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  • Title: [Contraception and abortion in the countries of eastern Europe].
    Author: Hassoun D, Jourdain A.
    Journal: Cah Sociol Demogr Med; 1995; 35(2):99-123. PubMed ID: 7497025.
    Abstract:
    For various reasons, including the population policies of the former Socialist countries, abortion is much more frequent than contraception in Central and Eastern Europe. The contrary occurs in Western countries. In the current context, countries in Central and Eastern Europe should improve abortion services and this should be a priority target in their health policy. The study does not detect a clear-cut advantage as concerns substituting contraception to abortion in these countries in terms for instance of reducing maternal mortality. In fact a health policy favouring contraception instead of abortion is firstly inspired by political or ethical reasons. If implemented in Central and Eastern Europe, it would require several decades to bear evident results. Although most countries of Europe have total fertility rates of under 2, these low rates are achieved in western and northern Europe primarily through widespread contraceptive usage with abortion serving as a backup, while in eastern Europe abortion plays the primary role. In eastern European countries, access to abortion preceded diffusion of modern contraception. When modern contraceptive methods became available in the 1960s, they did not reach the eastern European countries because of the lack of communication between Communist societies and the West. Erroneous ideas about the dangers of modern methods have persisted, while abortion is viewed as an everyday occurrence. Public opinion concerning modern methods is generally unfavorable. The availability of safe legal abortions in western Europe has resulted in a very low rate of abortion mortality, around 0.5 deaths per 100,000 abortions. In eastern Europe, abortion mortality rates range from 1 to 10/100,000 abortions, and infertility resulting from abortion is common. Illegal abortions persist because of poor accessibility of quality services. The psychological cost to couples of disorders resulting from abortion is difficult to evaluate but surely considerable. A comparison of the public health results of improving conditions of abortion in eastern Europe while continuing to limit contraceptive use to the traditional methods, or of providing modern contraception, indicates that there is no decisive advantage in favor of modern contraception. The manpower and thus the financial requirements would be less for the policy of providing safe abortions without modern contraception. The major argument against abortion is ethical, not financial or health related. Hungary and the German Democratic Republic have demonstrated that a change from fertility control through abortion to fertility control through contraception is feasible. Such a change would require a very large investment in services and manpower, and would not be fully achieved for many years.
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