Population Control, Family Planning, and Maternal Health Networks in the 1960s/70s: Diary of an International Consultant.

Over the past decade historians have explored the rise of the mid-twentieth-century population/family planning movement on both the international and the local levels. This article bridges the gap between these studies by exploring the work diaries of Dr. Adaline Pendleton ("Penny") Satterthwaite, a midlevel technical advisor who traveled to over two dozen countries for the Population Council from 1965 to 1974. Penny's diaries draw our attention to a diverse network of advocates who mediated between international population activists, state actors, and local communities while also acting as conduits for the transnational spread of strategies and resources. Her experiences also provide evidence of the coercive practices, gendered tensions, and political conflicts shaping the movement while illustrating the resistance and engagement of local actors, the existence of health- and women-centered approaches even during the high period of population control, and the many structural and social barriers shaping family planning projects in practice.

Gambling on the Protestants: the Pathfinder Fund and birth control in Peru, 1958-1965.

Among the agencies involved in population control activities in the mid-twentieth century, none scored as many early victories in Latin America as did the Pathfinder Fund, founded by Procter & Gamble scion Clarence Gamble. This article analyzes a style in the delivery of family planning assistance in the developing world through the work of the Pathfinder Fund in Peru, the organization's hub in South America, and shows how Pathfinder personnel collaborated with local Protestant institutions. Its Protestant allies helped Pathfinder set up and manage rapid interventions such as the production of pamphlets, the smuggling of contraceptives, and the enrollment of physicians as advocates of the use of intrauterine devices. Although these rapid interventions helped quickly disseminate information and certain technologies among a fortunate few, they also weakened legitimate state agencies, neglected the monitoring of the safety of the drugs supplied, and alienated allies with their high-handed boldness.

Planejamento Familiar no Brasil no contexto dos determinantes históricos e sociais / Family planning in Brazil in the context of the historical and social determinants

A Política de Planejamento Familiar envolve ações que lidam diretamente com as questões de concepção e contracepção. Questões estas que estão correlacionadas a assuntos como liberdade sexual, aborto, famílias muito numerosas de baixa renda, gravidez na adolescência, mortalidade materna, entre outros, assuntos que geram polêmica e discussão na sociedade e na mídia, muitas vezes por questões políticas e religiosas. O estudo tem como Objetivo Geral analisar as intervenções propostas pelo Governo Federal brasileiro que lidam com a questão do planejamento familiar, identificando sua orientação para enfrentamento dos problemas de saúde pública relacionados aos determinantes sociais (...). Foi possível identificar a necessidade de analisar a forma como a Política do Planejamento Familiar vem sendo implantada, baseado nos Problemas de Saúde Pública e nos Determinantes Sociais relacionados a linha de atuação desta Política.

Programa de planificación familiar en Chile 1965-1973: historia, beneficiarios y primeros resultados / Family planning program in Chile 1965-1973: history, beneficiaries and first results

En 1965 el gobierno de Eduardo Frei Montalva instauró el programa de Planificación Familiar en todas las dependencias del Servicio Nacional de Salud, con el objeto de reducir las elevadas tasas de aborto en mujeres que buscaban con esta acción controlar su fertilidad. El programa prescribía entregar información sobre métodos de control natal inocuos a mujeres de 15 a 49 años que asistieran a los servicios hospitalarios por motivos de parto o complicaciones de aborto. Este artículo busca analizar el Programa, caracterizar a las mujeres beneficiarias y saber sobre el funcionamiento del programa en las dependencias hospitalarias del Servicio Nacional de Salud. (AU)

[The medical debate on contraception and abortion in Buenos Aires in the 1960s]. / El debate médico sobre anticoncepción y aborto en Buenos Aires en los años sesenta del siglo XX.

During the 1960s, there were important medical debates in Buenos Aires about the effects of the birth control pill on women's health and about its political, demographic and moral consequences. Other issues addressed by healthcare professionals in the Buenos Aires Society of Obstetrics and Gynaecology were abortion and changes in gender relations and sexual behaviours. These discussions are analyzed in this article, taking account of the specific national and international context and pointing to some of the consequences of these debates for the "contraception culture" of the country.

[Family planning in Brazil in the context of public health policies: important historical factors]. / O planejamento familiar no Brasil no contexto das políticas públicas de saúde: determinantes históricos.

This study searches historical records for the formulation and implementation of public health policies in Brazil, focusing on those referent to family planning. Initial conclusions show that the policies were geared toward international controlling interests. Family planning today, though officially recognized as an inalienable right of every citizen, still reflects the contradictory political, economic and ideological interests of the ruling power.

The fertility impact of changes in the timing of childbearing in the developing world.

This study examines the role of tempo effects in the fertility declines of less developed countries. These effects temporarily inflate the total fertility of a population during periods when the age at childbearing declines and deflate it when childbearing is postponed. An analysis of data from the World Fertility Surveys and the Demographic and Health Surveys demonstrates that fertility trends observed in many less developed countries are likely to be distorted by changes in the timing of childbearing. In most countries women are delaying childbearing, which implies that observed fertility is lower than it would have been without tempo changes. This pattern is most clearly documented in Taiwan, where accurate birth statistics from a vital registration system make it possible to estimate the tempo components of fertility annually from 1978 to 1993. The small but unexpected rise in the total fertility of Colombia in the early 1990s is attributed to a decline in the negative tempo distortion that prevailed in the 1980s. Similar interruptions of ongoing fertility declines may occur in the future in other countries when existing negative tempo effects are removed.

The role of contraceptive supply and demand in Mexican fertility decline: evidence from a microdemographic study.

This paper uses retrospective life history data to assess the impact of family planning services on contraceptive use in a rural Mexican township. Between 1960 and 1990 contraceptive use rose and fertility declined dramatically. Both contraceptive supply and demand factors were influential in these trends. The start of the government-sponsored family planning programme in the late 1970s was associated with a sharp rise in female sterilization and use of the IUD. However, once we controlled for the changing socio-economic and demographic characteristics of the sample, the presence of family planning services had no significant effect on the likelihood that women used modern reversible methods compared to traditional methods. Men and women expressed concerns about the safety of modern methods such as the pill and the IUD. Efforts to increase modern contraceptive use should place greater emphasis on communicating the safety of these methods and improving the quality of services.

Intrauterine devices: learning from the past and looking to the future.

This paper reviews the historical development of the IUD, describing the challenges and successes, and attempts to offer a balanced perspective for family planning service workers today. Modern IUDs are an important component of family planning services and an excellent contraceptive choice for properly screened women, providing contraception that is safe, effective, long lasting and cost effective. Potential research strategies for the future are also discussed.

PIP: Although there are 100 million current IUD users on a global level, unwarranted apprehension about the device's safety persists on the part of both service providers and potential acceptors. Much of this concern is based on experiences with IUDs such as the Dalkon Shield that are no longer in use and unsubstantiated assertions emerging from past IUD research (e.g., the existence of an IUD-pelvic inflammatory disease link). The development of medicated copper IUDs has renewed confidence about the effectiveness and safety of this form of contraception. The Copper T 380A, Multiload Copper-375, Nova-T, and levonorgestrel-releasing IUD are expected to be the pillars of IUD contraception for the 1990s and beyond, although high production and distribution costs are jeopardizing widespread use in developing countries. Current research is focused on reducing expulsions and medical removal rates through innovative design modifications. At this point, there is sufficient data from prospective multicenter clinical trials to enable evaluation of rare side effects. There is a need, however, to widen the scope of research activities to focus on users' needs and expectations and the impact of sociocultural context. Educational campaigns directed both at the public and the medical community would help to dispel remnants of misinformation.

West Indian gender relations, family planning programs and fertility decline.

Nearly all West Indian islands initiated marked fertility declines sometime between 1960 and 1970. Family planning programs have not played an important role in these declines. Neither have other variables that conventional social theory tells us should promote reduced family sizes, like education and rising standards of living. The historical experience of Barbados and Antigua, which reached replacement-level fertility in the 1980s, suggests that West Indian fertility declines reflect structural changes in national economies that created job opportunities for women. Family planning programs need to be evaluated with reference to the distinctive health and human rights goals other than fertility transition that they can effectively reach.

Family planning in St Vincent, West Indies: a population history perspective.

St Vincent's population history, first as a slave society, then, after Emancipation, as a migration-oriented society, has strongly influenced cultural attitudes towards sexuality and fertility. In contemporary St Vincent, sexual activity and procreative ability are highly valued and linked to social status for both men and women. This paper assesses historical and contemporary factors influencing population dynamics in St Vincent, West Indies, and Vincentians' reactions to programs developed to curb population growth. The efforts of private and government programs to introduce family planning and change pronatalist attitudes are evaluated for their cultural appropriateness. Shifting migration patterns and modernization are also affecting gender roles, the social and economic value of children, and the acceptability of contraception to contribute to recent fertility declines.

Family planning in St. Vincent, West Indies: a population history perspective

St. Vincent's population history, first as a slave society, then, after Emancipation, as a migration-oriented society, has strongly influenced cultural attitudes towards sexuality and fertility. In contemporary St. Vincent, sexual activity and procreative ability are highly valued and linked to social status for both men and women. This paper assesses historical and contemporary factors influencing population dynamics in St. Vincent, West Indies, and Vincentians' reactions to programs developed to curb population growth. The efforts of private and government programs to introduce family planning and change pronatalists attitudes are evaluated for their cultural appropriateness. Shifting migration patterns and modernization are also affecting gender roles, the social and economic value of children, and the acceptability of contraception to contribute to recent fertility declines (AU)

West Indian gender relations, family planning programs and fertility decline

Nearly all West Indian islands initiated marked fertility declines sometimes between 1960 and 1970. Family planning programs have not played an important role in these declines. Neither have other variables that conventional social theory tells us should promote reduced family sizes, like education and rising standards of living. The historical experience of Barbados and Antigua, which reached replacement-level fertility in the 1980s, suggest that West Indian fertility declines reflect structural changes in national economic that created job opportunities for women. Family planning programs need to be evaluated with reference to the distinctive health and human right goals other than fertility transition that they can effectively reach (AU)

Contracepção: percepção e prática / Contraception: perception and practice

A necessidade da elaboração do presente trabalho surge da problemática vivenciada na atuação junto a clientela feminina, em uma unidade básica do serviço público de saúde. Emerge principalmente da exigência de um posicionamento frente a demanda feminina por anticoncepção. Num momento em que estava ainda presente a polêmica acerca do controle da natalidade. Termo já de tal maneira pejorativo que as ações buscando uma mudnça coletiva no comportamento no sentido de controlar a prole eram denominadas de forma mais agráveis, por exemplo, como atividades no sentido de prover a "Paternidade Responsável"...