In This Issue
Even in countries where abortion is legal, obtaining the procedure early in pregnancy can be difficult, especially for young, unmarried women. India is a case in point. In a study conducted by Shveta Kalyanwala and colleagues in two northern states, 91% of 549 15-24-year-olds who obtained abortions at clinics run by the nongovernmental organization Janani said they had realized they were pregnant during the first trimester of pregnancy, but only 75% obtained an abortion before entering the second trimester [page 62]. The risk of having a second-trimester abortion declined with increasing age and education. However, compared with other young women, those who lived in rural areas, those who did not receive both emotional and financial support from their partner and those whose pregnancy resulted from a forced sexual encounter were more likely to have a second-trimester abortion.
STIs, which can have long-lasting consequences for health and fertility, are common among youth in developing countries. In most cases, the severity of these consequences depends on how quickly the infection is diagnosed and treated, yet little is known about whether and how youth seek health care for STIs and whether their care-seeking behavior differs by sex. Of 538 Nigerian males and females aged 15-24 who participated in nationally representative reproductive health surveys in 2003 and 2005, males were more likely than females to have sought treatment for their STI symptoms (64% vs. 48%), according to a study by Kristen Mmari and colleagues [page 72]. The majority of females had sought care from a formal source, usually a government clinic, while the majority of males had sought care from an informal source, generally a traditional healer. The authors note that if STI treatment among youth in Nigeria is to be increased, interventions must be designed differently for males and females.
Fertility has dropped sharply in Vietnam over the last three decades, to 1.6 children per woman overall, but varies widely across the country's 54 ethnic groups. Using data for the five years preceding the 2001 Vietnam National Health Survey, Bussarawan Teerawichitchainan and Sajeda Amin examine the extent to which ethnic groupings (broadly defined by measures of poverty, geography and assimilation) have relied on contraceptive use and abortion to control fertility, as well as the implications of this information for family planning policies and programs [page 80]. Compared with women in the group comprising the Kinh majority and Chinese minority (total fertility rate, 1.5), minority women in the central highlands and the northern uplands, with TFRs of 2.8 and 2.6, respectively, were less likely to have used modern or traditional contraceptive methods (odds ratios, 0.4 and 0.7 for each geographic grouping) and less likely to have had an abortion (0. …