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Milbank Memorial Fund Quarterly 43, no. 4, pt. 2 (October): 263-271. Awan, A. K. 1969. "Attempted illegal abortions in 156 cases of fetal loss occurring among 1,147 married women -Saddar Pregnancy Study (1963-65)." Journal of the American Medical Women's Association 24, no. 7 (July): 571-586 para Beric, B. M., and M. Kupresanin. 1971. "Vacuum aspiration, using cervical block, for legal abortion as an outpatient procedure up to the 12th week of pregnancy. Lancet 2 (Sep tember 18):619-620. 10 Berthelsen, H, and E. Østergaard. 1958. "Komplikationer og mortalitet ved legal abortus provocatus." Ugeskrift for Laeger 121, no. 31:10051009 1 Brosset, A. 1954. "Endometriosis in the vaginal scar following vaginal hysterotomy for therapeutic abortion." Acta Obstetrica et Gynecologica Scandinavica 33:445-456, 12. Bulgaria: Laws, statutes, etc. "Instruction No. 0-27 of the Ministry of Public Health to regulate the artificial interruption of pregnancy." International Digest of Health Legislation. 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Céskoslovenská Gynekologie 33, no. 8 (October):597 602. 19 Chi, I. C., L. P. Chow, and R. V. Rider. 1972. "The randomized response technique as used in the Taiwan outcome of pregnancy study." Studies in Family Planning 3, no. 11 (November): 265269. 20 Chow, L. P. 1973. Measurement of the Incidence of Induced Abortion: Preliminary Results from a Study in Taiwan Presented at IUSSP Workshop on Abortion, Chapel Hill, N.C., 19-23 March. 22. Cutright, P. 1972. "The teenage sexual revolution and the myth of an abstinent past." Family Planning Perspectives 4, no. 1 (January):24–31. 22. Czechoslovakia: Institute for Health Statistics. Zdravotnicka Statistika CSSR Potraty Prague. Published annually since 1964. 23. Daily, E. F., N. Nicholas, F. Nelson, and J. Pakter. 1973. "Repeat abortions in New York City: 1970-1972." Family Planning Perspectives 5, no. 2 (Spring):89-93. 24. David, H. P. 1970. Family Planning and Abortion in the Socialist Countries of Central and Eastern Europe. A Compendium of Observations and Readings. New York: Population Council. 25. David, H. P., and N. Wright. 1971. "Abortion legislation: the Romanian experience." Studies in Family Planning 2, no. 10 (October):205-210. 26. David, H. P., Z. Alam, and M. G. Kalis. 1972. Abortion Legislation: A Summary International Classification Silver Spring, Maryland: AIR/ Transnational Family Research Institute. 27. David, H. P. 1973. "Psychological studies in abortion." In Psychological Perspectives on Population Edited by J. T. Fawcett. New York: Basic Books, pp. 241-273. 28 David, H. P., M. G. Kalis, and C. Tietze. 1973. Selected Abortion Statistics: An International Summary Silver Spring, Maryland: AIR/ Transnational Family Research Institute. 29. David, H. P., and H. L. Friedman. 1973. "Psychosocial research in abortion: A transnational perspective." Abortion Experience in the United States. Edited by H. J. Osofsky and J. D. Osofsky. New York: Harper & Row. 30. Denmark: Laws, statutes, etc. 1970. 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"Health and family planning services in the Chinese People's Republic." Studies in Family Planning 3, no. 7 Suppl. (July): 165–176. 37. Field, M. G. 1956. "The re-legalization of abortion in Soviet Russia." New England Journal of Medicine 255, (30 August):421-427. 38 Finland. Laws, Statutes, etc. 1970. "Law No. 239 of 24 March 1970 on the interruption of pregnancy." International Digest of Health Legislation 21, no. 4.699-705. 38A Central Statistical Office. Suomen Tilastollinen Vuosikirja. Published annually. 39 Finland: National Board of Health. Yleinen terveydenja sairaanhoito Helsinki. Published annually. 40. Freda, V. J., J. G. Gorman, R. S. Galen, and N. Treacy, 1972. "The need for RhoGam following abortion." In Abortion Techniques and Services. Edited by S. Lewit. Amsterdam: Excerpta Medica, pp. 38-41. 41. Frejka, T., and J. Koubek. 1968 "Les avortements en Tchecoslovaquie." Population et Famille 16, no. 1:1-57. 42. Gál, G., A. Nemeth, and S. Fazekas. 1965. "Ein Beitrag zur Frage der septischen, kriminellen, postabortalen Nierenkomplikation" Zeitschrift für Ärztliche Fortbildung 59, no. 11 (1 June):592-596. 43. Geijerstam, G. af. 1971. "Fertility control by induced abortion." In Control of Human Fertility. Edited by E. Diczfalusy and U. Borell. Stockholm: Almqvist & Wiksell, pp. 219-240. 44. George Washington University Medical Center: Department of Medical and Public Affairs. 1973. "Clinical use of PGs in fertility control." Popula tion Report, Series F, no. 1 (April). 45. George Washington University Medical Center: Department of Medical and Public Affairs, 1973. "Menstrual regulation: What is it?" Population Report, Series F, no. 2 (April). 46. George Washington University Medical Center: Department of Medical and Public Affairs. 1973. "Uterine aspiration techniques." Population Report, Series F, no. 3 (June). 47. German Democratic Republic: Laws, statutes, etc. 1972. "Law of 9 March 1972 on the interruption of pregnancy." International Digest of Health Legislation 23, no. 4:767-770. 48. Goldsmith, A., G. Goldberg, H. Eyzaguirre, and C. Lizana, 1972. "Immediate postabortal contraceptive device insertion: A double-blind study." American Journal of Obstetrics and Gynecology 112, no. 7 (April):957 962 49. Hall, R. E. 1965. "Therapeutic abortion, sterilization, and contraception. American Journal of Obstetrics and Gynecology 91, no. 4 (15 February): 518-532. 50. Han, S. H. 1973. The Study on Induced Abortion 1971 Fertility Abortion Survey Special Report Series No. 2, Korean Institute for Family Planning (April). 51 Hirschler, I. 1961. "Die Abortsituation in der Volksrepublik Ungarn. Internationale Abortsituation, Abortbekämpfung, Antikonzeption. Edited by K. H. Mehlan. Leipzig: Thieme, pp. 114-122. 52 Hong, S. B. 1971. Changing Patterns of Induced Abortion in Seoul, Korea. Seoul. 53. Hungary: Central Statistical Of fice. Demográfiai Évkönyv. Budapest. Published annually. 54. Hungary: Central Statistical Office. 1972. Perinatális halálozás. Budapest. 55 Hungary: Central Statistical Office. 1973. A Vetélések Adatai 1971. Budapest. 56. Hungary: Demographic Research Institute. 1970. Family Planning in Hungary. Main Results of the 1966 Fertility and Family Planning (TCS) Study Budapest (In English). 57 India: Laws, statutes, etc. 1971. "The Medical Termination of Pregnancy Act, 1971." International Digest of Health Legislation 22, no. 4:965967. 58. Inman, W. H. W., and M. P. Vessey. 1968. "Investigation on deaths from pulmonary, coronary, and cerebral thrombosis and embolism in women of child-bearing age. "British Medical Journal 2 (27 April): 193-199. 59. Institute for Sex Research. Indiana University. Unpublished data. 60. International Planned Parenthood Federation: Europe Region. 1972. Legal Abortion in Britain. London (November). 61. Israel: Central Bureau of Statistics. 1972. Diagnostic Statistics of Hospitalized Patients, 1968. Special Report Series No. 373. Jerusalem. 62. Japan: Ministry of Health and Welfare. Yu Sei Ho Go ToKei Ho Koku. Published annually. 63. Kleinman, R. L. (ed.). 1972. Induced Abortion. London: International Planned Parenthood Federation. 63A. Klinger, A. 1970. "Consequences of the legalization of induced abortion in eastern Europe." Therapeutische Rundschau 27, no. 10:681-692. 64 Klinger, A. 1973. Report on the Legislation, Practices and Statistics About Induced Abortion in the European Socialist Countries. Presented at IUSSP Workshop on Abortion Research, Chapel Hill, 19-23 March. 65 Klintskog, E. 1952. "Om mortaliteten vid de legala aborterna utförda i Sverige 1935-1951." Läkartidningen 49, no. 26 (27 June): 1691-1699. 66 Korea. 1971 Fertility-Abortion Survey. Unpublished data. 66A. Korea: Laws, statutes, etc. "The Maternal and Child Health Law" and "Presidential decree No. 6713 of 28 May 1973 for the implementation of the Maternal and Child Health Law." International Digest of Health Legislation. On press. 67. Lewit, S. 1973. "Sterilization associated with induced abortion: JPSA findings." Family Planning Perspectives 5, no. 3 (Summer): 177-182. 68 Mainichi Newspapers: Population Problems Research Council. 1970. Family Planning in Japan. Opinion Survey by the Mainichi Newspapers. Tokyo. 69. Mainichi Newspapers: Population Problems Research Council. 1972. Summary of Eleventh National Sur vey on Family Planning Series No 23, Tokyo. 70 Manabe, Y., and A. Nakajima. 1972 "Laminaria-metreurynter method of midterm abortion in Japan." Obstetrics and Gynecology 40, no. 4 (October): 612-615. 71. Mehlan, K-H. 1965. "Legal abortions in Romania." Journal of Sex Research 1, no. 1 (March):31-38. 72. Mehlan, K-H. Personal communication. 73. Miklos, M. 1973. "Az abortuslegalizáció népegsézsegügyi hatása es egyes társadalmi kisérőjelenségei magyarországon." Demografia 16, no 1:70-113. 74. Mojic, A. 1969. "Kretanje pobacaja i porodaja u SFRJ u toku poslednjih pet godina." Jugoslovenska Ginekologija i Opstetricija 9, no. 1-2 (JanuaryJune): 1-10. 75. Moon, H. S., S. H. Han, and S. Choi. 1972. Fertility and Family Planning An Interim Report on 1971 FertilityAbortion Survey Seoul: Korean Institute for Family Planning (September). 76. Moriyama, Y., and O Hirokawa 1966. "The relationship between artificial termination of pregnancy and abortion or premature birth." In Harmful Effects of Induced Abortion. Edited by Y. Moriyama Tokyo: Family Planning Federation of Japan, pp. 64-73. 77. Muramatsu, M. (ed.). 1967. Japan's Experience in Family PlanningPast and Present Tokyo: Family Planning Federation of Japan, Inc. (March). 78. Muramatsu, M 1970. "An analysis of factors in fertility control in Japan." Bulletin of the Institute of Public Health 19, no. 2:97-107. 79. Muramatsu, M. 1974. "Incidence of abortion in Japan: Analyses and results." In International Population Conference Liege 1973, August 27-September 1 Vol. 2. Liege: International Union for the Scientific Study of Population, pp. 319-331. 80. Nazer, I. R. (ed.). 1972. Induced Abortion- A Hazard to Public Health? Beirut: International Planned Parenthood Federation, Middle East and North Africa Region. 81. New York City Department of Health: Health Services Administration. Unpublished data. 82. New York City Department of Health: Health Services Administration. 1972. New York City Abortion Report: The First Two Years (October). 83 Nordic Council. Yearbook of Nordic Statistics. Stockholm. Published annually. 84. Nygren, K. G., and E. D. B. Johansson. 1973. "Insertion of the endouterine Copper-T (TCu 200) immediately after first trimester legal abortion." Contraception 7, no. 4 (April):229–306. $5 Olsen, C. E., H. B. Nielsen, and E. Østergaard. 1970. "Complications to therapeutic abortions." International Journal of Gynaecology and Obstetrics 8, no. 6 (November): 823-829. 56 Oram. V. 1952. "Dødsårsag og dødelighed ved legal svangerskabsafbrydelse in årene 1940-50 i Danmark. Ugeskrift for Laeger 114, no. 16.482-485 87 Ozbay, F., and F. C. Shorter. 1970. 88 Pakter, J., D. O'Hare, M. Helpern, 91. Romania: Laws, statutes, etc. 1967. 92 Romanian Communist Party: Central Committee. 1968. "Analiza starii de senatate a populatiei si masurile privind perfectionarea organizarii retelei sanitare si imbunatatirea asistentei medicale in Republica Socialista Romania." Scinteia (27 October). 93 Schulman, H., I. H. Kaiser, and G. Randolph. 1971. "Outpatient saline abortion." Obstetrics and Gynecology 37, no. 4 (April):521-526. 34. Serenko, A. 1969. "Abortkak sotsial 'no-gigienichskaya problema." Prepodavanie Sotsial'noy gigiyeny i Orgamizatsii Zdravookhraneniya Meditsinskikh Institutakh Edited by A. Serenko Moscow: I. M. Sechenov Medical Institute, pp. 34-35. 95 Simon, N. M., and A. G. Senturia. 1966. "Psychiatric sequelae of abortion. Review of the literature, 19351964." Archives of General Psychiatry 15(October): 378-389. 96 Singapore: Laws, statutes, etc. 1970. "Act no. 25 of 1969 concerning artificial interruption of pregnancy." International Digest of Health Legislation 21, no. 4:843-850. 97 Singapore: Family Planning & Popu lation Board. Unpublished data. 99. Sokolova, N. S. 1970. "Statistical 101. Stewart, G. K., and P. J. Goldstein. 103. Op. cit., p. 49. 107. Tatum, H. J. 1972. "Intrauterine of Obstetrics and Gynecology 112, no. 108. Tietze, C. 1950. "Therapeutic abor- 110. Tietze, C., and C. E. Martin. 1957. 111. Tietze, C. 1964. "The demographic 112. Tietze, C. 1969. "Mortality with. 113. Tietze, C. 1970. "Abortion laws and 114. Tietze, C. 1970. "United States: 115. Tietze, C., and S. Lewit. 1972. 116. Tietze, C. 1972. "The potential im- 120 Tunisia: National Family Planning 120A Tunisia: Laws, Statutes, etc. 1973. "Décret-Loi No. 73-2 du 26 Septembre 1973, portant modification de l'article 214 du Code Pénal." Journal Officiel de la République Tunisienne Tuesday 25-Thursday 28 September. 121 United Kingdom. Department of Health and Social Security, 1972. On the State of the Public Health London: Her Majesty's Stationery Office. 122 United Kingdom: Department of Health and Social Security, 1972. Report on Confidential Enquiries into Maternal Deaths in England and Wales 1967-1969 London: Her Majesty's Stationery Office. 123. United Kingdom: Laws, statutes, etc. 1968. "Abortion Act 1967." International Digest of Health Legislation 18, no. 4:887-889. 124 United Kingdom: Office of Population Censuses and Surveys. The Registrar General's Quarterly Return for England and Wales. London: Her Majesty's Stationery Office. Published quarterly. 125. United Kingdom: Office of Population Censuses and Surveys. The Registrar General's Statistical Review of England and Wales Supplement on Abortion London: Her Majesty's Stationery Office. Published annually since 1968. 126. United Kingdom: Office of Population Censuses and Surveys. The Registrar General's Weekly Return for England and Wales. London: Her Majesty's Stationery Office. Published weekly. 127 United Kingdom: Scottish Home and Health Department. Health Bulletin Published monthly. 128. United Nations: Statistical Office. 1971. Demographic Yearbook New York. Supplemented by unpublished data. 129. United States: Center for Disease Control. Abortion Surveillance Report-Legal Abortions, United States Annual Summary Atlanta. Published annually since 1970. 130. United States: Commission on Population Growth and the American Future. 1972. Population Growth and the American Future Washington, DC: US Government Printing Office. 131 United States: Supreme Court of the United States, 1971. United States v. Vuitch. 21 April. 132. United States: Supreme Court of the United States. 1973. Doe v. Bolton. 22 January. 133. United States: Supreme Court of the United States. 1973. Roe v. Wade. 22 January 134. United States: United States District Court for the District of Columbia. 1969. United States v. Vuitch. 10 November. 135. Valaoras, V. G., A. Polychronopoulou, and D. Trichopoulos. 1969. "Greece: postwar abortion experience." Studies in Family Planning 1, no. 46 (October): 10-16. 136. Vojta, M. 1961. "Die Abortsituation in der Tschechoslowakischen Sozialistischen Republik." In Internationale Abortsituation, Abortbekämpfung, Antikonzeption. Edited by K.-H. Mehlan. Leipzig: Thieme, pp. 107 113. 137. Wagatsuma, T. 1965. "Intraamniotic injection of saline for therapeutic abortion." American Journal of Obstetrics and Gynecology 93 (1 November):743-745. (Quoting Hashizama) 138 Warner, S. L. 1965. "Randomized response: a survey technique for eliminating evasive answer bias" American Statistical Association Journal 60 (March):63-69. 139. Weatherall, J. A. C. 1972. "Abor tion deaths." British Medical Journal 4 (21 October): 176-177. 140. World Health Organization. 1970. "Abortion laws: A survey of current world legislation. International Di gest of Health Legislation 21, no. 3: 437-512. 141. World Health Organization. 1970. Spontaneous and Induced Abortion Technical Report Series No. 461 Geneva. 142 World Health Organization. Unpublished data. 143 Wright, C. S. W., S. Campbell, and J. Beazley. 1972. "Second trimester abortion after vaginal termination of pregnancy." Lancet 1 (10 June) 1278-1279. The Population Council is an organization es tablished in 1952 for scientific training and study in the field of population. 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The Indian Investment in Family Planning 1971 232 pp Dr. TIETZE. I have limited myself to European and North American areas. As you can see the number of abortions involved in these statistics are very large and the number of deaths are small, you will have to look primarily at the pattern of rates as a whole. Individual death rates based on half a dozen deaths are, of course, subject to random variation. Now I would like to stress that in all of these countries, except the United States, there exists a special system of reporting legal abortions which also includes the associated deaths; hence it is possible to relate numbers of deaths from abortion to the characteristics of the women, including the duration of the pregnancy and the surgical procedures. I would say that all of the countries included here have statistical Systems in which I would have considerable confidence. You can see, for instance, in Table 3, how the mortality has declined in Sweden since the 1940's and in Denmark, Hungary, and Czechoslovakia since the 1950's. The important thing to consider here, is the fact. that the practices of abortion, as regulated by law and by medical custom, from country to country. For instance, in Sweden in past years, most abortions were done quite late in pregnancy but there has been a dramatic shift in the last 5 years from later to earlier abortions. A similar shift has taken place, less dramatically, in England and also in the United States, whereas in Czechoslovakia and in Hungary abortion has always been limited to the first 12 weeks of pregnancy, with the exception of rare medical cases. If you look at the statistics for England and Wales and for the United States, as shown in table 3, you will see that the mortality rates are substantially higher in England than in the United States; the reason for this lies in a combination of several factors. First, the medical authorization required by the British Abortion Act results in a larger proportion of legal abortion in the second trimester. Second, in the United Kingdom, abortion is far more often combined with sterilizing operations which increases the risk to the woman because she is really subject to two procedures, and third, our British colleagues still use procedures in the second trimester which are not considered suitable for the second trimester by American gynecologists. In table 4 I have made an attempt to compare some data from England and Wales and from New York State. While the overall mortality rates in table 3 may be quite different, when you come down to abortions without sterilization in the first trimester, at 12 weeks of gestation or less, the mortality rates in England is 3.8 and in New York it is 2.9 per 100,000 legal abortions. Given the small numbers of deaths on which these rates are based, they are certainly not significantly different, nor are they different in the second trimester, at 13 weeks of gestation or more. I would like to mention specially that the deaths shown here from New York State include the deaths of several women who obtained abortions in New York, because of its liberal abortion law, then went home, developed complications, and died in their home States. The population council, together with the New York City Health Department and with the Center for Disease Control, sponsored a survey of all gynecologists in the United States to locate these additional deaths. |