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1970 - 1979年美国家庭计划项目对出生、堕胎和流产的影响。

The impact of U.S. family planning programs on births, abortions and miscarriages, 1970-1979.

作者信息

Forrest J D

出版信息

Soc Sci Med. 1984;18(6):461-5. doi: 10.1016/0277-9536(84)90001-7.

Abstract

This paper estimates births (as well as total pregnancies, abortions and miscarriages) averted by program enrollment during the 1970s based not on the common assumption of constant program impact on birth rates, but on assumptions that take into account the changing use of abortion. Estimates of births averted from two national studies are translated into estimates of unintended pregnancies averted and projections of program impact throughout the decade are made assuming constant program impact on pregnancy rates. The number of pregnancies averted is broken into births, abortions and miscarriages averted based on actual distribution of those unintended pregnancies that did occur each year. This methodology is more appropriate to the United States or any other country during a time period when use of abortion has been changing. It also focuses attention on the fact that births averted reflect only part of the program's impact and that much of the program's effect is on averting abortions. During the decade, an estimated 5,434,000 unintended pregnancies were averted by enrollment in the family planning program. In 1979, 4,486,000 women were enrolled in family planning clinics. An estimated 792,000 unintended pregnancies were averted as a direct result, 1 for every 5.7 patients. The 274,000 averted births would have increased the number of births in 1980 in the U.S. from 3,598,000 to 3,872,000, an increase of 8%. The estimated 420,000 abortions averted would have increased abortions in the U.S. about 25% higher, to about 2,000,000.

摘要

本文估算了20世纪70年代因参与计划生育项目而避免的出生人数(以及总怀孕数、流产数和自然流产数),其依据并非是项目对出生率影响恒定这一常见假设,而是考虑到堕胎使用情况变化的假设。将两项全国性研究中避免的出生人数估算值转化为避免的意外怀孕数估算值,并假设项目对怀孕率的影响恒定,对整个十年的项目影响进行预测。根据每年实际发生的意外怀孕的实际分布情况,将避免的怀孕数细分为避免的出生数、流产数和自然流产数。这种方法更适用于美国或堕胎使用情况一直在变化的任何其他国家的某个时间段。它还将注意力集中在这样一个事实上,即避免的出生数仅反映了该项目影响的一部分,而且该项目的大部分效果在于避免堕胎。在这十年间,估计有543.4万例意外怀孕因参与计划生育项目而得以避免。1979年,有448.6万名妇女在计划生育诊所登记。据估计,直接避免了79.2万例意外怀孕,每5.7名患者中就有1例。避免的27.4万例出生数本会使1980年美国的出生人数从359.8万增加到387.2万,增长8%。估计避免的42万例流产本会使美国的流产数增加约25%,达到约200万例。

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