Women in difficult circumstances: war victims and refugees.

The majority of problems that women are confronting today originate from a lack of respect for human and reproductive rights. Escalating war crises are producing an enormous number of civilian victims, of whom women and children comprise the major part. Rape used as a war tactic in Bosnia has proven to be a very powerful tool. War in Bosnia has provided a tragic incentive to work on strategies and tactics for reaching the victims in such chaotic and unpredictable circumstances.

Initiation of contraception postpartum.

In this case-control study, we compared 97 cases who became pregnant within one year postpartum and underwent an induced abortion to 97 non-pregnant controls who were postpartum for a similar time interval. Two percent of cases conceived when fully breastfeeding and amenorrhoeic. A logistic model was used to identify risk factors for an unwanted pregnancy early postpartum. The most important risk factors were: time since menses resumption, number of menstrual bleedings, contraception, parity and education. The strong protective effect of breastfeeding and amenorrhoea was evident in the first 24 weeks postpartum, from 25-32 weeks the effect of amenorrhoea persisted, and after 32 weeks neither variable had any effect. The main risk factor for the outcome pregnant/non-pregnant in the first and the second interval was time since menses resumption; time since weaning works as a distal causal factor. After 32 weeks postpartum, the effect of contraceptive use and parity became important. The results of this case-control study suggest that the lactational amenorrhoea method, a recently proposed method of family planning, can be used up to 32 weeks postpartum for amenorrhoeic and fully or partially breastfeeding Slovenian women. Afterwards, women should be encouraged to use reliable contraceptives regardless of their breastfeeding and amenorrhoea status.

Fertility survey in Slovenia, 1989.

PIP: Slovenia, an independent state since January 1992, conducted a KAP-type survey of 1117 male and female respondents aged 15-44 years between August 1989 and March 1990. The aim of the survey was to assess the social, medical, and demographic factors in low fertility and to identify fertility determinants. An explanation was needed for inadequate use of contraceptives, which were easy and inexpensive to obtain, and for reliance on abortion. The questionnaire included 180 questions on 16 topics; the same questions were asked of men and women with a few exceptions. There was a mean age of 30 years and 59% were married. 77% were employed and 59% had finished secondary school. The average number of children was 1.3; desired number of children was 2.4. 43% of women with children wished to stop childbearing. 13% desired an additional child; 32% wanted 2 or more children and 12% wanted 3 or more children. 62% believed that every woman should have a child. The ideal family of 2 children was reported by 60%. 31% favored 3 children. 58% considered a family size of 2 children appropriate for their own family. Over 75% reporting 2 children appropriate for their family size thought 2 children were ideal. 99% considered family planning as a mutual decision. 24% thought men's participation in decision making was inadequate, because men did not have sufficient opportunity to speak with a doctor. Women did not have confidence in men and wanted to make decisions alone. There were significant differences in attitudes by sex. 87% of men and 90% of women were sexually active. 41% reported that at the beginning of their sexual activity there was little discussion of contraception. Of those discussing contraception, 57% decided to use contraceptives of which 71% decided on regular use and 20% on use only during the fertile phase of the cycle. 33% of women who decided alone relied on regular use of withdrawal, and a larger number of joint decisions involved withdrawal as a method of choice. The greatest differences in subjective and objective knowledge were for condoms, diaphragm, and foam/jelly. Ever use of contraception was 85% for women and 56% for a reliable method. There were big differences between characteristics of women who used or did not use contraception. Traditional sexual behavior occurs for most Slovenians; family planning is not an accepted part of their lives.^ieng

[Characteristics of patients with laparoscopically verified pelvic inflammation]. / Obiljezja bolesnica s laparoskopski utvrdenom pelvicnom upalom.

Comparing the characteristics of the two groups young women: one with laparoscopically confirmed pelvic inflammatory disease (PID) and the other with no PID (control group) but corresponding to the first group by age, marital status and number of pregnancies, it has been found that the patients with PID are below 25 years of age, have a lower degree of education (p less than 0.05), and 25.5% of them do not use any contraceptive method (p less than 0.01). It has also been observed that in their gynecologic history they mention an episode of lower abdominal pain (p less than 0.01). A further comparison of this finding with laparoscopically confirmed adnexal changes has shown that in 50% of the study group patients there exist sequelae of an earlier PID episode (asymptomatic salpingitis). The results obtained point to the need for carefully connecting the characteristics of the population regarding the risk of PID and the minimal clinical symptoms in diagnosing PID.

[Useful results from the study of induced abortion in routine practice in gynecology departments]. / Koristenje rezultata proucavanja vestackog prekida trudnoce u rutinskom radu ginekoloskih odjeljenja.

The article presents the evaluation of the application of the results proceeding from 25 clinical-epidemiologic studies in the field of induced abortion (IA). They were performed with the aim of optimizing the whole procedure and the diminishing of early complications at the former Family Planning Institute and at the University Department of Obstetrics and Gynecology in Ljubljana in the period from 1968 to 1988. On the basis of the accessible data provided by official statistics and the results obtained by the aimed evaluation survey performed at all Slovenian gynecological departments and in some other Yugoslav health-care facilities, the following can be concluded: -the results obtained by the studies could be used more efficiently in routine work at gynecological departments, permanent evaluation of the complete IA procedure concerning the behavior of women and operators is a necessity, and--a periodical evaluation is needed after the results of new studies have been introduced. Beside all this, an agreement would be necessary regarding the doctrinary approach to the IA procedure on a certain territory with the same characteristics of women and the same conditions for work. Additional studies of new, nonsurgical methods of pregnancy interruption with new prostaglandin analogues and antiprogesterones are needed, and a more intensive dissemination of results in professional, as well as in popular press releases, should be provided for.

[Present views on sterilization]. / Danasnji pogledi na sterilizaciju.

The author shows the increase in the use of sterilization (males and females) as a family planning method in the world at large, and also in Solvenia. She analyses causes which justify the increased use of sterilization and puts forward medical reasons which have changed attitudes towards sterilization, these being a prolongation of the woman's fertile age, a higher risk of complications in motherhood after the 35th year of age, and a higher risk of the use of some contraception methods in women over 35 years old.