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Some reproductive health indicators in Ukraine: A study with special emphasis on factors behind induced aboartion and perinatal mortality
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives: To study indicators specifically reflecting the reproductive health of Ukrainian women and to analyse factors behind the indicators.

Methods: Induced abortion and maternal mortality were studied in some countries/regions of the former Soviet Union, using official statistics. Abortion rates, contraceptive practices and intentions in Ukrainian women were analysed by a large self-completion survey in 1996, and by a classroom questionnaire to first year medical students in 1999 in Donetsk, Ukraine. Totally, 1694 women and 689 students participated. Perinatal mortality was studied, applying the Nordic-Baltic perinatal death classification to all cases in the Donetsk region in 1997-98 (n=1126) and in Denmark in 1996 (n=540). Clinical guidelines, use of technology and rates of interventions in the two regions were analysed.

Results: Abortion remains a major method of fertility control and abortion-related mortality contributes to maternal deaths. Perinatal mortality rate is twice as high in the Donetsk region as in Denmark. A substantial proportion of sexually active women do not practice contraception. Modern methods of contraception are not widely used. There is a lack of knowledge in reproductive health issues and negative attitude to OCs. There is a positive attitude towards abortion as an acceptable fertility control method and of having abortion instead of using OCs or IUD. Poor economy is an obstacle to the use of contraceptive methods associated with a cost. Lack of experience with contraception reduces the intention to use any method in the future. Being single, younger than 19 years, living with parents, having a positive attitude towards abortion as fertility control method, having a history of previous childbirth and/or abortion are important factors associated with pregnancy termination. Antepartum deaths of growth-retarded fetuses, intrapartum and neonatal deaths associated with asphyxia are more common in Ukraine than in Denmark, particularly among premature infants. Lack of evidence-based clinical guidelines and adequate resources for fetal monitoring during pregnancy and labour, together with negative attitudes towards, and limited resources for, instrumental delivery, contribute to high perinatal mortality.

Conclusion: Better reproductive education/information of all strata of society is needed. Implementation of evidence-based guidelines in perinatal medicine, where international collaboration can be of great value, should be a matter of high priority.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2002. , p. 50
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1215
Keyword [en]
Obstetrics and gynaecology, Ukraine, induced abortion, contraception, perinatal mortality, self-completion survey, perinatal audit
Keyword [sv]
Obstetrik och kvinnosjukdomar
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-3219ISBN: 91-554-5487-9 (print)OAI: oai:DiVA.org:uu-3219DiVA, id: diva2:162254
Public defence
2003-01-21, Rosén-salen, University Hospital, entr 95/96, Uppsala, 09:15
Opponent
Available from: 2002-12-18 Created: 2002-12-18Bibliographically approved
List of papers
1. Induced abortions and childbirths: trends in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine during 1970 to 1994.
Open this publication in new window or tab >>Induced abortions and childbirths: trends in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine during 1970 to 1994.
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1996 In: Acta Obstet Gynecol Scand, Vol. 75, no 10, p. 908-11Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-90076 (URN)
Available from: 2002-12-18 Created: 2002-12-18Bibliographically approved
2. Contraceptive practices and intentions of Ukrainian women
Open this publication in new window or tab >>Contraceptive practices and intentions of Ukrainian women
Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:uu:diva-90077 (URN)
Available from: 2002-12-18 Created: 2002-12-18Bibliographically approved
3. Ukrainian medical students' experiences, attitudes, and knowledge about reproductive health
Open this publication in new window or tab >>Ukrainian medical students' experiences, attitudes, and knowledge about reproductive health
2001 In: J Am Coll Health, Vol. 49, no 6, p. 269-72Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-90078 (URN)
Available from: 2002-12-18 Created: 2002-12-18Bibliographically approved
4. Factors associated with pregnancy termination in Ukrainian women
Open this publication in new window or tab >>Factors associated with pregnancy termination in Ukrainian women
2000 In: Acta Obstet Gynecol Scand, Vol. 79, no 12, p. 1126-31Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-90079 (URN)
Available from: 2002-12-18 Created: 2002-12-18Bibliographically approved
5. Using the Nordic-Baltic perinatal death classification to assess perinatal care in Ukraine
Open this publication in new window or tab >>Using the Nordic-Baltic perinatal death classification to assess perinatal care in Ukraine
Show others...
2002 Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-90080 (URN)
Available from: 2002-12-18 Created: 2002-12-18Bibliographically approved

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