first antenatal visit until after they were 20 weeks pregnant.

Is repeat pregnancy in adolescents a "planned" affair?

This study assessed whether girls who become pregnant more than once do so for different reasons than girls who are pregnant for the first time. Girls in group 1 (G1) were pregnant for the first time (n = 104, 69%) and those in group 2 (G2) were pregnant for the second time or more (n = 46, 31%). About 60% of the girls in G2 had living children at home, but they were more likely than those in G1 to state that they became pregnant because they wanted a baby (G2 44%, G1 21%; p less than 0.01) and, conversely, girls in G1 were more likely than those in G2 to state that the pregnancy was an accident and "just happened" (G1 61%, G2 37%; p less than 0.01). Many girls who become pregnant more than once appear to do so intentionally.

Teenagers' perceptions of unplanned adolescent pregnancies and oral contraceptive use

Adolescent women who are sexually active often do not use contraceptives consistently and correctly. Adolescents are sexually active for an average of 15 months before initiating regular contraceptive use and the majority of young women who initiate use discontinue within the first year after initiation. This study enrolled 50 young women who initiated oral contraceptive use and was designed to provide more understanding of their perceptions about the possibility of an unplanned pregnancy and about contraceptive use. They were again contacted 6 weeks after initiation of oral contraceptives to assess continuation. Findings revealed that 90% of the subjects were sexually active at the time of the first visit; the mean period of sexual activity was 15 months. Only 30% had used a nonprescription birth control method during this period. While perceiving themselves to be highly susceptible to pregnancy, many young women continue to have psychosocial barriers to contraceptive use. Follow-up contact revealed more than 10% of the subjects were not using oral contraceptives.