Postpartum sterilization in cesarean section and non-cesarean section deliveries: United States, 1970-75.

National Hospital Discharge Survey data indicate that the overall postpartum sterilization rate per 100 deliveries increased by 75 per cent from 4.0 in 1970 to 7.0 in 1975; by type of delivery, rates rose from 18.0 per 100 cesarean section deliveries and 3.2 for all other deliveries in 1970 to 19.0 and 5.6 respectively in 1975. The South had the highest postpartum sterilization rates overall. Deliveries to older mothers and cesarean section deliveries in hospitals with less than 100 beds were more often characterized by higher sterilization rates.

Demographic trends in tubal sterilization: United States, 1970-1978.

In the period 1970-1977, an estimated 4,236,000 women 15-44 years of age had tubal sterilization operations in United States hospitals. Both the number and the rate of tubal sterilizations increased each year from 1970-1977, but in 1978 both declined. Tubal sterilization rates for Black women were higher than for White women. Black women also tended to be younger at the time of tubal sterilization. For the nation as a whole, the mean age at the time of tubal sterilization remained constant at about 30 with the youngest age group having the highest proportion of never-married women.

Ectopic pregnancy in the United States 1970 through 1978.

Trends of the incidence and mortality associated with ectopic pregnancy (EP) in the United States were examined for 1970 through 1978. The estimated number of EPs rose from 17,800 in 1970 to 42,400 in 1978, and the EP incidence rate rose from 4.5 per 1,000 reported pregnancies to 9.4 during the same time period. The risk of EP was higher for older women and nonwhite women. Over 2.5% of all reported pregnancies among nonwhite women aged 35 to 44 years were ectopic. The death-to-case rate for EP declined almost 75% during the study period but remained consistently higher for nonwhite women as compared with white women.

PIP: 2 data sets from the National Center for Health Statistics were examined to study national trends in the occurrence of ectopic pregnancy (EP). 2 estimates of EP occurrence were calculated from the National Hospital Discharge Survey: 1) the number of EPs per 10,000 women aged 15-44 and 2) the number of EPs per 1000 reported pregnancies, which include EPs, legal abortions, and live births. From 1970-78, approximately 262,000 women aged 15-44 were discharged from US hospitals with a diagnosis of EP. The estimated number of EPs increased steadily from 17,800 in 1970 to 42,400 in 1978, while the EP rate/1000 reported pregnancies increased from 4.5 to 9.4. The EP rate/1000 reported pregnancies increased steadily with age, from 4.5 for women 15-25, 9.7 for women 25-34, to 15.2 for women 35-44. From 1970-78, the overall EP rate was 1.6 times higher for nonwhite than for white women. The EP rate for white women rose from 4.0/1000 reported pregnancies in 1970 to 8.4 in 1978, while for nonwhite women it rose from 7.1 to 12.5. The EP rate increased with age for both races. More than 1% of reported pregnancies in nonwhite women were ectopic; for nonwhite women aged 35-44 the rate was 2.6%. According to national vital statistics on mortality by cause, 437 women aged 15-44 died from EP between 1970 and 1978. The death-to-case rate declined more than 70% from 35 deaths/1000 EPs in 1970 to .9 in 1978. The death-to-case rate declined for both white and nonwhite women but remained consistenly higher for nonwhites. Overall the death-to-case rate for nonwhite women was 3.4 times that for white women. A likely cause of the marked increase in EP incidence between 1970-78 is pelvic inflammatory disease. Clinicians should consider the possibility of EP especially when treating nonwhite women over 35 who complain of menstrual irregularity and abdominal pain.

Hysterectomy among women of reproductive age. Trends in the United States, 1970-1978.

An estimated 3.5 million women aged 15 to 44 years in the United States underwent hysterectomy (excluding radical procedures) between 1970 and 1978. Data from the National Center for Health Statistics were used to study the influence of age, race, and geographic region on hysterectomy rates, surgical approach, and concurrent oophorectomy. The number and rate of hysterectomies increased between 1970 and 1972 but remained stable thereafter. Hysterectomy rates increased with age, and rates for black women slightly exceeded the rates for whites. Rates were consistently highest for women in the South and lowest for women in the Northeast. Women undergoing hysterectomy in the Northeast had the lowest percentage performed by a vaginal approach and the highest percentage performed in conjunction with bilateral oophorectomy. Women having a hysterectomy in the West had the highest percentage performed by a vaginal approach.