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Infertility and fertility treatment have the potential to impact and disrupt a couple's overall life. In order to study the associations between the impact of childlessness on one's life, and men and women's attitudes towards fertility treatment continuation and/or adoption, we analysed data from a one-year follow-up questionnaire in a prospective, longitudinal cohort study of consecutive couples initiating fertility treatment in Denmark. The study comprised 302 couples with no children at baseline and no joint children at one-year follow-up. In total, 71.9% of women and 72.5% of men reported that they wished to continue fertility treatment, while 20.2% of women and 19.2% of men reported that they wished to pursue adoption. The attitudes of nearly 8 in 10 couples were congruent towards further fertility treatments, while nearly 7 in 10 couples were congruent in their attitudes to pursuing adoption. Significantly more men who reported a lower impact of childlessness on their daily life wished to continue fertility treatment, compared with those reporting that childlessness had a greater impact on their life. Among women, significantly more were undecided about whether or not to pursue adoption when reporting a greater impact of childlessness on social life, compared with those reporting a lower impact of their childlessness. [ABSTRACT FROM AUTHOR]

Mobility is often portrayed as the antithesis of belonging. In this article, we challenge this perspective investigating how mobility and motility influence belonging in everyday life. We develop a perspective on belonging consisting of the dimensions of mobility, people and place and conditioned by the underlying dimensions of time, resources and structures of meaning. Applying this to interview material from a case study in Aalborg, we propose a tentative typology of mobile forms of belonging. It is discussed how different rhythms, conditions of mobility and variations in mobility resources result in different scales of belonging and modes of ‘centering’. [ABSTRACT FROM AUTHOR]

Objective: To compare perinatal and maternal morbidity and birth interventions in low-risk women giving birth in two freestanding midwifery units (FMUs) and two obstetric units (OUs). Design: A cohort study with a matched control group. Setting: The region of North Jutland, Denmark. Participants: 839 low-risk women intending FMU birth and a matched control group of 839 low-risk women intending OU birth were included at the start of care in labour. OU women were individually chosen to match selected obstetric/socio-economic characteristics of FMU women. Analysis was by intention to treat. Main outcome measures: Perinatal and maternal morbidity and interventions. Results: No significant differences in perinatal morbidity were observed between groups (Apgar scores <7/5, <9/5 or <7/1, admittance to neonatal unit, asphyxia or readmission). Adverse outcomes were rare and occurred in both groups. FMU women were significantly less likely to experience an abnormal fetal heart rate (RR: 0.3, 95% CI 0.2 to 0.5), fetal-pelvic complications (0.2, 0.05 to 0.6), shoulder dystocia (0.3, 0.1 to 0.9), occipital-posterior presentation (0.5, 0.3 to 0.9) and postpartum haemorrhage >500 ml (0.4, 0.3 to 0.6) compared with OU women. Significant reductions were found for the FMU group's use of caesarean section (0.6, 0.3 to 0.9), instrumental delivery (0.4, 0.3 to 0.6), and oxytocin augmentation (0.5, 0.3 to 0.6) and epidural analgesia (0.4, 0.3 to 0.6). Transfer during or <2 h after birth occurred in 14.8% of all FMU births but more frequently in primiparas than in multiparas (36.7% vs 7.2%). Conclusion: Comparing FMU and OU groups, there was no increase in perinatal morbidity, but there were significantly reduced incidences of maternal morbidity, birth interventions including caesarean section, and increased likelihood of spontaneous vaginal birth. FMU care may be considered as an adequate alternative to OU care for low-risk women. Pregnant prospective mothers should be given an informed choice of place of birth, including information on transfer. [ABSTRACT FROM AUTHOR]

The article discusses a study which compared reproduction patterns among Danish females born with isolated oral clefts (OCs) with the Danish women background population. The study indicates that childlessness level is higher in oral cleft women than those in the background population. It notes that oral cleft women are more often childless or get their first offspring later.

Introduction: The establishing of three Danish population-based registers, namely the Fertility Database, the Register of Legally Induced Abortions, and the In Vitro Fertilisation register, aimed at providing data for surveying of reproductive outcome. Content: The registers include information on births, abortions, and assisted reproduction as well as selected characteristics of the women (and men) involved. Validity and coverage: Both the validity and coverage of each register are considered of high quality. Conclusion: These registers provide, both individually and in combination, unique opportunities for undertaking detailed and comprehensive research in the field of reproduction. [ABSTRACT FROM PUBLISHER]

Aims: The most commonly used indicator of fertility, the period total fertility rate (TFRp), tends to underestimate actual fertility when women delay childbearing. The objective of this study was to examine to which extent fluctuations in Danish fertility rates result from changes in timing of births and, thus, whether the conventional TFRpis a distorted indicator of fertility quantum. In addition, we investigated whether such changes in timing explained the observed regional differences in the TFRp in Denmark. Methods: The study applied age-, period-, county-, and parity-specific data from the Danish Fertility of Women and Couples Dataset, 1980--2001. We evaluated fluctuations in period fertility rates by the tempo-adjusted TFR' - a proposed variant of the conventional TFRp taking period changes in timing of births into account. Tempo-effects were given by the difference between TFRp and TFR', and these period measures were compared to actual cohort fertility. Results: Mean age at childbearing increased with more than 3 years over the period 1980--2001 leading to considerable differences between TFRpand TFR'. A tempo-effect of up to 0.347 children per woman was observed. Comparisons with actual cohort fertility showed consistency with the TFR'. However, tempo-adjustment did not attenuate observed regional differences. Conclusion: This study indicates that the conventional TFRp consistently underestimates the fertility quantum in periods characterized by changes in timing of births, and that the TFR' generally provides good indication of actual cohort quantum for the period in question. Considerable tempo-effects were observed within counties; however, differences between regions were not explained by changes in tuning of births. [ABSTRACT FROM AUTHOR]

Previous analyses of period fertility suggest that the trends of the Nordic countries are sufficiently similar that we may speak of a common "Nordic fertility regime". We investigate whether this assumption can be corroborated by comparing cohort fertility patterns in the Nordic countries. We study cumulated and completed fertility of Nordic birth cohorts based on the childbearing histories of women born in 1935 and later derived from the population registers of Denmark, Finland, Norway, and Sweden. We further explore childbearing behaviour by women's educational attainment. The results show remarkable similarities in postponement and recuperation between the countries. Median childbearing age is about two to three years higher in the 1960-64 cohort than in the 1950-54 cohort, but the younger cohort recuperates the fertility level of the older cohort at ages 30 and above. A similar pattern of recuperation can be observed for highly educated women compared to women with less education, resulting in small differences in completed fertility across educational groups. Another interesting finding is that of a positive relationship between educational level and the final number of children when women who become mothers at similar ages are compared. Despite some differences in the levels of childlessness, country differences in fertility outcome are generally small. The cohort analyses thus support the notion of a common Nordic fertility regime. [ABSTRACT FROM AUTHOR]

Background: Equal access to health care is considered a key in Scandinavian healthcare policy. However, problematic differences between the socio-economic situation of immigrants and that of native Scandinavians are increasingly challenging this aspect of the Scandinavian welfare model. The present study focuses on how socio-economic characteristics and country of birth are associated with induced abortion. Methods: A structured questionnaire was used to collect information among 1351 women requesting abortion and a control group of 1306 women intending birth. Results: The strongest factor associated with the decision to have an abortion was being single (OR 39.1; 23.8-64.2), followed by being aged 19 years or below (OR 29.6; 13.4-65.5), having two children or more (OR 7.05; 5.29-9.39) and being unskilled (OR 2.48; 1.49-4.10), student (OR 2.29; 1.52-3.43) or unemployed (OR 1.65; 1.11-2.46). When evaluating the effect of social exposure on abortion among Danish-born and foreign-born women, the higher rate of abortion among non-Westerners was found to be caused by the composition of non-Westerners more often being unemployed, having a low income and having two or more children rather than the fact that they are coming from a non-Western country. Conclusion: Immigrant women comprise a vulnerable group, with a poor socio-economic status. This situation exposes immigrant women to increased risk of induced abortion. In a society with an increasing heterogeneous population, the vulnerable situation of immigrant women has to be addressed, if equal access to health care is to be maintained. [ABSTRACT FROM AUTHOR]

A high educational attainment is shown to have a positive effect on second birth rates for Danish one-child mothers during the period 1981-94. We examine whether a time-squeeze is a possible explanation: due to the longer enrollment in the educational system, highly educated women have less time at their disposal in order to get the desired number of children. Also, we examine to what extent the partner's education can explain some of the positive effect. We find no evidence that the positive effect of education is due to a time-squeeze nor to a partner effect. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated the tendency to repeat gestational age and birthweight in successive pregnancies and that this tendency is associated with infant survival. Thus, newborn outcome and survival is less favourable if the gestational age and size departs from this maternal tendency. This paper aims to study diseases or conditions that might be associated with this effect. Data were provided through a linkage between three Danish health registries: the Danish Fertility Database, the National Hospital Registry, and the Registry for Preventive Medicine. Such linkage was possible due to the use of unique ID-person numbers. The study included all 8219 second-order low-birthweight (LBW) singleton Danish births, 1980–94, of whom 7811 were liveborn. It was also required that the mother's first delivery took place during that period. The analysis considered 7803 of these births; eight were excluded due to insufficient information. Of the second-order LBW children, 26% had an elder sibling who was also LBW. Early neonatal mortality of a ‘non-repeat’ LBW birth was 1.3 times higher than ‘repeat’ LBW births [53.8 vs. 41.2 per 1000; RR 1.31; 95% CI 1.03, 1.65], as was infant mortality [78.4 vs. 60.8 per 1000; RR 1.30; 95% CI 1.06, 1.56]. Also, proportionately more LBW repeat births had Apgar scores of ≥7 after 1 and 5 min. Overall, repeat second-order LBW babies weighed 68 g more than non-repeat LBW babies ( P < 0.001). At term, the weight difference was 160 g higher among repeat LBW births ( P < 0.001). The mean number of hospitalisations during the first year of life was lower among repeat than non-repeat LBW babies (2.30 vs. 2.46, P < 0.001), while the mean duration of stay was 23.71 vs. 23.97 days ( P > 0.05). Newborn immaturity was the most common diagnosis for hospitalisation, and infections the second most common. There were no differences between repeat and non-repeat LBW births in the proportion with each diagnosis. Apart from the differences in birthweight, we were unable to explain the improved survival for repeat compared with non-repeat LBW babies. Except for differences in Apgar scores, we observed no differences in morbidity based on registered hospitalisations during infancy. [ABSTRACT FROM AUTHOR]

Objective: The aim of this project was to assess whether any changes in the birth prevalence of cleft lip with/without cleft palate (CL[P]) occurred in Denmark during the period 1988 through 2001. In this period an official recommendation of a supplementation of folic acid to pregnant women was introduced; furthermore, smoking among pregnant women decreased considerably. Design and Settings: There are few places in which ecological studies of oral clefts are possible. Denmark provides a particularly good setting for this kind of study because of a high ascertainment and a centralized registration of subjects with cleft over the last 65 years. Participants: Cleft occurrence in Denmark from 1936 to 1987 has previously been reported. Here we extend the study to include all live-born children with oral clefts born in Denmark in 1988 through 2001. Among a total of 992,727 live births, 1332 children with CL(P) were born during this period. Results and Conclusions: The birth prevalence of CL(P) in Denmark has previously been found to be constant in the period 1962 through 1987, with a frequency of 1.4 to 1.5 per 1000 live births. This study showed a similar occurrence in 1988 through 2001 (birth prevalence = 1.44 per 1000 live births, 95% confidence interval = 1.37 to 1.52). The introduction of folic acid and the decrease in smoking prevalence among pregnant women do not seem to have reduced the birth prevalence. This may be due to noncompliance with the folic acid recommendation and/or only a weak causal association between folic acid and smoking and occurrence of CL(P). [ABSTRACT FROM AUTHOR]

Background: To analyze the trends in legally induced abortions among women younger than 30 years in the five Nordic countries, Denmark, Finland, Iceland, Norway and Sweden, since the liberalized abortion laws came into force.Methods: Data stem from national registrations of vital events. Some have been published in the national vital statistics while others have been retrieved for this study. General and age-specific abortion rates are used to analyze the trends. Further, an index has been calculated by dividing the age-specific abortion rates by the Nordic average.Results: The analysis reveals an overall reduction in the general abortion rates in the Nordic countries, apart from Iceland. The rates have been highest in Denmark and Sweden and lowest in Finland since the early 1980s. In the mid-1980s, the abortion rates increased among 15-19-year-old women in Sweden and among 20-24-year-old women in Denmark, Norway and Sweden, followed by a reduction. In Iceland the very low age-specific abortion rates for all age groups under 30 years at the beginning of the study period increased and Iceland had the highest rate for 15-19-year-old women in the late-1990s.Conclusions: The relatively low abortion rates in Finland demonstrate effective preventive efforts, although the recent increase challenges further studies on the relationship between abortion rates and counseling activities. The rise in abortion rates in Iceland indicate a need for improved sex education, contraceptive services and availability of contraceptive methods for young people. [ABSTRACT FROM AUTHOR]

Aims: This study describes women with induced abortion and thereby elucidates how living conditions and contraceptive failure are associated with the choice of induced abortion in a population of Danish pregnant women. Methods: The study population consisted of pregnant women attending Odense University Hospital. They were categorized in two groups: women with induced abortion ( n =373) and a reference group consisting of women with spontaneous abortion and antenatal care attendees ( n =2,176). The two groups were compared by use of a case-referent design. The variables studied comprise age, number of children, partner relationship, education, occupation, economical situation, and contraceptive use. Results: Being single, aged 15-24 or 35 and above, having either no children or two or more children, and the experience of contraceptive failure were parameters which were associated with the choice of induced abortion. Among married/cohabiting women aged 20-39 with fewer than two children, being under education, unemployed, on leave, or willing to invest effort in obtaining a more satisfying job influenced the choice of induced abortion. Conclusions: To reduce the number of induced abortions, it should be recognized that many women both want to establish a family with the number of children they wish for and to have a satisfying job with influence and challenge. [ABSTRACT FROM AUTHOR]

During past decades, we have witnessed a remarkable decline in fertility rates (number of births per 1000 women of reproductive age) in the industrialized world. It seems beyond doubt that the enormous social changes of our societies play the major role in this decline, but can it be attributed to changing social structures alone or is a reduced fecundity in the population also a factor? To address this we have focused on trends in teenage pregnancies (which to a large extent are unplanned). During the period in question fertility rates among 15-19 year old Danish women have been falling and the decline in fertility rate is not counterbalanced by an increase in the rate of induced abortion. When seen together with recent results from Denmark, which have shown that more than 30% of 19 year old men from the general population now have sperm counts in the subfertile range, we argue that this fall may not be attributable to social factors, changes in conception practices or diminished sexual activity alone. It seems reasonable also to consider widespread poor semen quality among men as a potential contributing factor to low fertility rates among teenagers. Due to the concern caused by the low sperm count among younger Danish men, the Danish Ministries of Health and Environment have launched a surveillance programme which includes an annual examination of the semen quality in 600 young Danes from the general population. We propose that researchers in other countries with low and falling fertility rates among young women should consider the possibility that semen quality of their younger male cohorts may also have deteriorated. [ABSTRACT FROM AUTHOR]

Objective: To study how living conditions influence pregnancy planning and acceptance among Danish women.Method: A cross-sectional questionnaire study performed among 3516 pregnant women attending Odense University Hospital, Denmark. The study population consisted of women with spontaneous abortion, women with ectopic pregnancies, women attending antenatal care and women with induced abortion. They were divided into four groups: women with planned and accepted pregnancies (accepting planners, n=2137), women who accepted an initially unplanned pregnancy (accepting non-planners, n=1006), women who rejected an initially planned pregnancy (rejecting planners, n=31), and women with unplanned and rejected pregnancies (rejecting non-planners, n=342). The association between socio-economic characteristics and pregnancy planning and acceptance was evaluated by comparing accepting non-planners with accepting planners and by comparing rejecting planners with rejecting non-planners. The variables studied comprise age, number of children, partner relationship, education, occupation, economic situation and contraceptives.Results: The characteristics of accepting non-planners and accepting planners were in accordance and in contrast to those of rejecting planners and in particular of rejecting non-planners. The contraceptive prevalence rate among accepting non-planners was 15%. Among rejecting non-planners the same figure was 51%.Conclusion: Accepting non-planners seemed to be in a situation which could be considered appropriate for childbirth. The contraceptive prevalence rate among accepting non-planners was low and might reflect that these women were not entirely against the thought of having a child, although they did not actively plan to have one. [ABSTRACT FROM AUTHOR]

Using data from seven malformation monitoring systems around the world, the feasibility of monitoring fresh dominant mutations using skeletal dysplasias was explored. Based on a total of over 9.5 million births, 1500 infants with skeletal dysplasias were identified (16 per 100,000). In spite of efforts to get exact diagnoses, an average of 21% were unspecified. Comparisons of rates of specific diagnoses in different programmes suggested that classification differed. By analysing maternal age distribution, estimates were made of the proportion of fresh mutations in different subgroups: conditions regarded as dominant (achondroplasia, thanatophoric dysplasia, spondyloepiphyseal dysplasia) were estimated to consist of 58% fresh mutations--some of the remaining cases were inherited, others were probably misclassified. Among conditions regarded as recessive, only 5% were estimated to be truly dominant mutations. In the total group of skeletal dysplasias, 21% were estimated to be fresh dominant mutations and if osteogenesis imperfecta were excluded, the figure was 31%. By power analyses it was shown that equal monitoring power may be obtained by a programme covering about 45,000 births per year with intensive diagnosis of each individual case of skeletal dysplasia and a programme some three times greater where no specific diagnoses are obtained. An increasing trend in the occurrence of skeletal dysplasias was seen but probably explained by changing ascertainment. An impact of antenatal diagnosis resulting in a decrease in occurrence was also apparent in some programmes. [ABSTRACT FROM AUTHOR]

Investigates the effect of vasectomy on the increase in the risk of cancers for testis and prostate in Denmark. Percentage of the incidence of testicular cancer in men with vasectomy; Relationship between vasectomy and prostate cancer; Increase in testicular cancer in men with reduced fertility.

It has been suggested in the literature that twinning rates are reduced by psychosocial stress associated with urban life. No support for this hypothesis was found in a study based upon the 5762 twins and 280158 singletons that were born in Denmark in the period 1978 to 1982. [ABSTRACT FROM PUBLISHER]

This study demonstrates that socioeconomic differences do exist in all three Scandinavian countries, and these differences have implications for perinatal and infant survival. Using parental education as a proxy for socioeconomic conditions, the association with perinatal survival seems to be stronger in Denmark and Norway than in Sweden. For postneonatal mortality the association is equally strong in the three countries. Data from one of the countries (Norway) demonstrates the joint importance of parental education, and the association with paternal education is equally strong as that with maternal education. If father and mother have the lowest level of education, their offspring has 50 to 80% higher perinatal and infant mortality risks. These observations call for further research into the association between social variables and health in order to tease out causal relationships which might lead to future preventive actions. [ABSTRACT FROM AUTHOR]