Sterilization regret among Puerto Rican women.

This study examined sterilization regret among Puerto Rican women with contraceptive tubal sterilizations (TS) using retrospective data from a population-based survey of women aged 15 to 49 years. Twenty-one percent of the 846 respondents expressed some regret, with 11% stating definite dissatisfaction with the decision. Factors associated with regret were young age at TS, absence of daughters, someone else making the decision to be sterilized, medical indications for TS, sterilization failure, and living with a new marital partner. There were no significant effects associated with the timing of sterilization, whether interval or postpartum, or with the type of last delivery. Other factors not independently associated with regret included years since TS, parity, education, and age at follow-up.

PIP: Reasons for sterilization regret in Puerto Rican women were examined from interview data from the 1982 Puerto Rico Fertility and Family Planning Assessment. 846 of the 3175 women surveyed had contraceptive tubal sterilization, i.e., medical sterilizations, vasectomies and hysterectomies were excluded. Sterilization took place between 1954 and 1982, in women aged 15-49 years old at the time of the interviews. 42% of the subjects lived in rural areas. Regret was expressed on the questionnaire as definitely yes, maybe yes, maybe no, or definitely no. 21% of these women expressed some regret, and 11% felt definite regret for having been sterilized. The most common reasons for regret were desire for more children then, or change of heart later, and not being consulted about the operation. Factors associated with regret were age under 25 at operation, having no daughters, husband or physician having decided on sterilization, medical indications for sterilization, sterilization failure and living with a new partner. Factors not significantly related to regret included timing of sterilization with respect to childbirth, years since sterilization, parity, education and age at survey.

Contraceptive use and the need for family planning in Puerto Rico.

In 1982, 69 percent of Puerto Rican women in union were practicing contraception. Forty-five percent relied on contraceptive sterilization (40 percent, female, and five percent, male), eight percent were using the pill, four percent each, the IUD and the condom, five percent relied on rhythm, and three percent were using other methods. Thus, sterilization is the dominant form of fertility regulation in Puerto Rico, and there is relatively little use of reversible methods for childspacing. Reliance on female sterilization peaks among women in union in the age-group 35-44 (54 percent), whereas pill use is highest among those aged 15-24 (approximately 23 percent). Overall, eight percent of all women aged 15-49 are at risk of unintended pregnancy because they are fecund, sexually active, not pregnant or seeking pregnancy and not using any kind of contraceptive method. However, among women in union, this risk ranges from nine percent among those aged 30-39 to 22 percent among women aged 15-19. Reliance on sterilization rather than reversible methods of contraception is strongly influenced by socio-demographic variables. Women with less than a high school education, the wives of blue-collar workers, women living outside of the major cities and those born in Puerto Rico depend upon sterilization more than do women with a college education, the wives of white-collar employees, women living in cities and those born outside of the country. These findings point to the need for improved availability of reversible family planning services, especially for young women, and those whose childbearing is incomplete.

PIP: In 1982, 69% of Puerto Rican women in union were practicing contraception. 45% relied on contraceptive sterilization (40%, female, and 5%, male), 8% were using the pill, 4% each, the IUD and the condom. 5% relied on rhythm, and 3% were using other methods. Thus, sterilization is the dominant form of fertility regulation in Puerto Rico, and there is relatively little use of reversible methods for child spacing. Reliance on female sterilization peaks among women in union in the age-group 35-44 (54%), whereas pill use is highest among those aged 15-24 (approximately 23%). Overall, 8% of all women aged 15-49 are at risk of unintended pregnancy because they are fecund, sexually active, not pregnant or seeking pregnancy and not using any kind of contraceptive method. However, among women in union, this risk ranges from 9% among those aged 30-39 to 22% among women aged 15-19. Reliance on sterilization rather than reversible methods of contraception is strongly influenced by socio-demographic variables. Women with less than a high school education, the wives of blue-collar workers, women living outside of the major cities and those born in Puerto Rico depend upon sterilization more than do women with a college education, the wives of the white-collar employees, women living in cities and those born outside of the country. These findings point to the need for improved availability of reversible planning services, especially for young women, and those whose childbearing is incomplete.

Alcohol consumption among Mexican American and Anglo women: results of a survey along the U.S.--Mexico border.

A household probability survey of 1233 Mexican American women and 798 Anglo women residing along the U.S.-Mexico border was conducted. A higher proportion of abstainers was found among the Mexican Americans than among the Anglos in almost every social and demographic category examined (age, marital status, education and employment status). Because the level of alcohol consumption increased markedly with the years of education completed, almost all of the overall ethnic differences observed could be accounted for by the generally lower level of education among the Mexican Americans. However, ethnic subgroups of Mexican American women reported different levels of alcohol consumption that could not be accounted for by differences in education, suggesting that additional ethnic factors contribute to drinking patterns.

Differentials in the planning status of most recent live births to Mexican Americans and Anglos.

Data from personal interviews with 705 Mexican American and 363 Anglo women during the 1979 U.S. Mexico Border Survey were analyzed to answer the question, To what extent do Mexican Americans and Anglos differ in having the number of children they want, when they want them? Mexican Americans had a significantly higher percentage of unwanted births than did Anglos. Much of this difference is related to the fact that Mexican Americans, when compared with Anglos, have completed fewer years of schooling and have incomes closer to the poverty threshold than do Anglos. Both Mexican Americans and Anglos had relatively moderate levels of planned births; thus, neither group is in full control of the number and timing of their births. Our results suggest that there is a substantial need for family planning services for Mexican Americans and Anglos in the Southwest.

Lung cancer mortality and smoking habits: Mexican-American women.

Lung cancer mortality was reported to be higher among Mexican-American women as compared with Anglo women from 1950 until 1970; however, smoking habits of Mexican-American women have not been adequately described. This study updates lung cancer mortality data in Texas, describes smoking patterns of 1,255 Mexican-American women from a household survey in the four states bordering Mexico, and compares these findings to a reference group of Anglo women residing in the same area. In 1970, lung cancer mortality rates were similar for Mexican-American and Anglo women in Texas; however, by 1974-1976 Mexican-American women in Texas had a 40 per cent lower rate than Anglo women and by 1979, a 49 per cent lower rate. In our 1979 survey results, Mexican-American women reported lower levels of smoking, both in prevalence and amount smoked, as compared with Anglo women. The lower prevalence was reported for all social and demographic categories examined. The relatively low lung cancer mortality rate is most likely due to relatively low levels of cigarette smoking among Mexican-American women. Based on the trend in lung cancer deaths and our survey findings, we would anticipate a continuing low level of lung cancer mortality among Mexican-American women.

Trends in the incidence of breastfeeding for Hispanics of Mexican origin and Anglos on the US-Mexico border.

In 1979 the Centers for Disease Control conducted a household probability survey of reproductive aged women living in 51 selected US countries on the US-Mexico border. Information on the incidence of breastfeeding for the period 1971-1979 was analyzed on 345 Anglo women and 689 Hispanic women of Mexican origin. Results indicated that the Anglos are following the national trend of increased breastfeeding, but Hispanics show no indication of an increase in the practice of breastfeeding.

Family planning practices among Anglo and Hispanic women in U.S. counties bordering Mexico.

PIP: The US Center for Disease Control surveyed women of reproductive age living on the US side of the Mexican border as to contraceptive use and source of care. It found that overall contraceptive practice is quite similar among married Hispanic and Anglo (white, non-Hispanic) women: 75% of Anglo and 66% of Hispanics use some method. Among never marrieds however, Anglos are twice as likely as Hispanics to use a method. About 22% of Anglo and 12% of Hispanic women are protected from pregnancy by contraceptive sterilization of themselves or partners, the difference almost entirely attributable to a very low incidence of vasectomy among Hispanic males. The pill is the most popular reversible method among both groups. Hispanic women are more likely to go to Planned Parenthood or health department clinics, Anglo women to go to private physicians or clinics. Unmet need is much higher among Hispanics: about 4 times the proportion of married Hispanic women as comparable Anglo women were at risk of unintended pregnancy and were using no method.^ieng