birth control
Reproductive rights: an international sample.

Boyd S.

PIP: This discussion considers the issue of reporductive rights in the countries of Mexico, Nigeria, Iraq, India, Germany, China, Colombia, Poland, Italy, Egypt, and Ireland. In Mexico abortion is illegal, but an estimated 3 million illegal abortions are performed yearly. Complications from these abortions send 600,000 women to Mexican hospitals each year. The Mexican government, concerned about overpopulation, appears to be moving toward a liberalization of its abortion policy. Birth control is available, often without a prescription, in pharmacies, public health agencies, and some hotels. In Nigeria if a pregnant women goes abroad she must take a medical test upon returning to prove she has remained pregnant during the trip. Underground abortionists cater especially to unmarried teenagers. Women in Nigeria obtain birth control with the written permission of their husbands. Elective abortion is illegal in Iraq. Theoretically, contraception is available to all without a doctor's prescription, but in actuality, only married women buy contraceptives which are often simply not in stock in pharmacies and stores. Elective abortion is legal in India where the government has launched an agressive family planning compaign. India's family planners have had to work against religious prohibitions against abortion. Germany has zero population growth and the lowest birthrate in the world. Birth control is available to all, both by prescription and over the counter. Abortion became legal in 1978. In China "one couple one child" is the favorite slogan and the eventual goal of an aggressive family planning campaign inaugurated in 1979. The Chinese hope this policy will reduce population growth to 5% by 1985 and allow the country to achieve zero population growth by the end of the century. To this end, the Chinese government has launched a massive public education program encouraging late marriages and the use of contraception. Abortions, sterilizations, and contraceptive devices are available free at pharmacies or the workplace. In Colombia abortion is illegal; contraceptives are available to married women by prescription. Since 1960 Polish women have had the right to abortion once they have made an "oral declaration" establishing the need for one. Birth control is freely available. Abortion is legal in Italy during the 1st trimester for women 18 or older and for women under 18 with parental permission for medical, economic, social, family, or psychological reasons. Nontherapeutic abortion is illegal in Egypt, but birth control is available to all without a prescription and is increasingly used among urban, educated Egyptians. In Ireland birth control is available only by prescription and only to married women. A constitutuional amendment bans abortion.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12178930&dopt=Abstract birth control



birth control
Birth control in the third world.

Pradervand P.

PIP: The Third World is concerned about the resources being used in birth control programs instead of economic development and technical assistance. They do not regard birth control as a remedy for underdevelopment. Support is offered for the argument that contraception will be widely adopted only when a certain living standard has been reached after a massive drop in mortality. With limited availability of global resources, the greatest threat to ecology is the increased consumption and wastage in poorer countries. Countries which have become industrialized such as the United States are not necessarily those with low birthrates. The U.S. in the last century had the most rapid demographic increase in the history of the world.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12178967&dopt=Abstract birth control



birth control
[Population ethics and growth]

[Article in Portuguese]

Boim D.

PIP: In order to formulate and implement a national demographic policy, various areas of science are called upon; however, since human lives are involved, ethical aspects play an important role not only in broad ideological terms, e.g, concerning overpopulation, but whenever practical decisions affecting technology and human resources are made. The article describes how the Catholic Church proposes certain "utopian" views or interpretations as part of an ethical "dynamism" and plurality needed when addressing the problem of overpopulation. 3 main starting point are defined for the determination of a population ethic: 1) ethics defined in terms of "nature," 2) in terms of the "human person," and 3) in terms of social "dialectic" involvement. The first point stresses the natural order of things as prescribed by God and impugns any birth control method; however, so-called natural birth control methods are allowed. The second point suggests that the human person is ethically center stage, a modernized position taken by the Church in tune with social realities and man's inherent intelligence. The primacy of live and responsibility is stressed as opposed to mere biological processes. Following this view, use of contraceptive, and even sterilization is allowed; however, abortion is excluded, since it means the elimination of a human life. The problem of overpopulation should be solved within the individual or micro-social context. The third point holds that it would be extremely myopic to reduce the position of the Church to advocating exclusively natural birth control methods while excluding social involvement. A "cosmic" view of faith would end putting material well-being before individual personal lives, would alert against egoism disguised as quality of life enhancement, and ultimately result in socially responsible fertility. In conclusion, the Church acknowledges that its contribution to the question of population ethics occurs in a pluralistic society that does not necessarily accept its opinions and proposals; however, the Church understands its contribution as a defense and not an imposition of its convictions. It considers it an obligation to accuse, criticize, and propose.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12286718&dopt=Abstract birth control



birth control
Survey of central and eastern Europe (part I), a textbook case.

Kamaras F.

PIP: From 1974 to the present abortion has been restricted. The number of legal abortion peaked in the late 1960s. There were 130 abortions per 100 live births and the value of the total abortion rate (TAR) was 2.7 per female. Since 1974, the number of abortions has fallen significantly. The yearly number of abortions was lowest at the beginning of the 1980s. It was about 15% higher in 1989 than at the beginning of the 1980s. Family planning sample surveys show the relationship between the development of abortion and attitude to birth control. In the 1960s, abortion was a well-used form of birth control. The pill and the IUD were not yet available, so it was mostly men who used birth control (condoms and coitus interruptus). In 1967, the 1st oral contraceptive was introduced. Between 1969 and 1973 the number of abortions fell by about 20%. In 1974, all females over 18 could use and by pills without medical supervision. The use of oral contraceptives was still growing. From the mid-70s, the IUD began to increase. Now only 3-4% of families use condoms. 1/4 of married women now use abortion as a method of birth control. The number of repeated abortions fell significantly. After 6 years of marriage, there were 28 abortions per married women at the end of the 1980s. The Hungarian abortion ratio is still very high. Unmarried women have more abortions than married women do. Development of the ratio of induced abortions by age-group of females (per 1000 females) is shown in tabular form, as is distribution of 15-39-year-old females by birth control methods. There is also a table describing the distribution of 15-39-year-old married females using contraception by main methods of contraception.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12222208&dopt=Abstract birth control



birth control
Family planning in Europe.

Blayo C.

PIP: Today Europe has the lowest fertility ever, and even Albania and Ireland are recording less than 3 children/woman. Europe can be divided into 3 groups of countries: 1) countries in which women rely on medical contraception, where abortion is used only to correct contraceptive failures, and where there are few sterilizations; 2) countries where abortion is less frequent (UK, the Netherlands especially), because sterilization is much more widespread; and 3) countries of the former Communist bloc where abortion frequently takes the place of contraception and sterilizations are insignificant. Couples' free access to birth control in practice faces legal and administrative restrictions and poor reception systems that discriminate against adolescents, ethnic minorities, and migrants. In Europe a certain inequality of access to birth control persists. The legislators occasionally resist, as in Ireland and in Poland. In many eastern European countries there is resistance toward the widespread distribution of modern contraceptive methods; other countries place more emphasis on sterilization than on stricter practice of contraception. Voluntary sterilization of couples reached the 40 or 50% level in the US and Canada at the end of the 1980s, while it has only exceeded 20% in the UK and the Netherlands. Europe has made progress in legislation on abortion. Prohibitions had disastrous effects on the maternal mortality rates in Albania and Romania before the recent political changes. The European birth control literature is rife with analyses based on approximations, biased indexes, and partial statistics, but assessment is often avoided because of political and economic interests. In order to comprehend the resistance to the spread of contraception and the reasons for the sociocultural choice of abortion, sterilization, or contraception, these events in particular abortions and sterilizations, must be recorded.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12222242&dopt=Abstract birth control



birth control
Association of adolescent risk behaviors with mental health symptoms in high school students.

Brooks TL, Harris SK, Thrall JS, Woods ER.

Division of Adolescent/Young Adult Medicine, Children's Hospital, Harvard Medical School, Cambridge, Massachusetts, USA. tbrooks hms.harvard.edu

PURPOSE: To examine the hypothesis that self-reported symptoms of depression and stress may be associated with other risk behaviors. METHODS: A secondary data analysis of the 1992 Massachusetts Adolescent Health Survey involving a representative sample of 2,224 ninth and twelfth grade students was performed. The dichotomous dependent variable was positive if the adolescent reported feeling depressed or stressed for 10 or more days in the past month. Potential independent variables examined were age, gender, race/ethnicity, and 14 risk or protective behaviors: each scored on a seven point scale representing increasing frequency of a behavior in the past month. A four-level sexual risk variable was constructed as well. Associations were assessed using Chi-square, and phi/contingency coefficients, and logistic regression analyses to predict the odds of reporting depression/stress. RESULTS: The mean age of the sample was 16.2 +/- 1.6 years; 52% males; 78% were white, 9% black, 6% Latino, 2% Asian, and 4% other racial/ethnic heritage; 35% reported feeling depressed/stressed > or = 10 days in the past month. A logistic regression model found that feelings of depression/stress were associated with increasing age (OR = 1.09 with each additional year [95% CI, 1.02-1.18]), female gender (3.28 [2.62-4.12]); increasing levels of tobacco use (1.07 [1.01-1.12]), physical fights (1.19 [1.11-1.28]); and non-use of birth control compared with never having been sexually active (1.81 [1.31-2.49]). Independent variables of reporting depression/stress for males included increasing age (1.15 [1.03-1.28]), and physical fights (1.20 [1.10-1.30]), and non-use of birth control compared with never sexually active (1.91 [1.28-2.92]). Independent risk and protective factors for females included tobacco use (1.10 [1.02-1.19]), healthy diet (0.89 [0.83- 0.96]), and always (1.49 [1.03-2.28]) or sometimes used birth control (1.56 [1.03-1.28]) compared with never sexually active. CONCLUSIONS: Female gender had greater than threefold increased odds of reporting depression/stress. Other associations, with some gender differences, include older age, physical fights, non-use of birth control, lack of a healthy diet, and use of tobacco.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12225736&dopt=Abstract birth control



birth control
Teen sexuality. Reaching out in the malls.

Evans SJ, Wright BL, Goodbrand L, Kilbreath JP, Young J.

School of Nursing, University of Western Ontario. evans ucalgary.ca

BACKGROUND: Existing sexual health programs have not significantly reduced teen pregnancies or sexually transmitted diseases. A more creative approach is needed. METHODS: An assessment of 539 teens in one Ontario city was conducted to identify knowledge about and use of birth control, comfort in discussing sexual health, and preferred sites, providers and methods of service delivery. RESULTS: Knowledge of, and comfort discussing, birth control was not associated with frequency of use but was associated with grade. Adolescents were less comfortable discussing sexual health with teachers than health professionals. Over time, comfort increased with health professionals, but not teachers. Sexually active teens reported willingness to attend mall-based clinics. CONCLUSIONS: Using birth control appears to be maturational given its association with grade. Since teens were consistently less comfortable with teachers, providing sexual health services in schools is likely ineffective. Teens may respond to clinics in creative settings such as malls.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11925700&dopt=Abstract birth control