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Record linkage was used to identify births in 1974 to patients who had received contraceptive services from public family planning clinics in metropolitan Atlanta. The record linkage methodology is described. Results indicated that patient educational level, age. contraceptive choice, and race were the factors most associated with subsequent patient fertility. Black teenage patients experienced the highest fertility. Patients age 20 years and over with some education beyond high school experienced approximately one-third the fertility of less-educated patients. The program effectiveness of the IUD and the Pill was substantially better than that of foam and condoms. Excluding teenagers, the program effectiveness of the IUD was better than the Pill, Changes in family planning services for high-risk patients may help them achieve their- fertility control objectives. Linking family planning clinic records to official birth records as described in this study can help determine clinic success in meeting patient objectives. Other applications of record linkage are discussed briefly. [ABSTRACT FROM AUTHOR]

We reviewed 86 third-trimester induced abortions reported to the Georgia Department of Human Resources in 1979 and 1980. Only three of the 78 with adequate data were classified correctly. Fetal deaths in utero accounted for 67.4 per cent of reported cases and first- or second-trimester abortions 18.6 per cent. The true rate of induced abortions performed in the third trimester was 4.3 per 100,000 legal abortions. Diagnosed anencephaly accounted for two out of the three valid third-trimester induced abortions performed.

The sources for determination of abortion-related deaths in Georgia are the cause of death listed on the death certificate and reports from informal reporting channels. Although Georgia residents 10-44 years of age obtained 19,877 induced abortions in 1975, no deaths related to abortion were found through these two usual sources. To determine the sensitivity of this system, all abortion certificates for 1975 were compared with all death certificates of Georgia females aged 10-44 who died in 1975 and the first 2 months of 1976. Based on the age and racial distribution of the women who received abortions, approximately 13 deaths (from all causes) would be expected to have subsequently occurred during the period of time studied. The authors found only 10. From national death-to-case rates for legal abortion, the expected number actually atrributable to abortion was 0.78 death. Of the 10 deaths, 2 were potentially related to the previous abortion, but a causal relationship to the preceding abortion was not clearly evident for any of the 10 deaths. The data, therefore, tend to support the assertion that no large numbers of deaths related to abortion are undiscovered and that current measurements of abortion mortality are accurate.