Global Population Growth - Is It Sustainable? Meeting of the Parliamentary and Scientific Committee on Monday 22Nd October 2007

Total Page:16

File Type:pdf, Size:1020Kb

Global Population Growth - Is It Sustainable? Meeting of the Parliamentary and Scientific Committee on Monday 22Nd October 2007 GLOBAL POPULATION GROWTH - IS IT SUSTAINABLE? MEETING OF THE PARLIAMENTARY AND SCIENTIFIC COMMITTEE ON MONDAY 22ND OCTOBER 2007 Dr Malcolm Potts MB, BChir, FRCOG Bixby Professor Population, Family Planning and Maternal Health, University of California, Berkeley Is population growth a every decade. Petroleum geologists problem? suggest oil production could peak as early as 2020. Perhaps less profligate Global population grows more rapidly use and alternative sources of energy now (217,000 more births than deaths will keep pace with demand, but if each day) than in the 1960s (165,000 they do not the world economy could more). Rapid population growth used spiral downwards. to command wide attention, but today it meets a collective yawn. Some scientists suggest that human activity exceeded the Earth’s capacity Ninety-nine per cent of the projected to support it in 1985. Such predictions In Kenya, prior to Cairo, when family growth in population by 2050 will have wide margins of error and even planning was emphasised, the TFR fell take place in the developing world. bringing today’s global population to from 8 to below 5. After Cairo, family Already 1.2 billion lack access to clean western standards of consumption and planning budgets dropped, unwanted water. By 2025 a staggering 3 billion pollution would probably exceed the births doubled, and the fall in the TFR people will be short of water. world’s resources. In 1993, a stalled. The population in 2050 could Population Summit of 60 national be 83 million instead of 44 million. Population projections depend on scientific academies, including the Unless there is a renaissance of interest calculating the total fertility rate (TFR) Royal Society, issued a sombre and investment in family planning, – the average number of children a warning, “science and technology may Kenya will become a failed state, like woman will have over her fertile life, not be able to prevent irreversible Somalia and the Congo. based on current age-specific fertility degradation and continued poverty for rates. The Ethiopian TFR is 5.4. The Last year, the All Party Parliamentary much of the world.” The Academies population has multiplied 15 times Group on Population, Development recommended “zero population since 1900 and unless family planning and Reproductive Health held hearings growth within the lifetime of our receives more attention it will reach on the impact of population growth on children.” 145 million in 2050. Already, 8 the Millennium Development Goals. million Ethiopians depend on external Unfortunately, a year later the After taking a great deal of expert food aid. Niger has a TFR of 8. Four International Conference on evidence, they concluded that it is out of 10 children are malnourished Population and Development in Cairo “difficult or impossible” to achieve the and 84% of adults are illiterate. If the did not listen to the world’s scientists. MDGs in high fertility countries. TFR falls to 3.6 the population will Women advocates “redefined” If population growth is a problem can grow from 14 million today to 50 population, framing anything to do anything be done about it? million in 2050: if it remains constant with “population” as intrinsically there will be 80 million. coercive, and even the word In the 1960s offering family planning “demographic” became politically to lower birth rates in the absence of For the 2 billion people living on 50p incorrect. Compelling evidence of the socio-economic improvements was a day or less, future population growth success of family planning dubbed “wishful thinking”. Now we is unsustainable. The rich also face programmes was ignored, or criticised know that socio-economic changes are formidable problems. World Bank as “target driven”. It was asserted that not a prerequisite for dropping the projections suggest a four-fold increase fertility decline would occur when birth rate. In fact, some countries in the global domestic product in the holistic social and health goals were cannot get out of poverty unless next 50 years. Past growth has reached. population growth is slowed. As a depended on doubling oil output result of rapid population growth, 18 Science in Parliament Vol 65 No 1 Spring 2008 developing countries need 2 million lack of access to contraception, not a which now has more women than more teachers annually, just to hold desire for bigger families which is men in universities, and, along with class size constant. driving the disparity. Family planning much slower population growth, is is often over-medicalised raising likely to be increasingly stable. Iran Slowing population growth pays what innumerable, unnecessary obstacles demonstrates that a pack of oral has been called a demographic between women and the methods they contraceptives and access to voluntary dividend. Individuals with smaller need. Providers, fearful a woman sterilisation can help start a social families have more income to invest might be pregnant, often refuse revolution from within. Ultimately, the and a rapid fall in the birth rate contraceptive advice unless she is Pill is mightier than the sword. produces a relatively large work force. menstruating when she visits the When all the other parameters are clinic. Reasons for hope fixed demographic changes by The wonderful discovery of the past themselves pushed the savings rate in India and Iran Taiwan higher than in the US or 50 years has been that people all over France where the birth rate fell more India was the first nation to develop a the world want voluntary family slowly. It is precisely the countries that national population policy, but it still planning. Tragically, 200 million have been able to slow population grew from 357 million to over one women, almost all in poor countries, growth, which are now undergoing billion in 50 years. The government cannot get access to the choices they rapid economic expansion, and often built a top-down national programme need and deserve. becoming more democratic. around western trained physicians, It is imperative to make as wide a while most of India’s population range of fertility regulation options Jeffrey Sachs writes in The End of growth is in rural areas where there available, through as wide a range of Poverty, “. that impoverished are no doctors. Instead of correcting distribution channels as resources families choose to have lots of this shortcoming, Indira Ghandi’s permit. Priority must be given to children.” But, the decision to have a government used coercive measures to ensuring modern contraceptives and child is not like choosing to buy a car, meet demographic targets, leading to the information people need to use where the person balances their election defeat in 1977. The Islamic them. Government services are finances against their perceived need. Republic of Iran was one of the last overloaded, have weak logistics and Sex is often irrational and passionate, countries to confront rapid population lack incentives, and the very poor tend and human beings have sexual growth. In 1988, Ayatollah Khomeini to use the private/informal health intercourse up to a thousand times was pursuaded to adopt a national sector. As the All Party Report points more frequently than is necessary to family planning policy: contraceptive out, an emphasis on Sector-Wide conceive the children they want. factories were built, every newlywed Approaches (SWAps) in foreign aid Having a child is not a single decision couple is required to attend family misses some of the poorest and most made one night to turn fertility on, but planning instruction, and vulnerable groups. a difficult, consistent, prolonged appropriately trained health workers struggle to turn fertility off. are stationed in the rural areas. Iranian As the world’s scientific academies Impoverished families have “lots of family size fell from six to two - as foresaw a decade and a half ago, and children” not because they want them, rapidly as in China, but without any as the All Party Group reiterated in but because they do not have access to coercion. January this year, without a significant modern contraceptives to turn fertility slowing of population growth we face off. The 9/11 Commission Report called “a “irreversible degradation of the natural large, steadily increasing population of environment and continued poverty Over the past decade the disparities in young men [is] a sure prescription for for much of the world.” Building on family size between rich and poor in social turbulence.” Pakistan, which the All Party Report, there is no better developing countries have increased – never had a well-organised family place in the world to make this implying less education for the planning programme, will more than happen than here, in the mother of children of the poor, more hunger, double its population by 2050 and Parliaments. more women dying and more infants become increasingly violent. Iran, dying. The poor use contraception less, but the statistics also show that The Report of Hearings by the All Party Group on Population, Development and they have a much greater unmet need Reproductive Health (Return of the Population Growth factor: Its Impact upon the for family planning, suggesting it is Millennium Development Goals) is on the web at www.appg-popdevrh.org.uk Science in Parliament Vol 65 No 1 Spring 2008 19 GLOBAL POPULATION GROWTH - IS IT SUSTAINABLE? Lessons from China Dr Therese Hesketh Clinical Senior Lecturer, Centre for International Health and Development, University College London urrently 1.7 billion people live consequence of high fertility, and in countries where the Total improved survival, resulting from CFertility Rate is between three relative societal stability, food security and five children for every woman of and improved public health measures. Bureau sets targets and policy reproductive age. A further 740 direction, but implementation is the Concerns about this rapid growth and million people live in countries where responsibility of local family planning particularly the possibility of food the TFR is greater than five.
Recommended publications
  • Population Reports
    Population Reports Series B Number 3 May 1979 Reprinted January i980 INTRAUTERINE DEVICES Population Information Program, The Johns Hopkins University, Hampton House, 624 North Broadway, Baltimore, Maryland 21205 , USA IUDs- Update on Safety, Effectiveness, and Research Summary. After nearly two decades of use, the IU D remains " a does the latest permutation of device. With this recognition, generally safe, effective and useful form of birth control " (337). attention is now focusing on specific techniques of insertion, With fewer than si x pregnancies per 100 woman-years of use training of personnel, and conscientious follow-up. The result and fewer than ten deaths per one million woman-years of use, has been improved performance over the years with the first according to a comprehensive new review by the United States generation of IUDs, especially the Lippes Loop, which for the Food and Drug Administration, the IUD has an important place la st decade has been the standard device against which others in modern famil y planning programs. were measured . The number of women using IUDs is growing slowly but stead­ To ensure best results, proper insertion is crucial. The IUD ily. Most extensive use is in the People's Republic of China, must be inserted gently and high into the uterine fundus. New where visitors have been told that half or more of all those measuring devices ma y well facilitate selection and precise using contraception have accepted IUDs. In Korea and placement of the right size of device. For postpartum use, a Taiwan, where successful programs have been underway since longer inserter or even hand insertion may be most effective.
    [Show full text]
  • History of Contraception Malcolm Potts and Martha Campbell Vol
    History of Contraception Malcolm Potts and Martha Campbell Vol. 6, Chp. 8, Gynecology and Obstetrics, 2002 INTRODUCTION The factors controlling human fertility and the development of rational therapies to limit births are not necessarily more difficult to understand than the isolation and cure of bacterial diseases. The surgery of voluntary sterilization or early abortion is intrinsically simpler than the treatment of appendicitis or the forceps delivery of a baby. Yet fertility regulation has diffused less rapidly through society than the means to cure disease and prevent death. This imbalance has generated an explosion in global population that is difficult to accommodate, and it has contributed to great inequalities in wealth and untold personal misery. Useful insights into current problems can be gained by looking at the history of contraceptive practice. The aim of this chapter is to document the historical diapause between the acquisition and the application of relevant biologic knowledge to birth control; to analyze the historical factors affecting the delay; and to suggest that early 19th and 20th century attitudes toward contraception in the West are still palpable and cast their shadows over global events in the 21st century. IN THE BEGINNING Homo sapiens evolved to be a slowing breeding animal. Prehistoric societies, like the few preliterate societies that remain, probably had total fertility rates of 4 to 6.1 Approximately half the children who were born died before they could reproduce, and population grew slowly. Puberty was in the upper teens, babies were breastfed for 3 to 4 years, and pregnancies were therefore naturally spaced by long intervals of amenorrhea.
    [Show full text]
  • Joint IGCC/IFRP East and South East Asia Seminar on Regional Fertility Research, Bangkok, Thailand, 1979 1979 219P. FA301.32.161
    BIBLIOGRAPHIC DATA SEET 1. CONTROL NUMBER 2. SUBJECT CLASSIIICATION (695) BIB-~r7LOGRAP -AD DATA SPN AAH-605 PCOO-0000-G570 3. TITLE AND SUPTrtLE (240) Joint IGCC/IFRP East and South East Asia Seminar on Regional Fertility Research, Bangkok, Thailand, 1979 4. PERSONAL AUTHORS (100) 5. CORPORATE AUTHORS (101) Int. Fertility Research Program 6. DOCUMENT DATE (110) 7. NUMBER OF PAGES (120) 8. ARC NUMBER (170) 1979 219p. FA301.32.161 9. REFERENCE ORGANIZATION (130) I FRP 10. SUPPLEMENTARY NOTES (500) 11. ABSTRACT (950) 12. DESCRIPTORS (920) Contraceptives 13. PROJECT NUMBER (150) Fertility Maternal/child health 932053700 Meetings Southeast Asia East AsiaHealth 14. CONTRACT NO.(140 ) 15.CONTRAC TYPEh(G40) Family planning Dealie systems Nutrition Delivery systems AID/pha-C-1172 16. TYPE OF DOCUMENT (160) AID 590-7 (10-79) CONTENTS Page 1. ACKNOWLEDGEMENT ........................ 1 II. INTRODUCTION ............................. 2 III. FOREW ORD ................................. 3 IV. ADDRESSES ................................ 4 Paper 1 (ii) Welcome Address By Dr. Somboon Vachrotai .............. 4 Paper 2 (ii) Opening Address By His Excellency, Dr. Krasae Chanawongse, Deputy Minister of Public Health ......... 5 Paper 3 (iii) Introductory Statement By Dr. Malcolm Potts ................. 6 Paper 4 (iv) Introductory Statement By Dr. L.S. Sodhy ................... 8 Paper5 (v) Closing Remarks By Dr. Somboon Vachrotai ............. 9 V. Paper6 AIDE MEMOIRE ............................... 10 VI. Paper7 AGENDA FOR THE WORKSHOP ................. 12 VII. SUMMARY OF PROCEEDINGS .................. 14 VIII. GROUP SESSIONS ........................... 27 IX. COUNTRY PAPERS ........................... 36 Paper 8 (i) Indonesia ............................ 36 Paper 9 (ii) Malaysia ............................. 45 Paper 10 (iii) Nepal ............................... 54 Paper 11 (iv) Philippines ........................... 59 Paper 12 (v) Singapore ............................ 32 Paper 13 (vi) Horg Kong .... ...................... 63 Paper 14 (vii) Japan ...............................
    [Show full text]
  • Reproductive Health: Collaborating for a Large-Scale Impact by Johanna Van Hise Heart
    Feature Reproductive Health: Collaborating for a Large-scale Impact by Johanna Van Hise Heart Traditional birth attendants in rural Tanzania participate in a study aimed at preventing deaths from postpartum hemorrhage. is to make this drug available and interdisciplinary network of colleagues affordable in the developing world, to tackle multi-layered international health conundrums and look for where 600 million women are opportunities to actively make a large- struggling to survive on two dollars scale difference. a day or less. Mobilizing an Interdisciplinary The industrialized West is insulated from Team Malcolm Potts, M.B., B.Chir., many of the tragic disparities in women’s Their professional connections arise from long careers working in the fields Ph.D., F.R.C.O.G., and Martha health prevalent in the world's developing nations. Women are dying needlessly of of family planning, population growth, Campbell, Ph.D., are acutely aware AIDS—especially those for whom socie- and AIDS prevention. Potts, holder of of a tremendous problem: women are tal status makes it difficult to negotiate the Fred H. Bixby Endowed Chair in bleeding to death. According to the the use of condoms. And upwards of Population and Family Planning and director of the School’s Bixby Program World Health Organization (WHO) 68,000 women are dying annually of complications from unsafe abortions. in Population, Family Planning & more than 130,000 women die each Maternal Health, is a British, Cambridge- year from postpartum hemorrhage— What can be done? Potts and Campbell trained obstetrician and reproductive sci- entist. In 1972 he introduced the manu- a condition for which there is actually have many good ideas.
    [Show full text]
  • The Worldwide Burden of Postpartum Haemorrhage: Policy Development Where Inaction Is Lethal
    International Journal of Gynecology and Obstetrics (2006) 94 (Supplement 2), S116---S121 www.elsevier.com/locate/ijgo KEYNOTE ADDRESS The worldwide burden of postpartum haemorrhage: Policy development where inaction is lethal Malcolm Potts *, Anke Hemmerling School of Public Health, University of California, Berkeley, 518 Warren Hall, Berkeley, CA 94720-7360, USA Abstract timates for maternal mortality rates and progress monitoring mortality extremely difficult; underes- Most maternal deaths occur to women who are not timation is not only possible but very likely. De- attended by trained health professionals. Postpar- spite numerous efforts and global initiatives, begin- tum hemorrhage is the single most common cause ning with the Safe Motherhood Initiative launched of maternal death. The delivery of large haemo- in Nairobi in 1987, the number of women dying chorial placenta in our species predisposes to heavy in childbirth has not substantially decreased over bleeding and can be dealt with only by using effec- the last decade [2,3] (Table 1). With an unprece- tive uterotonics. The 1987 Safe Motherhood Initia- dented increase in the number of women of fertile tive has failed to reduce maternal mortality signifi- age worldwide, it is quite possible that unless bold cantly, and shortages of trained personnel will not new policies are adopted, more women will die from be remedied in the foreseeable future. Bold new pregnancy, childbirth and abortion in the coming 10 policies are imperative and need to be derived from years than in any decade in human history. an appropriate evidence base. It is suggested that these should include the low-cost shock garments in primary health facilities and making misoprostol Table 1 World total maternal deaths easily accessible in both the public and private sec- 1968---1971 4 years at 250,000 1,000,000 deaths tor.
    [Show full text]
  • The Population Policy Pendulum
    Downloaded from bmj.com on 28 November 2005 The population policy pendulum Malcolm Potts BMJ 1999;319;933-934 Updated information and services can be found at: http://bmj.com/cgi/content/full/319/7215/933 These include: References 1 online articles that cite this article can be accessed at: http://bmj.com/cgi/content/full/319/7215/933#otherarticles Rapid responses One rapid response has been posted to this article, which you can access for free at: http://bmj.com/cgi/content/full/319/7215/933#responses You can respond to this article at: http://bmj.com/cgi/eletter-submit/319/7215/933 Email alerting Receive free email alerts when new articles cite this article - sign up in the box at service the top right corner of the article Topic collections Articles on similar topics can be found in the following collections Family Planning (235 articles) Reproductive medicine (307 articles) Health education (including prevention and promotion) (648 articles) Notes To order reprints of this article go to: http://www.bmjjournals.com/cgi/reprintform To subscribe to BMJ go to: http://bmj.bmjjournals.com/subscriptions/subscribe.shtml Downloaded from bmj.com on 28 November 2005 Editorials Family planning can reduce maternal and infant safely as medical practitioners.13 Moving reproductive mortality by as much as 25% by enabling women to health provision down the medical skills’ pyramid is space and avoid unwanted and high risk births.9 It saves critical if, in a world of six billion people, we are serious lives and is therefore an important public health meas- about reaching the millions of couples who want chil- ure.
    [Show full text]
  • Sharing Responsibility: Women, Society and Abortion Worldwide
    SHARINGTHEALANGUTTMACHERINSTITUTE RESPONSIBILITYWOMEN SOCIETY &ABORTION WORLDWIDE STHE HALAN AGUTTMACHERRIN INSTITUTEG RESPONSIBILITY WOMEN SOCIETY &ABORTION WORLDWIDE Acknowledgments haring Responsibility: Women, Society and Pathfinder International, Peru; Tomas Frejka, independent Abortion Worldwide brings together research consultant, United States; Adrienne Germain, International findings about induced abortion and Women’s Health Coalition, United States; Forrest S unplanned pregnancy from the work of The Greenslade, Harrison McKay and Judith Winkler, Ipas, Alan Guttmacher Institute (AGI), assisted by a large num- United States; Dale Huntington, Population Council, ber of individuals and organizations. Susheela Singh, direc- Egypt and United States; Ngozi Iwere, Community Life tor of research at AGI, oversaw the development of this Project, Nigeria; Shireen Jejeebhoy, consultant, Special report, which is based on analyses conducted by her, Programme of Research, Development and Research Stanley Henshaw, deputy director of research, Akinrinola Training in Human Reproduction, World Health Bankole, senior research associate, and Taylor Haas, research Organization, Switzerland and India; Evert Ketting, inter- associate. Deirdre Wulf, independent consultant, wrote the national consultant on family planning and sexual and report, which was edited by Dore Hollander, senior editor, reproductive health, Netherlands; Firman Lubis, Yayasan and Jeanette Johnson, director of publications. Kusuma Buana, Indonesia; Paulina Makinwa-Adebusoye, The
    [Show full text]
  • EDITORIAL Abortion Perspectives
    The European Journal of Contraception and Reproductive Health Care, June 2010;15:157–159 EDITORIAL Abortion perspectives Malcolm Potts Bixby Center for Population, Health and Sustainability, University of California, Berkeley, USA KEY WORDS Abortion; Fertility control; Reproductive rights; Responsibility; Embryology; Theology ........................................................................................................................................................................................................... I look at abortion from the perspective of a doctor a death rate of less than one in 100,000. Where who has performed abortions, a physician who also has abortion is illegal and unsafe, as in much of Africa, it a PhD in embryology, and as someone who had the can be literally 1000 times more dangerous. privilege of working all over the world in various aspects of human reproduction and sexuality. EMBRYOLOGY AND ETHICS ABORTION PROVIDER I am unusual – perhaps unique – as a physician who has done abortions and also has a PhD in embryology. As a young obstetrician in England I practised before Embryologic development is a slow, unbroken chain the reform of the abortion law. I saw many women of complex events. There is no unambiguous mile- who had resorted to illegal, unsafe abortions. The latter stone when one can say, ‘Now the embryo has either failed or were dangerous. Those of us trying to the status of a human being’. It is daily living that change the law were told by senior gynaecologists that forces us to divide biological continuums into arbitrary abortion was exceedingly hazardous, even when legal. stages. For personal use only. In 1966, I was sent to Eastern Europe where abortion Think about the less emotionally charged issues had been legally available and was carried out safely for related to life after birth.
    [Show full text]
  • Getting Family Planning and Population Back on Track
    COMMENTARY Getting family planning and population back on track Malcolm Pottsa After a generation of partial neglect, renewed attention is being paid to population and voluntary family planning. Realistic access to family planning is a prerequisite for women’s autonomy. For the individual, family, society, and our fragile planet, family planning has great power. or policy makers and for practitioners, the reward countries, such as Kenya,8 stalled. The policy community F and satisfaction of family planning is that it is an paid less and less attention to population as a factor in inextricable mixture of helping individuals achieve their development, in resilience to climate change and to the reproductive goals while also maintaining an aware- long-term sustainability of the global economy. The ness of the multiple ways in which demography has urgent need for new family planning initiatives, particu- determined our past and will inevitably shape our larly in sub-Saharan Africa, was set aside. Today, there future. Voluntary family planning programs since the are approximately 424 million African children aged 14 1960s have helped 48% of the world’s population achieve or under. In 2050, Africa could have 770 million children, 1 replacement-level fertility or below. (Replacement-level allowing a great deal of demographic momentum to fertility is the fertility rate at which each generation has build up.1 It is questionable whether some economies in only enough children to replace itself, and thus the sub-Saharan Africa will be able to benefit from the population eventually stops growing. This is generally demographic dividend in the way that much of Asia did.9 when the total fertility rate [TFR] is about 2.1 children These were costly mistakes that will help shape the per woman, although it can be at higher levels in remainder of the 21st century.
    [Show full text]
  • A Women Cannot Die from a Pregnancy She Does Not Have
    VIEWPOINT A Woman Cannot Die from a Pregnancy She Does Not Have More than 99% of maternal deaths* occur in low-resource provements in obstetric care play in reducing maternal By Nadia settings; in parts of the developing world, as many as one mortality? And, which intervention decreases maternal Diamond-Smith in six women die of maternal causes.1 Currently, seven de- mortality most effectively? and Malcolm Potts veloping countries—Afghanistan, Angola, Malawi, Niger, Rwanda, Sierra Leone and Tanzania—have maternal mor- A Hypothetical Exercise tality ratios of at least 1,400 maternal deaths per 100,000 To highlight the role of fertility decline in reducing mater- Nadia Diamond- 2 Smith is a doctoral live births. nal deaths, we conducted an exercise using historical data candidate in the De- Levels of maternal mortality were similarly high in Eu- on fertility and maternal mortality to create two hypothet- partment of Popula- rope and North America only a century ago; today, how- ical scenarios. In the first scenario, fertility levels in a pop- tion, Family and ever, a woman’s lifetime risk of dying from maternal caus- ulation stayed the same between the early 1900s and the Reproductive Health, es is as low as one in 30,000 in these areas (e.g., the MMR early 2000s, while maternal mortality ratios fell to 2005 Johns Hopkins 1,3,4 Bloomberg School of in Sweden in 2005 was 12/100,000). Much of this de- levels. This scenario estimated the impact of improved ob- Public Health, cline in maternal mortality has resulted from improve- stetric care on maternal mortality.
    [Show full text]
  • Population Reports. Series K, Number 14
    , Population Reports SERIES K . ~ . NUMBER 1 MARCH 1975 -.~. : I ' .. .. , ' .. Department of Medical and Public Affairs, The George Washington University Medical Center, 2001 S Street, N.W. Washington, D .C. 20009 -Injectable Progestogens­ This Population Report on injectable proges­ togen contraceptives was prepared by Ward Officials Debate Rinehart and Jane Winter on the basis of pub­ lished and unpublished papers, personal But Use Increases interviews, and correspondence, The assistance of the following reviewers is ap­ The place of the injectable progestogen in family planning preciated: Ridgely C, Bennett, Victor R. Berliner, remains uncertain. Although some compounds have been Elizabeth Connell, Hanni Levi Ellis, Suporn used as injectable contraceptives for over a decade and are Koetsawang, Richard Lincoln, Edwin B, McDaniel. both popular and effective, controversy still surrounds Malcolm Potts, Allan G, Rosenfield, Paul C, them , Schwallie, J , J, Speidel, Andrew Wiley, and Nicholas Wright Frances G, Conn is Executive Editor. Comments and additional updated ma­ Depo-Provera ® (depot medroxyprogesterone acetate), a terial are welcome. product of the Upjohn Company, USA, is currently the only injectable progestogen in widespread use; it is available commercially for contraceptive purposes in 64 countries, Another will be available soon, Schering AG of the Federal The injectable progestogens are not without problems. Republic of Germany is now registering an injectable Over the short run, they disturb menstrual patterns in progestogen,
    [Show full text]
  • Abortion Policy and Fertility Outcomes: the Eastern European Experience*
    ABORTION POLICY AND FERTILITY OUTCOMES: THE EASTERN EUROPEAN EXPERIENCE* PHILLIP B. LEVINE and DOUGLAS STAIGER Wellesley College Dartmouth College Abstract Theory suggests that abortion restrictions will influence fertility outcomes such as pregnancy, abortion, and birth. This paper exploits the variations in abortion policy generated in Eastern Europe in the late 1980s and early 1990s to examine their impact on fertility outcomes. We distinguish among countries with severe, moderate, and few restrictions on abortion access and examine the impact of changes across all three categories. As we hypothesize, the results indicate that countries that changed from very restrictive to liberal abortion laws experienced a large reduction in births. Changes from modest restrictions to abortion available on request, however, led to no such change in births despite large increases in abortions, which indicates that pregnancies rose in response to more liberal abortion availability. This evidence is generally consistent with the situation that was brought about by changes in abortion access in the United States. I. Introduction Political turmoil in Eastern Europe in the late 1980s and early 1990s led to a number of dramatic changes in social policy that may have had important influences on individual behavior. One set of changes involves abortion pol- icy; over this period, a number of countries changed the extent to which abortion was restricted. Most of them removed varying degrees of restrictions that used to exist, but one country (Poland) imposed greater restrictions. Those countries in which abortion access was largely unrestricted prior to this period did not significantly alter their policies. Although these changes had the potential to alter fertility outcomes for women, the specific behavioral implications are far from clear.
    [Show full text]