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Questionnaires were administered to 300 postpartum women in 3 delivery wards in Moscow to determine their opinions about contraceptives. Similarly, 100 gynecologists-obstetricians were queried in 2 wards, at 2 counseling sites for women, and at regional seminars of gynecologists-obstetricians. 52% of the physicians recommended the condom to nursing mothers whenever sexual activity was resumed and the IUD from the 3rd and 4th month on. 60% of the doctors thought that women who were not breast feeding could similarly start using the condom and from the 3rd and 4th month either the IUD (82%) or oral contraceptives (36%). 71.1% of the women were under 30 years of age, and were relatively well educated. 68% of them had their first birth, 28.3% had their second, only 3.7% had their third or higher order of births. 35% of the women did not plan the present pregnancy. 81% of the women were using contraception up to the time of the present pregnancy, and the most popular methods were coitus interruptus (36.3%), the rhythm method (35.3%), the condom (28.3%), the IUD (13%), and hormonal methods (10.6%). Although 46.3% of the women preferred the IUD after birth, only 7.3% of them preferred hormonal preparations. In this study 71.5% of the mothers were breast feeding their infants. 13.5% of the women had gestosis in the 2nd half of the pregnancy, 5.8% had anemia, and 21.3% experienced the threat of miscarriage. In 12.9% of the cases there were other pathologies unrelated to pregnancy, and 14% of the births were accomplished by means of cesarean section. Only 12.1% and 13% of the women, respectively, received information about postpartum contraception at the women's counseling sites and delivery wards. 46.3% of the women wanted to use IUDs, but only 7.3% wanted to use hormonal preparations. Only about half of the women expressed their opinion about sterilization: 23% were against it, while 29.7% were for it. The results indicated that the preparation of women for postpartum contraception should already start at the counseling place during pregnancy.

The authors present new methodologic approaches to analysis of the efficacy of maternity and childhood protection: reproductive loss, fetal and neonatal mortality comprising stillborns and infants dead before the age of 1 year, coefficient of late to early infant mortality, and population working potential loss. The said indexes were calculated for four territories of the Russian Federation. The results demonstrate a high share of induced abortions (the mean value 65%) among the causes of reproductive loss. A high share of perinatal loss (feto-neonatal mortality) necessitates increase of resources allotted to perinatal technology to 70%, this value being associated with working potential loss: 11.9 thousand man-years among men and 9.0 thousand man-years among women.

Maternal mortality in the USSR in 1988 stood at 43/100,000 population. this figure broke down into mortality from ectopic pregnancy (5%); from induced and self-induced abortion (29.1%); and, from 28 weeks of gestation, mortality from births as well as during the postpartum period (65.9%). Prior to 1991, in 3 years 2020 women died of abortion-related causes, 76.7% of them in connection with non-medical abortions. The original medical documentation of 342 women who died of abortion was analyzed. 69.6% of the women died in connection with non-medical abortion. 72.6% of these women died during the period of 13-27 weeks of gestation. It was especially noteworthy that 58.8% of the women died in cases where their pregnancy was up to 12 weeks of duration and termination of pregnancy could have been performed. Contributory factors were intervention with the purpose of abortion outside of a medical facility, belated provision of medical help, and inadequate equipment at the medical facility. 78/1% of the deaths of non-medical abortions were caused by introduction of catheters or solutions into the uterine cavity and by the opening of the fetal sack through the use of drugs. 32 women carried out the intervention themselves, and 34 were done by strangers, including 18 medical personnel. Sepsis and peritonitis caused 88.6% of the deaths, and hemorrhage caused 6.7%. After induced medical abortions, 44.2% of women died from peritonitis and sepsis, 17.4% from extragenital diseases, and 26.9% from other causes. Only 22.7% of the cases were selected as case studies for medical conferences. Measures regarding the lowering of mortality from abortions have to be directed primarily at the prevention of non-medical or criminal abortions.

Guidelines for the assessment of gynecologic morbidity in children and adolescents have been developed by the authors. A methodology of elucidation of gynecologic morbidity in children and adolescents was obtained and a classification of gynecologic diseases suggested. Efficiency of current therapy in childhood and adolescence as a determinant of reproductive health in womanhood is shown.

The change in antenatal care is discussed for the last 40 years. Evidence is presented on the efficacy of antenatal care with the advent of current approaches. Its role in the reduction of maternal mortality is shown.

The results of cluster analysis of maternal mortality after cesarean section in the USSR are reported. The statistical data were collected for the 1980-1986 period for USSR in total and for various regions. Region A included Baltic republics and Byelorussia; region B included Russia, Ukraine, Armenia and Moldavia; region C included Uzbekistan, Kazakhstan, Kirgizia, Azerbaijan, and Georgia; and region D included Tadzhikistan and Turkmenia. In the USSR, cesarean section was performed in 1.6-3.1% of all pregnancies (2.4-4.6%, 1.8-3.7%, 0.9-1.9%, and 0.8- 1.5% in regions A, B, C and D, respectively). Mortality rate after cesarean section was 0.4-0.2% for the USSR (0.09-0.08%, 0.35-0.10%, 0.80-0.40%, and 1.60-0.50% for regions A, B, C and D, respectively). Indications for cesarean section included abruptio placentae (34.2%), late toxemia (22.9%), cicatrix in the uterus (8.7%), narrow pelvis (8.7%), anomaly of labor activity (8%), extragenital pathology (5.8%), placenta previa (5.1%), fetal distress (3.6%), and others (3%). Emergency cesarean section was performed in 90% of the patients (only 18% underwent emergency cesarean section within 1 hour after the diagnosis). The most frequent cause of death after cesarean section was hemorrhage (36.2%). The 2nd leading cause of death was late toxemia (17.5/%). Other causes of death included cerebral hemorrhage (8.1%), brain edema (9.8%), complications of anesthesia (9.5%), extragenital diseases (7.7%), and hypotonia of the uterus (5.6%).