Number Of Unplanned Pregnancies Research Articles

Exploring factors contributing to unplanned pregnancies among students at higher education institution in South Africa

Unplanned pregnancies among female undergraduate & postgraduate students at higher education institution pose severe public health issue in South Africa (SA) and are also linked to bad health and social consequences that have a detrimental influence on academic advancement and future employment opportunities. The number of unplanned pregnancies among students at higher education institutions continues to rise, despite the government introduction of contraceptives and other preventative methods. Thus, the objective of this study was aimed at explore factors that contribute to unplanned pregnancies among students in higher institution of learning The study adopted non-empirical research, in which existing literature on factors that contributes to unplanned pregnancies among students in higher education institutions. This paper is solely based on a review and analysis of published research and data. The findings of this study indicate that peer pressure, contraceptive uptake, and substance abuse contribute to unplanned pregnancies among students at higher education institution. Peer pressure and inconsistent contraceptive usage are the two interdependent factors that significantly impact unplanned pregnancies at higher education institutions. However, it seems that the lack of sexual knowledge makes these problems worse. The paper notes factors such as peer pressure, contraceptive uptake, and substance abuse that contribute to unplanned pregnancies among students at higher education institutions. The paper recommends adopting policies that emphasize sexual abstinence or the use of contraceptives inclusive of condoms and the government to introduce a long-term injectable contraceptive.

Socio-Cultural Factors Influencing Uptake of Long-Acting Reversible Contraceptives among Reproductive Women in Kenya

Uptake of long-acting reversible contraceptives has been low among many women in Kenya. This has seen a surge in the number of unplanned pregnancies, which leads to continued poverty due to large sizes of families. This study therefore sought to establish the socio-cultural factors influencing the uptake of long-acting reversible contraceptives among women of reproductive age in Kenya. The study adopted descriptive cross sectional study design. The study was conducted in public hospitals in Kenya. The target population included the women of reproductive age of between 18 and 45 years. A sampling formula was used to identify the appropriate sample for the respondents. The 379 respondents identified were picked through simple random sampling. The data were collected using an interviewer-administered questionnaire. The collected data were analysed using descriptive statistics through SPSS version 26. The findings revealed that socio-cultural factors such as religious believe affected the uptake of long lasting reversible contraceptives among reproductive women in Kenya. The study concluded that through misconceived social cultural believes, the uptake of long lasting family planning methods/long-acting reversible contraceptives was minimal among reproductive women in Kenya. The study recommended the need for the government, the hospitals and other stakeholders to create awareness and education on the need for long-acting reversible contraceptives and other family planning methods among women. There is need for the communities to also embrace modern methods of family planning so as to stimulate their economic and social development.

Reasons reported by women for choosing the levonorgestrel intrauterine system as a contraceptive method.

To assess the reasons provided by women for choosing the use of the 52mg levonorgestrel intrauterine system (LNG-IUS) as a contraceptive method. We conducted a cross sectional study from January 2021 to August 2021 at the University of Campinas, Campinas, SP, Brazil. Women who had never used the 52mg LNG-IUS and were requesting it for contraception answered a questionnaire asking for their sociodemographic characteristics, the last contraceptive method in use, how they received information about the device, and their main reasons for choosing the method. We enrolled 516 women, 365 (70.7%) of whom were under the age of 35 and 352 (68.2%) of whom were parous. The last contraceptive method in use was a short-acting reversible method among 387 (80.8%) women, 454 (88%) reported that they wanted to use the IUS only for contraception, and the main source of information was their health care providers. The main reported reasons for choosing the method were because it is safe, has high contraceptive efficacy, and reduces menstrual bleeding. Health care providers should continue their efforts to provide guidance about the LNG-IUS, including the non-contraceptive benefits, which may contribute to a reduction in the number of unplanned pregnancies.

Гормональна контрацепція в аспекті профілактики порушень та реабілітації гінекологічного здоров’я жінок-військовослужбовців. Огляд літератури та результати власних досліджень

SummaryIncreasing the representation of women in the modern army requires improvedgynecological care. If the issue of women’s reproductive health holds a special place inmodern medicine, the development of safe and effective contraceptive methods,including hormonal, remains one of the priorities in gynecology.The benefits of hormonal contraception, namely the foolproof birth control andincreased regulation of the menstrual cycle or suppression of menstruation may be moreattractive to active duty women than to women in the general population.The use of hormonal contraception, in addition to contraceptive action has adistinctive therapeutic effect and prophylactic value, which is especially important forwomen while serving in areas of military operations. The use of hormonal contraceptives can prevent the development of menstrual-associated and cyclical complications, bleeding and anemia, which according to the literature, are almost 2 times morecommon among military women than among civilians, even in peacetime.The participation of women in hostilities is expected to increase the negative impacton women’s reproductive health. The protective capabilities of various methods andregimes of hormonal contraception can be effectively used to maintain the health andrehabilitation of reproductive potential of military women who have been adverselyaffected by physical, chemical and psychological factors of the military environment.The low level of military use of effective modern methods of hormonal contraceptionmay lead to an increase in the number of unplanned pregnancies in the militaryenvironment belonging to the high-risk group, abortions and complications, andconsequently reduce the operational efficiency and combat capability of the militaryunit.The reserve of preserving women’s health at various stages of military careers,especially during military operations is ensuring access to contraception andcounseling, as well as improving the education of military medical providers in thesphere of reproductive health and contraception.

Unintended pregnancies and family planning among women after kidney or liver transplantation

Background: To evaluate the incidence of unplanned pregnancies in female organ transplant recipients.Methods: In a single-center cross-sectional study 252 women aged 18–45 years who underwent kidney or liver transplantation were asked to fill in a survey form.Results: 217 (86%) women were enrolled in the study. Fifty-three percent of women declared 181 pregnancies, of which 30% (54/181) were unplanned. Women more frequently consulted their conception with a doctor post-transplantation (74 versus 88%, p = .064). The number of unplanned pregnancies decreased post-transplantation (34 versus 20%, p = .051). The mean time elapsed from an organ transplant to unintended conception was 27.0 ± 12.5 (3.0–63.0) months. Women with longer (>24 months) rather than shorter (≤24 months) time elapsed from the transplant became pregnant less frequently (38 versus 15%, p = .060). In 70% (38/54) of unplanned pregnancies women did not use any birth control. All cases of conceptions within the post-transplant year were unintentional. Every third woman, who underwent the transplantation up to 1 year before the study enrolment, was unaware of the necessity to prevent the pregnancy.Conclusions: Although unwanted pregnancies occur more frequently in the early post-transplant period, it seems that women after kidney or liver transplantation seem to plan their pregnancies more carefully.

Do women want to talk about birth control at the time of a first-trimester abortion?

ObjectiveTo investigate if women desire talking to a counselor or physician about contraception when seeking first-trimester medical or surgical abortion. Study designWe conducted a cross-sectional study by distributing self-administered anonymous surveys to women at three clinics in Sacramento, California; Chicago, Illinois; and Cleveland, Ohio, from October 2014 to February 2015. Participants completed surveys after registration and before any in-office counseling. We asked whether women want to discuss contraception, specific topics they want to discuss, reasons why they may not want to talk about contraception and whether they want to receive contraception services as part of their abortion care. We conducted regression analyses to assess associations between patient characteristics and the desire for counseling. ResultsAmong 3041 eligible women, 1959 (64.4%) completed surveys. Overall, 1208 (61.7%) did not want to discuss contraception prior to having an abortion, primarily citing that they already know which method they want. We found no association between the desire to discuss contraception and age, race, planned abortion method, clinic site and number of unplanned pregnancies. Among those who desired to talk about contraception, subjects preferred to discuss which contraceptive methods are easier to use and more effective as compared to previously used methods. Regardless of their desire for a discussion about contraception, 1386 (70.8%) of subjects wanted to leave the clinic with a specific method, including a long-acting reversible method [intrauterine device or implant (190, 13.7%)] or other hormonal method [pills, patch, ring or injectable (680, 49.1%)]. ConclusionsThe majority of women seeking first-trimester abortion do not come to the clinic wanting to discuss contraception, most commonly because they have a preferred method in mind. ImplicationsProviders should ask women presenting for abortion if they want to discuss contraception and not assume that they need or desire such information. Focused discussions, starting with the preferred method if known, may better satisfy women's preferences. Providers should account for such desires when allocating resources for contraception services during abortion care.

Knowledge of women in family planning and future desire to use contraception: a cross sectional survey in Urban Cameroon

BackgroundThe rate of modern contraceptive use will be on an increase and maternal mortality on a decrease if women had a good knowledge on family planning and its methods. This survey was designed to evaluate the knowledge and determine the future desires to use contraception among women in Urban Cameroon.MethodsWe conducted a cross sectional community based survey from March 2015 to April 2015 targeting women of childbearing age in the Biyem-Assi Health District. Participants were included using a multistep cluster sampling and the data collected face to face by well-trained surveyors using a pretested and validated questionnaire. The data were then analysed using the statistical software Epi-Info version 3.5.4. Proportions and their 95 % confidence intervals were calculated and in a multiple logistic regression model with threshold of significance set at p value ≤0.05, the odds ratio was used as the measure of association between selected covariates and future desire to use contraception.ResultsAmong the 712 women included in the survey, the mean age was 27.5 ± 6.5 years. A good proportion (95.6 %) identified contraception as used to prevent unwanted pregnancy and this showed an increasing trend with increasing level of education. Also, 77.5 % thought that contraception should be used by all sexually active women. The most cited contraceptive methods were; condom 689 (96.8 %), oral pills 507 (71.2 %), and implants 390 (54.8 %). Their main sources of information were the health personnel (47.7 %) and the school (23.6 %). It was estimated that 31.0 [25.5–37.0] % of current contraceptive non-users had no desire of adopting a contraceptive method in the future. With the level of education, age, and marital status controlled, the number of unplanned pregnancies more than 3 (OR 0.66 [0.45–0.97], p = 0.035), and past adoption of more than 2 modern contraceptive methods (OR 0.45 [0.21–0.97], p = 0.041) were statistically significantly associated to decreased desire to adopt contraception in the future. The level of knowledge showed an association though not statistically significant with future desire to use contraception (OR 0.80 [0.47–1.37], p = 0.061).ConclusionThe knowledge of women of childbearing in the Biyem-Assi Health District was relatively high but still unsatisfactory. The proportion of contraceptive non users who have no desire of adopting any contraceptive method in future is still unacceptably high. Policy makers should improve on their strategies while empowering the health personnel and working in collaboration with the education ministries.

Preconception care in Saudi women with diabetes mellitus.

Background:The rate of preexisting diabetes mellitus (DM) in Saudi Arabia is one of the highest in the world. The role of preconception care (PCC) is well-established as a means of improving pregnancy outcomes in DM.Objectives:To assess the rate of preconception counseling, the level of PCC knowledge, and the rate of unplanned pregnancies in Saudi women with DM.Materials and Methods:A cross-sectional study was conducted among 355 Saudi women aged 18–49 years with self-reported DM. The study questionnaire contained variables about the provision of preconception counseling, knowledge of PCC facts, and the number of unplanned pregnancies after developing DM. The level of PCC knowledge was evaluated using a modified Likert scale. Statistical Package for Social Sciences 20 was used for statistical analysis. Descriptive statistics, mean and standard deviation, and percentages were calculated; t-test was used for statistical significance.Results:About one-third of the participants had received preconception counseling after being diagnosed with DM. Counseling on PCC for older and married participants was significantly less. Of the 355 participants, 42.8% had little or no PCC knowledge. All pregnancies that occurred after developing DM were unplanned.Conclusions:The rate of preconception counseling, the level of PCC knowledge in the studied Saudi women with DM is suboptimal, and none of the pregnancies that occurred after developing DM was planned. The study highlights the need for PCC programs that target all Saudi women of child-bearing age with DM, and their families starting at the age of puberty and at diagnosis of type 2DM, to optimize women's health and improve pregnancy outcomes.

Linking HIV & family planning services to improve dual methods of contraception among women infected with HIV in Mumbai, Maharashtra, India.

Background & objectives:Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women.Methods:An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year.Results:At the end of one year, 60 per cent women in the intervention group reached Family Planning Centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods along with increase in consistent use of condoms and less number of unplanned pregnancies in the intervention group than the control group.Interpretation & conclusions:The study findings demonstrate that linking HIV and family planning services may facilitate the uptake of dual methods of contraception without reducing consistent condom use among HIV infected women. The PPTCT programmes need to focus on the component of Prong 2 of PPTCT which aims to prevent unintended pregnancies among HIV positive women.

Uso de la anticoncepción de emergencia en un grupo de estudiantes universitarias

Objective: to identify the use of emergency contraception (ec) on a group of female university students (fus). Material and methods: descriptive and cross-sectional study with non-random sample. In 2009, it was made a pilot test with 44 users; the final instrument was applied between August 2009 and April 2010 to 107 students from the Ciudad Universitaria campus of the National Autonomous University of Mexico, unam. The information was processed using the spss program. Results: the ages of girls requesting more ec were between 19 and 21 years; 87% said to know its use. In the six previous months 27.1% had used once ec; 15% used it on two occasions. The contraceptive method used by 8 of every 10 students was the condom. Conclusions: the frequency of the use of the ec indicates that the University students use it as if it were a sequential method of birth control, which could lead to damage their health, as well as a greater number of unplanned pregnancies due to hormonal imbalances.

The effect of spousal communication on contraceptive use in Central Terai, Nepal

Objective Family planning has several social and health benefits; it can reduce maternal mortality and the number of unplanned pregnancies, as well as increase educational and economic opportunities [1,2]. Utilizing quantitative data from an endline household survey (July 2009) and data from focus group discussions, the Centre for Development and Population Activities (CEDPA) seeks to determine whether spousal communication increases contraceptive use among married women of child-bearing age in Nepal's Central Terai region. Methods Quantitative household survey and qualitative focus group discussions. Results Women who discuss family planning with their husbands (OR = 7.254), perceive husband approval on family planning (OR = 5.558) and have born a son (OR = 2.239) are more likely to use a modern contraceptive method. Qualitative data show that several other considerations can be motivating factors for contraceptive uptake. Conclusion While results do not explain the direction of causality, it is clear that spousal discussion and partner approval are significant in a woman's decision to use modern contraceptives in the Central Terai region of Nepal. Practice implications More research needs to be conducted on the effect of spousal communication and contraceptive use, in particular, the role of frequency, quality, and content of spousal communication, as well as individual motivations.

Estudio descriptivo sobre el uso de la anticoncepción de emergencia en Cataluña. Comparación entre una zona rural y una urbana

Objective In the last few years, the number of unplanned pregnancies has increased, especially in young women. Among other measures, emergency contraception (EC) was introduced by the Health Department to reduce unwanted pregnancies. The aim of this study was to analyze EC use in Catalonia, and to compare a rural with an urban area (Lleida province and the metropolitan area of Barcelona). Methods We performed a descriptive study that included 17,149 women of fertile age who sought access to the EC pill between October 2004 and August 2007. Data were provided by the Maternal/Infant Health Program of the Public Health Department. Results EC was used primarily by women between 16 and 24 years of age, usually on the weekends. Most of these women (78.5%) had used EC twice and only 1.8% had used this medication once. Consumption was higher in Lleida, with a comparative utilization figure and 95% confidence interval of 1.42 (1.35–1.50) with respect to Barcelona. Conclusions The finding that EC use was higher in younger women coincides with the goal of distributing this medication. EC seems not to be associated with a decrease in voluntary pregnancy terminations. More reproductive information is required from all the actors involved in policies and health interventions, encouraging healthier sexual behavior.

Title X in California

In Estimates of Pregnancies Averted Through California's Family Planning Waiver Program in 2002 [2006, 38(3):126-131], Diana Greene Foster and colleagues discuss the many successes of California's Family PACT program. As the authors note, Family PACT (Planning, Access, Care and Treatment) funds services to eligible individuals with incomes up to 200% of the federal poverty level through a fee-for-service system that includes nearly 3,000 providers statewide who participate in Medi-Cal, California's Medicaid program. However, contrary to a statement made in the article, the Title X program in California is also a major source of support for services for needy men and women. Through community-based not-for-profit public and private providers at more than 300 sites, Title X funds clinical services for individuals with incomes up to 250% of the federal poverty level, as well as education and community outreach services not funded by any other public source. The increasing price of contraceptives and new contraceptive technologies, the rising cost of advanced diagnostic tests, the severe shortage of health care workers and the inadequate level of Medicaid reimbursements all contribute to gaps between costs and payments to providers. Title X, the last public source to which agencies can turn, helps to offset some of these service payment gaps. The value of the Title X dollars in California cannot be underestimated. Although the state is home to nearly 11% of the U.S. population, it receives less than 8% of the national Title X grant. Still, the California Title X program serves more than 790,000 women and men-or roughly 15% of all those receiving care through Title X nationally-each year. The program serves more men than any other Title X program in the United States, and a higher proportion of Title X clients in California than elsewhere are men. Through its collaborative effort with Family PACT, California averted more than 200,000 unplanned pregnancies in 2002, as Foster and her colleagues point out.1 Yet, even with the waiver program, only 56% of women in need of publicly funded family planning services were served in FY 2004-2005.2 The unmet need is large, and the possibilities for even more dramatic results are significant. California has made family planning a priority, and its efforts have paid off in dramatic reductions in teenage pregnancy rates and in the number of unplanned pregnancies. I regret that Title X's important role in achieving these remarkable results was not communicated clearly in the Foster article.

Vaginal delivery of contraceptives

Although a steady increase in contraceptive use has been observed both in developed and less-developed countries, the large number of unplanned pregnancies may indicate that the contraceptive needs of a significant percentage of couples have so far not been met. Several new contraceptive products have reached the market during the last 2 years. Among these is a new contraceptive vaginal ring, which has become available for prescription. This new female method has been developed to expand the contraceptive choices available to couples. This review will address the specifics of the vaginal route for delivering contraceptive steroids and describe the various systems available or under evaluation.

The Potential of Comprehensive Sex Education in China: Findings from Suburban Shanghai

More and more Chinese adolescents are engaging in premarital sexual activity. As a result, the numbers of unplanned pregnancies and sexually transmitted infections (STIs) among Chinese young adults have increased markedly. A comprehensive sex education program, including information on abstinence, contraception and healthy sexual behaviors, was carried out in a suburb of Shanghai. The program used six methods for providing information and services to unmarried 15-24-year-olds over a period of 20 months. Sexual behavior surveys were conducted among intervention participants and among controls in a comparable town, who did not receive a similar intervention; chi-square tests and logistic regression were used to compare the results. Participation in the intervention was not associated with delayed sexual initiation, but was associated with reduced odds that youth coerced a partner into having sex (odds ratio, 0.3) and with increased odds of contraceptive use (6.2) and condom use (13.3) during the intervention period. The greater the level of participation, the larger the protective effects. Furthermore, the proportion of youth reporting pregnancy involvement during the intervention period was significantly lower in the intervention group than among controls (19% vs. 26%). Comprehensive, community-based interventions may be effective in reaching large numbers of Chinese youth and in promoting sexual negotiation, contraceptive use, and pregnancy and STI/HIV prevention.

Behavior and attitudes of adolescents relevant to their reproductive health

Increase in adolescent sexual activity is a phenomenon noticed in modern societies, as well as in Serbia. The sexual activity reveals new health related problems, in relation to the unpremeditated pregnancies and sexually transmitted diseases. Reproductive health is vulnerable especially in case of persons having first sexual experiences being adolescent, what could be explained by the physical immaturity and psychosocial infirmity to be responsible in sexual behaviour. The study of 300 sexually active adolescent women aged 19, attending The Youth Advisory Center of The Mother and Child Health Care Institute of Serbia was conducted between 1995 - 1997. The aim of this study was to evaluate how much the reproductive health in this population was endangered, by analyzing their sexual behavior, their attitudes in the spheres of sexuality and reproduction, as well as some variables of social microenvironments that might be relevant to adolescent sexual behavior. Questionnaire included investigation of youth opinion about some acceptable social measures in this field. According to the results of this study the adolescents reproductive health is seriously endangered. Interwieved adolescent females most frequently used traditional birth control methods, like coitus interruptus (54,3%), and often didn't think about the risk of acquiring sexually transmitted disesase (with new sexual partner the regular condom use was reported only in case of 55,6% girls). Adolescent girls had also poor health behaviors so that 31,0% of interviewed adolescent females visited gynecologist for the first time not earlier than one to three years after their first sexual experience. That resulted in large number of unplanned pregnancies (16,0% of interwieved girls had one or more induced abortions) and, possibly, a high prevalence of sexually transmitted infections. The model of sexual behavior, that was accepted by adolescent females was partly due to the lack of adolescents knowledge about sexuallity, contraception and sexually transmitted diseases. Improper were the main sources of relevant knowledge (peers, parents, mass media), therefore, youth had many misconceptions in this sphere (about the harmfulness of modern contraception, reliability of coitus interruptus method, lack of risk for sexually transmitted diseases transmission). The social adolescent sexual and reproductive health programme doesn't exist in Serbia. Parents of adolescent females were passive, and school and health care workers are not engaged in these matters enough. The possibility for social intervention programme exists, because young people were willing to improve their knowledge about sexuality and reproduction (83,3%) mostly by sex education in schools (51,0%) and through mass media (33,3%). The most appreciated sources of relevant knowledge would be physicians (67,0%), from whom they expect to have time and patience for them and their problems (91,3%).

Preventing abortion and repeat abortion with the Gynefix intrauterine implant system--preliminary results.

The provision of immediate post-abortal contraception is important to reduce the number of unplanned pregnancies and the number of repeat abortions. Immediate post-abortal insertion of an IUD has many advantages and is an acceptable and safe method. However, side-effects and expulsion of conventional IUDs remain a problem. In an attempt to minimize these problems, the frameless intrauterine implant (IUI) was developed. Clinical studies conducted over the past 12 years have shown the validity of the anchoring concept. The design characteristics of the IUI (fixed, frameless and flexible) are responsible for the low expulsion, high effectiveness and high tolerance rates. This communication is the first report of clinical experience with the post-abortal version of Gynefix (Gynefix PT) in a limited number of women with pregnancies of less than 10 weeks' duration. This experience suggests that immediate post-abortal insertion of Gynefix PT is easy, safe and the implant appears to be as reliable and effective as interval insertion of the interval version. We conclude that the immediate post-abortal insertion of Gynefix PT is an important novel approach to reducing the incidence of repeat abortions.

Training in family planning.

In spite of extensive programmes for training in family planning and extensive services in contraception in the UK, the number of unplanned pregnancies has not decreased. On the contrary it is increasing. Medical graduates are now educated in methods of contraception. There is an extensive programme for postgraduates, regulated by the Joint Committee on Contraception (JCC), which is well integrated and co-ordinated. The provision of good training opportunities at a local level will be enhanced by the establishment of consultant posts in Reproductive Health/community Gynaecology and the development of higher training programmes to meet the projected expansion of these posts. They can play a role in education in reproductive health with respect to sexuality and personal relationships, as well as in the provision of family planning services and training to all reproductive health care professionals and teachers.

Contraceptive problems in the developed world

In most developed countries contraception is available and relatively cheap. In Britain 50% of women use reversible contraception and over the age of 35 more than 50% of women (or their partners) have been sterilised. Nevertheless large numbers of unplanned pregnancies still occur in all countries. Annual abortion rates (per 1000 women aged 15-44) are 5.6 in the Netherlands, 13 in Britain and 28 in the USA. In Britain about 50% of all conceptions are unplanned. Ambivalent attitudes to sex mean that there is inadequate public discussion about contraception. The media publicise adverse effects of oral contraceptives more than their benefits. Advertising of condoms is restricted, and the marketing of oral contraceptives to doctors emphasizes their side-effects. Contraception should be made more accessible to potential users, particularly the young, who are at greatest risk of unwanted pregnancy. Opinion among teenagers and their parents is in favour of more sex education at school. Efforts should be directed towards providing young people with better education on sex and contraception.

The public health implications of abortion.

Balancing the moral and public health issues surrounding abortion requires consideration of the current status of abortion the health effects of the procedure the critical events in the history of legal abortion and the implications of possible future scenarios. The number of legal abortions performed in the US has increased each year rising 75-80% from 1973-78. The total abortion rate (number of abortions a group of women would undergo if the age-specific rates for a given year persisted through their reproductive life) grew from 355/1000 in 1972 to 649/1000 in 1979 an 83% increase. Mortality related to legal abortion declined by over 40% from 1972-75 to 1976-79. The increased occurrence of repeat abortion (up from 100800 women in 1974 to 339200 in 1978) is not considered to reflect a decrease in the effectiveness or proper use of contraception. Women who seek legal abortions come from groups at greatest risk of perinatal and infant mortality leading to a favorable influence on these rates. The number of unplanned pregnancies among unmarried women was almost 3 times greater in 1979 than in 1970 indicating a need for pregnancy prevention research and more effective family planning services. 1st trimester abortions increased from 80% of all procedures in 1972 to 90% in 1978 and the recent trend toward use of dilatation and evacuation in 2nd trimester abortions has made the procedure less risky. Controversy about abortion is certain to continue and the course of future action around the issue is unclear. If abortion is restricted (e.g. through strict limits on the use of public funds for this purpose) 5 public health effects can be anticipated: 1) the number of legal abortions will decrease; 2) illegal abortions will increase; 3) live births will increase; 4) reproduction-realted mortality will rise due to the greater number of illegal abortions 2nd trimester abortions and term births; and 5) womens future reproduction will be impaired. Conversely continued permissive abortion practices will have the following implications: 1) legal abortions will continue to increase as long as the number of women of childbearing age increases 2) the number of illegal abortions will remain small 3) a fertility increase seems probable in the absence of a precedent for longterm trends of low fertility 4) reproduction-associated mortality should remain low and 5) some women may have impaired fertility after abortion.