The figures for abortions performed under The Abortion Act, 1974 of Singapore in a private clinic over a period of 20 months were studied. Overall, an alarming proportion of repeat abortions were found, and this was true for all age groups suggesting that abortions are being used as a regular method of family planning in Singapore.
PIP: The initial results of a study conducted to develop guidelines for the clinical management of family planning acceptors with regard to return of fertility following contraceptive use, are presented. 193 parous women attending an urban family planning clinic were interviewed regarding their last pregnancy conceived after stopping a method of contraception. The average interval to pregnancy was 3.9, 2.8 and 1.8 months for ex-users of oral pills, intrauterine devices and conventional methods of contraception, respectively, with median delays to conception of 1.9, 1 and within the 1st month for the 3 categories. In comparison, 149 women who had not used any method at all took 7.3 months before becoming pregnant. Selected variables including age and parity, duration of use and problems encountered, and outcome of pregnancy are further analysed. Follow-up investigations and treatment are recommended 12 months after stopping oral pills and 6 months after removal of intrauterine device for those who have not yet conceived.
The estimation of fecundability from survey data is plagued by methodological problems such as misreporting of dates of birth and marriage and the occurrence of premarital exposure to the risk of conception. Nevertheless, estimates of fecundability from World Fertility Survey data for women married in recent years appear to be plausible for most of the surveys analyzed here and are quite consistent with estimates reported in earlier studies. The estimates presented in this article are all derived from the first interval, the interval between marriage or consensual union and the first live birth conception.
PIP: The estimation of fecundability from survey data is plagued by methodological problems such as misreporting of dates of birth and marriage and the occurrence of premarital exposure to the risk of conception. The availability of data collected with a standard interview schedule from over 40 countries in the World Fertility Survey (WFS) is an invaluable resource for assessing the potential utility of measures of fecundability derived from single-round surveys as well as for comparing estimates across countries and regions of the world. In this article, data are used from 5 WFSs in Latin America (Colombia, Costa Rica, Panama, Mexico and Paraguay) and 3 in Asia (Korea, Malaysia and Sri Lanka) to determine the general usefulness of single-round survey data for the estimation of fecundability from survey data, given the limited information on contraceptive use available from many surveys and the data quality problems associated with reports of dates of marriage and dates of birth. Explored in the process are several different procedures for estimation and variations in estimates of fecundability by country, time period, and women's age. For most of this analysis, the median waiting time to conception in the absence of contraception is used as a measure of fecundability. All of the estimates presented are derived from the 1st birth interval. The estimates are based on data collected in both the birth and the marriage histories in the WFS individual interviews. The 8 surveys chosen for this analysis are characterized by relatively complete reporting of dates of birth and marriage. The primary conclusion of this exercise is that reasonable estimates of fecundability can be derived from WFS data only if one is careful to avoid numerous methodological pitfalls. The most plausible estimates appear to be for women married in the period from about 2 to 10 years before the survey. The average waiting times to 1st conception range from about 4 to 7 months; the corresponding monthly probabilities of conception lie between 0.17 and 0.26. The effect of age at marriage on fecundability is most apparent for ages below 16; differences between women married at ages 16-17 and at ages 18 and above are more modest. Suggestions for improvement of the estimation of fecundability by including a number of questions in survey questionnaires are presented.
PIP:
This paper presents data on contraceptive prevalence from 26 national sample surveys conducted in the Asian and Pacific region during the 1966-84 period. The basic data presented are: contraceptive prevalence rates, cross-classified by age where possible; the percentage of couples using each contraceptive method, also cross-classified by age where possible. To facilitate comparison between countries and across time, the data are presented in a standardized form, both numerically and graphically. Contraceptive prevalence rates range from 1-85% (the highest and lowest ever reported). In the Asian and Pacific region as a whole, the prevalence rate was around 40%, which was about the same level as in the Latin American region. In Africa the prevalence rate was around 12%, and in developed countries around 70%. In the late 1960s, prevalence rates in the Asian and Pacific region were less than 20%. By the early 1980s, contraception had spread throughout all parts of society so that the rates in many countries were over 50%, and in some over 60%. Most of the countries with high prevalence rates were in East and Southeast Asia, and most of those with low prevalence in South Asia. Displayed graphically with the age of wife (from 15-49 years) on the x axis, contraceptive prevalence rates appear as an inverted U, low at both ends of the age range and high in the middle. Curves skewed to the left generally have stronger effects on fertility than those skewed to the right. This is due to the fact that most births occur among younger couples and contraception used by younger couples prevents more births than contraception used by older couples. The curves of countries relying primarily on sterilization are generally skewed to the right. The data show a wide variation in the mix of contraceptives used in each country. The use of various contraceptives by age is similar throughout the region. Young couples generally use oral contraceptives (OCs), those in the middle of the reproductive ages the IUD, and those near the end of the childbearing ages sterilization. Rhythm and withdrawal methods appear to be preferred both by couples in the youngest and oldest age groups. Contraceptive needs change as couples progress through the life cycle. Consequently, family planning programs must work to provide a broad mix of contraceptives. The tables show that Thailand and the Republic of Korea, 2 countries which are thought to have excellent family planning programs, have provided well-balanced mixes of contraceptives. Other countries in the region have depended on only 1 or 2 methods.