According to official Swedish epidemiological figures, during 1996 the number of abortions increased for the first time in the 1990s, breaking a declining trend, especially among women under 24 years of age. In several European countries a similar increase was reported. The number of induced abortions declined by 16.1% during 1990-95, whereas it increased by 2.3% in 1996 compared to the previous year. The corresponding increase was 4.1% for teenagers and 2.5% for women in the 20-24 age group. In Norway, a 7.2% increase was reported in the first half of 1996 compared to the first half of 1995, although there, too, there had been a declining trend during the 1990s. Preliminary figures from Denmark indicate an increase of abortions to 18,022 for 1996 vs. 17,720 for 1995. Similarly, in Great Britain, in the first half of 1996, the figure increased by 10% compared with the same period in 1995. More than 90% of women in Sweden use or have used oral contraceptives (OCs); about 50% of women up to age 24 use them, and for women up to age 29 OCs also continue to be the most frequently used contraceptive. In October 1995, the World Health Organization published an extensive epidemiological study, which showed that low-dose OCs containing third-generation gestagens pose double the risk of deep venous thrombosis compared to low-dose OCs containing second-generation gestagens. Immediately after this alarming report the trend of declining abortions stopped and the users of OCs dropped from 440,000 before the report to 370,000 in 1996 in Sweden.
We evaluated the use of curettage in second trimester medical induced abortions retrospectively in 186 women at Herning Hospital, Denmark. Curettage was carried out in a total of 55% of the women. The incidence of curettage was associated with low gestational age (r?=?0.32, p?
BACKGROUND: Due to high abortion rates in a low status area in Göteborg, Sweden, a study was performed focused on the pregnancy test. METHOD AND MATERIAL: The aim of the study was to facilitate the accessibility of contraceptive counseling offering immediate and extended family planning advice to women with negative pregnancy tests not wishing to become pregnant. There was also an ambition to better understand the lack or inconsistent use of contraceptives and decrease the rate of unwanted pregnancies, which could have an impact on the abortion rates. RESULTS: In an area with 5,200 women of fertile age immediate and extended family planning advice was offered by midwives to all women with no desire for pregnancy and negative pregnancy test results. During the six month data collection period in 1988-1989, 463 women received such a consultation, of whom 310 did not use any contraceptives at the time of the study. Several reasons, on different explanatory levels, for not using contraception were recognized. CONCLUSION: The abortion rate declined in the area, and this decline was observed two years earlier than for the rest of Göteborg. This decline, together with the information on contraception behavior received, may indicate that this kind of approach could be successful.
A law on Induced Abortion on Request came into force in Denmark in 1973. During the first years the rate of abortion increased but since the early 1980s the rate has been rather constant. The paper reviews recent findings concerning induced abortion and discusses its role in controlling fertility.
Trends in induced abortion is described from routine statistics while information on the aborting women are taken both from a survey and from a register based study of fertility- and abortion-pattern among a cohort of women.
Fertility trends in Denmark are characterized by an increasing age at first birth. Half of the aborters to day have no children before and 10% had given birth less than 18 months earlier. Among aborters a higher proportion than among parturients were still under education and a higher proportion were single with no steady partner. Half of the aborters became pregnant in spite of contraceptive use, indicating a need for better contraceptives.
Induced abortion has become a generally accepted form of birth control in Denmark and the decision to terminate a pregnancy is influenced by many factors including the woman's conjugal--and educational situation. A strategy for prevention of induced abortion must take into consideration the social circumstances of women and for families with children.
The reports on a higher risk of venous thromboembolism associated with third generation oral contraceptives (OCs) received a great deal of media attention in Norway. The Norwegian Medicines Control Authority recommended restricting the use of third generation OCs. The sale of the only third generation OC in Norway decreased by 73%. The total sales of OCs also decreased by 10%, however, despite a recommendation to change drug rather than stop using OC. During the first six months of 1996, the number of legal abortions in 11 hospitals covering 60% of all legal abortions in Norway increased by 297, or 7%, compared with the same period in 1995. A continuous downward trend in the number of legal abortions during the period 1990-95 has been broken, and replaced by an increase, which could represent a greater risk to women's health than a few cases of venous thromboembolism.
Comment In: Tidsskr Nor Laegeforen. 1997 Feb 10;117(4):558-99148461
This article describes findings from a new source of data for estimating the incidence of induced abortion in the Russian Federation, the Russian Longitudinal Monitoring Survey (RLMS). According to RLMS data, the abortion rate in 1994 was 56 per 1,000 women aged 15-44, with a 95 percent confidence interval of plus or minus 12 per 1,000, an estimate that varies from that advanced by official sources and other studies. The sensitivity of this estimate to survey design, underreporting of abortion, and potential confusion about miniabortions is considered. Consistency of abortion estimates with patterns of contraceptive use is also evaluated. A significant advantage of RLMS data is the ability to estimate abortion rates specific to respondent characteristics. The article presents findings concerning socioeconomic differences.
STUDY OBJECTIVE--The aims were (1) to determine whether in Europe, 1980-86, geographical differences in total prevalence of neural tube defects persist; (2) to examine the stability of total prevalence rates over time; (3) to evaluate the impact of prenatal diagnosis in terms of frequency and timing of termination of pregnancy. DESIGN--Prevalence rates of neural tube defects were determined from case registration data in 20 EUROCAT regional registers of congenital anomalies, 1980-86. The chi 2 test for homogeneity in proportions was used to test whether differences in total prevalence rates were significant between regions or over time. SETTING--Geographically defined populations were used in the Republic of Ireland, United Kingdom, Belgium, The Netherlands, Luxemburg, Denmark, France, Italy, Yugoslavia, and Malta. PATIENTS--The patients were 3113 cases of anencephaly, spina bifida, encephalocele, and iniencephaly. Total cases (livebirths, stillbirths and induced abortions following prenatal diagnosis) were registered in 14 regions. Induced abortions were excluded from registration in six regions. MEASUREMENTS AND MAIN RESULTS--Total prevalence rates (including livebirths, stillbirths and induced abortions) were 24 to 38 per 10,000 in six areas of Ireland and United Kingdom. Average total prevalence rate in eight continental European areas was 11.5 per 10,000. There was a secular decline in total prevalence in Dublin (Republic of Ireland) and Northern Ireland (United Kingdom) and a fluctuation in Glasgow, Liverpool, and South Glamorgan (United Kingdom). Total prevalence in continental Europe was stable over time. There was no significant geographical or secular variation in the spina bifida to anencephaly ratio (1.3). The ratio of encephalocele to other neural tube defects was lower in the British Isles (0.09) than in continental Europe (0.18). The impact of prenatal diagnosis and termination of pregnancy is increasing over time. Terminations were performed 1984-86 in at least 80% of total cases of anencephaly in 6/11 centres registering induced abortions, and in at least 40% of total cases of spina bifida in four centres. Serum alpha fetoprotein screening in British centres was associated with earlier prenatal diagnosis of spina bifida than ultrasound screening in other centres. CONCLUSIONS--Geographical and secular variation in total prevalence of neural tube defects persists in Europe 1980-86, independent of the practice of prenatal diagnosis. There is considerable regional variation in the impact of prenatal diagnosis in terms of frequency and timing of diagnosis and pregnancy termination linked to different policies and practices of prenatal screening.