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Objective: Poland has a restrictive abortion law. Emergency contraception (EC) is expensive and available only on prescription, which is not easily obtainable in public health care. We aimed to identify the main reasons for EC requests, observed failure rates and the type and incidence of adverse effects., Design: Prospective single-center observational study., Population: A cohort of women living in Warsaw, who requested EC., Methods: Data were collected via a questionnaire completed by healthcare providers prescribing EC, and included age, date of the request, previous EC use, time from intercourse to clinic visit and day of menstrual cycle on which intercourse took place., Main Outcome Measures: Reason for EC request, time lapse between unprotected intercourse and EC use, age of women requesting EC, reported cases of pregnancy., Results: A total of 4655 women requested EC. Of these 62.9% (n = 2928) were ≤25 years old. During follow up, 0.75% (31 individuals) became pregnant. Adverse effects of hormonal EC were rare and mild. The main reason for requesting EC was problems associated with condoms (63.2%, n = 2609). The mean interval between unprotected intercourse and EC use was 21.2 h, but 26.7 h when EC failed (n.s.). Considering intake within and after 24 h, the difference was significant (p < 0.05)., Conclusions: Women living in Warsaw seeking EC used the EC product very soon after unprotected intercourse, and this was probably one of the most important reasons for the low pregnancy rates in the studied population., (© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.)

Prenatal and preconceptual testing and screening programs provide information on the basis of which people can choose to avoid the birth of children likely to face disabilities. Some disabilities advocates have objected to such programs and to the decisions made within them, on the grounds that measures taken to avoid the birth of children with disabilities have an "expressive force" that conveys messages disrespectful to people with disabilities. Assessing such a claim requires careful attention to general considerations relating meaning, intention, and social practices; it has only begun to receive such attention. Building on work by Allen Buchanan, who has challenged this claim, I further consider the disabilities advocates' objection, ultimately concluding that it is misplaced; neither individual actions nor general practices of this type necessarily express disrespectful messages.

Objectives: To assess knowledge and attitudes of pregnant women towards HIV infection and testing, and to compare them according to the outcome of the pregnancy (elective abortion vs delivery)., Methods: Between March 30 and April 26, 1992, all women ending their pregnancy in a medical center located in South Eastern France, were asked to complete an anonymous questionnaire: 3,589 (89.6%) responded: 2,825 women who delivered and 764 who chose abortion., Results: 61.7% of the women who delivered and 24.1% of the women who chose abortion declared having been tested for HIV during pregnancy (p < 0.001). Among women who reported not having been tested, very few did so because they refused the test (2% among women who deliver and 1.5% among women who terminated pregnancy). A total of 2.6% of women tested during prenatal care and 19.6% in the context of abortion did not know the result of their test (p < 0.001). Knowledge about HIV transmission among women who delivered dit not differ significantly from that of women who terminated pregnancy. However risky behaviors were more frequent among the latter group (38.8% vs 17.7%, p < 0.001)., Conclusion: This research confirms that systematic HIV screening during prenatal care was already diffused in France but remained mainly motive by foetal concerns and was not always associated with adequate preventive counselling, specially for migrant women and women with a low level of education. HIV screening and counselling is not guaranteed for women coming for elective abortion although they are more at risk for HIV infection. In spite of psychological difficulties, systematic proposal of HIV screening should be extended to the context of elective abortion.

This article examines the debates surrounding the personhood of the fetus in relationship to the mother as these issues were socially constructed in the Mississippi state legislature in 1990 and 1991. In examining the patriarchal assumptions that underlay the proposed Mississippi legislation, the article also addresses the legal ramifications of defining the fetus as a person whose rights are posited as equal to, or greater than, those of the pregnant woman. By relying on medical/scientific definitions of personhood, the groundwork for further refinement and monitoring of women and fetuses is being established, such that what it means to be human is increasingly defined in essentialist terms. In the final evaluation, focusing on conception as the moment in which an "unborn child" is created sets the stage for the ultimate essentialist metaphor: a eugenic definition of personhood.

To study the role of soluble interleukin-6 receptor (sIL-6R) during pregnancy, sIL-6R levels in the sera of pregnant women in the first, second, and third trimesters were determined and found to remain unchanged during pregnancy, but were significantly higher than those in nonpregnant women in the follicular, ovulatory, and luteal phases of the menstrual cycle (P < 0.001). IL-6 levels, however, in the sera of pregnant women at all trimesters showed no difference from those in nonpregnant women at any stage of the menstrual cycle. Recombinant sIL-6R (rsIL-6R) augmented hCG production by rIL-6-stimulated trophoblasts dose dependently, but failed to enhance hCG production by unstimulated trophoblasts. rIL-6- and rsIL-6R-induced hCG production was significantly blocked by anti-IL-6R antibody, PM1; antisignal transducing glycoprotein 130 (gp130) antibody, GPX7; or a tyrosine kinase inhibitor, genistein. Thus, sIL-6R in serum from pregnant women forms a complex with placental and decidual IL-6 in a manner similar to trophoblast membrane-bound IL-6R. These two discrete types of IL-6R and IL-6 complex might act cooperatively by binding to gp130 and subsequently evoking tyrosine kinase activity in the trophoblasts to produce hCG in vivo.

This paper had identified a contemporary ethicolegal dilemma concerning the circumstances, if any, in which a pregnant woman's refusal of medical treatment may be judicially overridden either in her interests or those of the unborn child. On the one hand, the obstetrician will be concerned about the interests of both his patients in potentially life-threatening situations when they can be protected by what might be regarded as relatively straightforward procedures and where to fail to take those steps might expose the practitioner (at least outside New Zealand where its accident compensation legislation has impact in this regard) to allegations of negligence. On the other hand, the imposition of treatment in these circumstances will necessarily interfere with the woman's rights of autonomy and self-determination. In such cases also, the conduct of medical procedures in the face of an express prohibition by the woman may give rise to liability for battery. (In New Zealand, such a potential liability would not, in the writer's view, be affected by the prohibition on proceedings for damages for medical misadventure as contained in the Accident Rehabilitation and Compensation Insurance Act 1992.) At the heart of an analysis of this issue is the status of the fetus as it is the fact of the woman patient's pregnancy which distinguishes the cases discussed in this paper from others in which the Courts have had to deal with refusals of treatment by those competent to do so. In regard to this aspect, the approach of the Courts in various jurisdictions has arguably been confused and contradictory.(ABSTRACT TRUNCATED AT 250 WORDS)

Hundred-forty-eight pregnancies in immigrants from South-east Asia were analyzed. A high number of such patients underwent legal abortion; in the women who carried on pregnancy, the authors considered the course of pregnancy, delivery and puerperium and some neonatal parameters. The results have shown that pregnancy in immigrants presents a certain amount of risk.

A case of combined intrauterine and extrauterine pregnancy as rare complication of legally induced abortion is reported. After several ultrasonic examinations, a concomitant ectopic gestation was suspected and subsequently confirmed on laparotomy and on microscopic examination. The early preoperative diagnosis of combined gestation is nowadays mainly based on its exact localisation by vaginal ultrasound. The ultrasonic signs and the predisponsing factors for the development of combined gestation will be discussed.

Developments in medical technology continue to increase the potential for conflict between the rights of mother and fetus during pregnancy. Although a number of court cases have ordered medical treatment over the objections of pregnant patients, the law has yet to address definitively the difficult issues raised by this kind of forced intervention.

The article describes experiences in a family guidance clinic when counselling women in early pregnancy. The women voluntarily sought help in deciding whether to have a legal abortion or to have the child. In this setting we have focussed mainly on the emotional relationship between the partners, and on the psychological reactions of the women confronted with this difficult choice.

A methodology previously used to calculate the number of unintended pregnancies averted nationally through publicly funded contraceptive services has been adapted for a state-level analysis in California. An estimated 136,800 unintended pregnancies--which would result in approximately 36,000 births, 85,100 abortions and 15,700 miscarriages--are averted each year because publicly funded contraceptive care is available from clinics and private physicians in California. Federal and state expenditures of $46 million for contraceptive services in California in FY 1989 resulted in an estimated savings of $232-$509 million in public costs for abortions, for prenatal and maternity care and for medical care, welfare and supplementary nutritional programs during the first two years after a birth. These savings represent an average of $7.70 saved for each dollar spent to provide contraceptive services. This savings/cost ratio is 75 percent higher than that previously estimated for the United States as a whole.

The acceptability of pregnancies was studied in two birth cohorts in Northern Finland which represent 96% of all births in the region in 1966 (12,068 births) and 99% (9362 births) in 1985-1986. The numbers of women of fertile age in the area during these years were 148,000 and 158,000, so that fertility may be said to have fallen from 81 to 59 per 1000. The pregnancy was wanted in 63.0% of cases and unwanted in 12.2% in 1966, the rest being classified as accepted later. The corresponding figures in 1985-1986 were 91.8% and 1.0%. The latter figures changed very little when maternal age, parity and social class were standardized to the 1966 levels. Acceptability was connected with age, in that the age groups in which childbearing was most frequent, 20-25 years in 1966 and 26-30 years in 1985-1986, had the highest incidence of desired pregnancies. In spite of the fact that there were 1.4 times as many births per woman aged 15-49 years in the former cohort, more wanted children were born to the age group 25-34 years in the latter cohort. The percentage of wanted pregnancies also varied with the woman's parity, social class and marital status. The children in the 1966 cohort were followed until the age of 14 and the incidences of cerebral palsy (CP) and mental retardation (IQ less than 71) were 3.2 times higher among the unwanted children than among the wanted ones.(ABSTRACT TRUNCATED AT 250 WORDS)

The Janis-Mann model of decision-making provides the theoretical orientation for empirical analyses of decisions to deliver or abort in matched samples of never-married women. Results focus on four variables: happiness about pregnancy; initial acceptance of delivery or abortion; ease of decision-making; and satisfaction with final choice. Path analyses summarize findings, which are discussed in terms of conflict resolution strategies.