A sample of 339 girls aged 13-19 who requested postcoital contraception from the Centri Educazione Matrimoniale e Prematrimoniale in Milan between 1983 and 1987 is analyzed in terms of contraceptive behavior. The majority were aged 16-19, although 8.8% were 15. 75.5% had had their 1st sexual experience between age 17 and 19. 43% had relied on withdrawal; 20% had used no contraceptive; and 51.2% had used condoms, and broken or improperly used condoms accounted for 36.8% of the requests for postcoital contraception. 41% came to the Center within 3 months of commencing sexual activity. 50% returned to the Center to request contraceptives; in 78% of the cases they chose the pill. Several cogent facts about adolescents' knowledge and attitudes emerged from the analysis. Many of the girls had only vague or inaccurate knowledge of reproductive physiology and menstruation. Many considered contraception unnecessary because they had intercourse only occasionally. Many feared the side effects of contraceptives. Adolescents often do not use contraceptives because they fear that their parents will find out. Others fear going to a gynecologist, and often the girls say that the boys do not want to use a condom.
A questionnaire was devised to determine whether abortion is a matter which affects men. 104 men were interviewed, almost all resident in Genoa, a few in Venice and Milan, Italy, aged 19-67 years. The best represented group was the 30-40 age group with 42 men (40.38%). There were only 4 men under 20 and only 2 over age 60. Clerical workers and civil servants were the dominant group (34.6%), followed by the professional and managerial class (23%) and workers (21%); there were fewer craftsmen, traders, and students. 61.5% indicated they had a "direct" experience of abortion (of their women partners). 43.7% stated that the choice was made by both partners; the initiative was the couple's. In 34.3% of the cases, the woman took the initiative on her own. If there were quite a few men who still spoke with resentment of this imposition, the silence of most of them in this regard is thought to be because the woman's decision also could have been a painful necessity dictated by the man's absence. The situation is reversed in the 21.8% cases where the man made the decision. Among these cases there emerged a sort of counterdecision, that of 1 man who forbade his wife absolutely to proceed with an abortion which she wanted, and conquently the abortion did not occur. According to the men, they accompanied their wives or companions, encourage them, and helped them with the housework. 59.3% of the 64 men who indicated they had this experience stated that they played an active role; 31.2% felt that the abortion was something totally to do with the woman, and they let her do everthing. Almost all men reported fear, anxiety, and tension. 9.3% indicated that the matter did not affect them. That abortion leaves a long-lasting memory was confirmed by 17.8% of those men who had experienced it. In 46.8% of the cases, the relationship suffered serious aftereffects, and in a further 15.6% of cases the final breakup was attributed to the abortion itself.
England's Family Planning Association's (FPA) MEN TOO campaign evolved from the recognition that men seemed to receive less support and encouragement than women in their involvement in the emotional aspects of relationships, family planning, and child rearing. Created out of a concern for balancing the selective attention given to men and women, the longterm goal of the MEN TOO campaign was to support the growing number of men who are concerned about increasing their participation in emotional expression, family planning, child rearing and related areas and to explore ways of improving the information and education services that contribute to a better understanding of these issues. The shortterm project goals were to: raise the "unspoken issues" for public debate; encourage more communication and an improved quality in personal and sexual relationships; and raise the support for effective contraceptive use in sexual relationships. Prior to the publicity campaign a select bibliography, a document outlining the need for and general aims of the MEN TOO project, and a report indicating that family planning services needed to be more flexible and accommodating to men were prepared. A press conference officially launched the MEN TOO project. During the autumn of 1984 and the spring of 1985 public service announcements were transmitted on all 9 of the independent television stations participating in the scheme. The FPA's 1-day conference, "Men, Sex and Relationships" in March 1985, in London. 400 delegates, attended both professional and laypersons, about 1/3 of them men. To give the initial impetus to changing the general atmosphere within family planning clinics and to changing staff attitudes toward men, a letter was sent from the FPA's Secretary General to all District Medical Officers, with copies to Senior Family Planning Officers and to District Health Education Officers, describing the campaign and expressing the hope that more men would come forward to seek contraceptive advice. All family planning clinics were given window stickers welcoming MEN TOO together with details of the project. 4 experimental courses serving 20 participants each were organized by the PFA Education Unit, designed specifically for clinic receptionists. These courses aimed to increase the communication skills of the reeptionists and to provide some factual information about contraception and preventive health care. To meet the needs of young men with learning problems, the Brook clinics produced an explanatory "teaching the use of the sheath" chart to be used as a prompt by clinic staff. A spinoff of the MEN TOO campaign was the establishment of 2 WELL MAN clinics. Early feedback is encouraging. Family planning attendance figures for 1984 showed the highest ever attendance by men.
This article highlights the findings of a 3-stage analysis conducted in 1982-85 by the Council of Europe Committee of Experts on Fertility Trends: The 1st phase involved a demographic analysis of reproductive behavior in the past decade, the 2nd focused on the background of recent fertility trends, and the 3rd examined possible consequences of these trends. Participating countries included Belgium, France, Federal Republic of Germany, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Switzerland. During the 1970s; most of these countries experienced a continuation of the fertility decline begun in the mid-60s, resulting in the large majority of countries in below-replacement reproduction. In general, the effect of the fertility decline on the birth rate has been partially compensated by the favorable age structure of the reproductive age population. In the 1st half of the 1970s, both nuptiality and reproductive behavior in marriage contributed to the fertility decline; in the 2nd half, marital fertility showed increases. The fertility decline in the 1st half of the 1970s largely reflected the steep decline in fertility among younger age groups, whereas a rise in the fertility in the older age groups was a characteristic of the late 1970s. However, the stabilization or even slight increase in fertility noted in the late 1970s in several European countries reverted to a decline in the early 1980s. In general, small family size appears to be viewed as a good compromise between pyschological and economic costs and benefits. These low fertility trends have had a dramatic effect on household composition and have also facilitated women's personal growth and economic independence. These trends are expected to lead to demographic aging of the population and alleviation of pressures on the labor market. All such changes will require adaptive population policy measures. It is important that such policies do not endanger achievements of modernization such as human rights, fertility regulation, and female employment.
The dominant cultural message has been that doctors, not women, ensure health, and that men, not women, are biologically the more vulneralbe sex, with a mortality and physical morbidity record exceeding that of women from birth to death. Ther is therefore something paradoxical about women's relationship to health and health care. As providers of health and health care women are important through their role in the division of labor. In their domestic lives they provide health by attending to the physical needs of those with whom they live. Also within official health care systems women are important as providers of care. In Britain 75% of the workers in the National Health Service are women, but only about 20% of British doctors are women. As doctors, midwives, and nurses, women health care providers in Britain and most other so-called developed countries are concentrated in the lower status grades of health services. But today women's roles as health care providers in the home and as midwives are being eroded because of the changing role of women and because of advanced technology regarding childbearing. Th place of childbearing in women's lives has been a theme of debate of feminists. The extent of medical surveillance over pregnancy and birth is about 100% in most developed countries today, and in some European countries operative deliveries are now over 20%. In Britain about 1% of the public money spent on health, education, and social services is spent on services for young children, and although some other countries do better, the rule is still that mothers are themselves responsible for the children. Thus there is a contradiction; women are considered both irresponsible to make certain decisions at certain times in their lives, and are considered over-responsible for their children. In the privacy of the home, and as mothers, women are powerful, but in public they are not. Another aspect of this situation is the predomination of women over men in admissions to hospitals for psychiatric problems. This can be interpreted another way: when men and women present essentially the same symptoms to their doctors, the women are more likely to get a psychiatric diagnosis. Thus in a way health status is socially determined and therefore women take a wider degree of responsibility for their own health and health care decision making, and should continue to do so in the future, even if this means taking some of the responsiblitity away from medical professionals. Especially vulneralbe to unequal treatment by the medical professional are women having young children; these women are often regarded and/or treated as depressed. The emotional, political, and financial dependency of women's family welfare role is perhaps their greatest disablement today. In being carriers of society's unresolved problems of dependency in human relationships, women are not helped to articulate their own interests.
