Family planning in Baltimore City--1960-1966.

Abstract

Data were collected on the 12000 women (representing 2% of the white and 16% of the nonwhite women of reproductive ages in the city) who received oral or intrauterine contraception between June 1960 and May 1966 from the 16 public clinics in Baltimore (6 City Health Department clinics 6 hospital clinics and 4 Planned Parenthood clinics) and analyzed to determine the characteristics of receivers and the impact of the program on the citys birth rate. Of the total group 84% were nonwhite; 1/2 were under 25 years of age with nonwhites significantly younger than whites (all significance levels = .01% and oral users younger than IUD users. 45% had 2 children or less nonwhites having more children than whites and IUD contraceptors having larger families than oral users. Over 1/2 the women came from the lower 2 socioeconomic fifths and those accepting oral contraception were from lower socioeconomic levels than those accepting IUDs. 28% were unmarried which included 32% of the nonwhites and 8% of the whites and IUDs were accepted by a higher proportion of these women than were pills. Of the 3 services the City Health Department was especially effective in reaching women who needed contraception the most as suggested by their socioeconomic levels young ages and high parities. Continuation rates for IUDs (63% still using after 1 year) were high compared to those for oral contraception (54% still using after 1 year). The necessity of frequent return visits for oral contraceptors and ease of discontinuance of the method were 2 suggested explanations for this difference. The characteristics of acceptors suggest that the citys birth rate may have been affected by these services. Although the rate has been declining since 1957 it has dropped particularly fast recently: from 19.3 and 30.9 per 1000 population for white and nonwhites respectively in 1964 to 15.6 and 25.3 in 1967. The program has probably been ineffective in preventing first illegitimate births among teenagers although once a woman has had a child she is reached regardless of her marital status. Statistics of new acceptors for the first 3 years have suggested a quick increase followed by a leveling off.