"Infertility as a social and medical problem."

1. Infertile marriage.

4. Role social workers in the prevention of infertility.

Relevance chosen topic is the need to increase the birth rate in Russian Federation to overcome the difficult demographic situation

Object is infertility.

the role of social workers in the prevention of infertility.

Purpose test work is to study the causes of infertility in men and women and the role of social workers in the prevention of infertility.

Infertile marriage.

Infertility- inability of persons of working age to reproduce. A marriage is considered infertile if a woman does not become pregnant within a year of regular sexual activity without the use of contraception. Infertility can be male or female. The male factor accounts for 40-60% in a childless marriage.

Consequently, a diagnosis of infertility in a woman can be made only after excluding infertility in a man (with positive tests confirming the compatibility of sperm and the cervix).

Relative– the possibility of pregnancy cannot be excluded. Absolute – pregnancy is not possible. According to the WHO classification, the main groups of causes of infertility are distinguished:

· ovulation disorder 40%

tubal factors associated with fallopian tube pathology 30%

gynecological inflammatory and infectious diseases 25%

· unexplained infertility 5%

The primary incidence of infertility, according to official statistics, was in 1998. 134.3 per 100,000 women. In total, 47,322 women applied for infertility issues during the year. This married women those who want to have children and go to a medical facility, therefore, the real level of infertility is much higher. According to special studies, the number of infertile marriages in Russia is 19%, according to international experts 24-25%. Thus, every fifth married couple cannot have children.

The causes of infertility are socially determined, being a consequence of abortions, sexually transmitted diseases, gynecological diseases, unsuccessful birth. Infertility often develops in childhood. Prevention of infertility should be aimed at reducing gynecological morbidity in women, preventing abortions, the formation healthy image life and optimal sexual behavior.

Infertility is an important medical and social problem, as it leads to a decrease in the birth rate. By solving the problem of infertility, it would significantly improve population reproduction rates. Infertility is an important socio-psychological problem, as it leads to socio-psychological discomfort of the spouses, conflict situations in the family, an increase in the number of divorces.

coarsening of morals, antisocial behavior (extramarital affairs, alcoholism), aggravation of selfish character traits, disturbances in the psycho-emotional sphere and sexual disorders in spouses. Long-term infertility creates a large neuropsychic tension leads to divorce. 70% of infertile marriages are dissolved.*

Diagnosis of infertility is carried out by antenatal clinics and family planning services. And in in some cases requires inpatient treatment in gynecological departments.

Abortion.

According to experts, from 36 to 53 million abortions are performed annually in the world, i.e. every year about 4% of women of fertile age undergo this operation. In Russia, abortion remains one of the methods of birth control. In 1998 1,293,053 abortions were performed, which is 61 per 1,000 women. If at the end of the 80s it was 1/3 of everyone in the world, then since the beginning of the 90s, thanks to the development of family planning services, the frequency of abortions has been gradually decreasing. However, in Russia compared to other countries they still remain high.

Abortion is legal in most countries around the world. For only 25% of women in the world, legal reproduction is not available (mostly these are residents with strong clerical influence or a small population). All European countries, with the exception of the Republic of Ireland, Northern Ireland and Malta, allow induced abortion. IN different countries There are various laws governing the procedure for terminating a pregnancy.

· L. V. Anokhin and O. E. Konovalov

1. Laws allowing abortion at the request of a woman. In most European countries, abortion can be performed up to 12 weeks of pregnancy, in Holland up to 24 weeks, in Sweden up to 18 weeks. The age at which a girl can independently decide to have an abortion:

Denmark and Spain - after 18 years

In a number of countries (Italy, Belgium, France), a woman is given a mandatory 5-7 days to think and make an informed decision. These laws apply in countries where 41% of the world's population lives.

3. Laws restricting the right to abortion. In a number of countries, abortion is allowed only in case of threat to physical or mental health women: congenital deformities, rape. About 12% of the world's population lives in conditions where the right to abortion is restricted.

4. Laws prohibiting abortion under any circumstances.

The USSR legislation on abortion can be divided into three stages:

Stage 1 (1920-1936) - legalization of abortion.

Stage 2 (1936-1955) - prohibition of abortion.

Stage 3 (1955 to the present day) - permission for abortion.

Currently in Russia, any woman has the right to have an abortion up to 12 weeks of pregnancy. Artificial termination of pregnancy for medical reasons is carried out with the consent of the woman, regardless of the stage of pregnancy. Scroll medical indications determined by Order of the Ministry of Health No. 242 dated 12/12/96, artificial termination of pregnancy up to 22 weeks of pregnancy can be performed with the consent of the woman for social reasons.*

The system of prohibitions, including abortion, does not lead to the desired results. The ban on abortion and the lack of family planning programs lead to an increase in the number of criminal abortions. Teenagers use illegal abortion to terminate their first pregnancy. At the same time, in developing countries, more than half of maternal deaths occur due to illegal abortions.

But even legal abortion has serious negative impact ________________________________________________________________

*"Work organization antenatal clinic»

on the woman's body.

Abortion is the cause of secondary infertility in 41% of cases.

After an abortion, the frequency of spontaneous miscarriages increases 8-10 times.

About 60% of first-time women over the age of 30 suffer from miscarriage caused by their first abortion. In young women who terminate their first pregnancy with an abortion, the risk of developing breast cancer increases by 2-2.5 times.

The role of social workers in the prevention of infertility.

- this is freedom in deciding the number of children, the timing of their birth, the birth of only desired children from parents who are ready for a family.

Helps a woman regulate the onset of pregnancy optimal timing to preserve the child’s health, reduce the risk of infertility; reduce the risk of contracting sexually transmitted diseases;

· makes it possible to avoid conception while breastfeeding, reducing the number of conflicts between spouses;

guarantees birth healthy child in case of an unfavorable prognosis for the offspring;

· contributes to the decision about when and how many children a given family can have;

· increases the responsibility of spouses to future children, cultivates discipline, and helps avoid family conflicts.

· Provides the opportunity to lead sex life without fear unwanted pregnancy without exposing yourself to stress, continue your studies without hindrance, master a profession, build a career;

Enables husbands to mature and prepare for future fatherhood, helps fathers provide for their family financially.

Childbirth is regulated in three ways:

2. sterilization

CONTRACEPTION.

In economically developed Western countries, more than 70% of married couples use contraceptives. About 400 million women in developed countries use various methods contraception to prevent unwanted pregnancy. Over the 30 years of family planning services, more than 400 million births have been avoided around the world.

by the number of intrauterine devices and hormonal contraception. Thus, in 1998, 17.3% of women of fertile age with intrauterine devices were under observation, and 7.2% using hormonal contraception. It should be noted that while the number of women who have IUDs has not changed significantly since 1990, the number of women using hormonal contraception has increased 4.3 times. Special studies show that in Russia approximately 50-55% of married couples regularly use birth control.

social factors (in particular, the attitude of the country’s government towards contraception, economic situation)

cultural factors (in particular traditions)

attitude towards religion

·legal restrictions (limiting the types of contraception that can be used)

When deciding on a particular contraceptive, the following points must be taken into account:

any method of protection better than nothing protection in general;

The most acceptable method is the one that suits both partners;

Basic requirements for methods of protection:

·reliability of the method;

·minimal impact on the sexual partner;

· ease of use;

·safety;

rapid restoration of fertility

Thus, providing women with the right to reproductive health care, including family planning, is a fundamental condition for their full life and the realization of gender equality. The realization of this right is possible only with the development of the planning service, the expansion and implementation of the “Safe Motherhood” programs, the improvement of sex and hygiene education, and the provision of contraceptives to the population, especially young people. Only this approach will help solve the problem of abortion and STDs.

STERILIZATION.

indications and contraindications for surgical sterilization. There are only three social indicators:

3. age over 30 years with 2 children

However, sterilization cannot be regarded as the optimal way to prevent pregnancy; it is not very popular among the population.

1. V. K. Yuryev, G. I. Kutsenko “Public health and healthcare”

Publishing house "Petropolis" St. Petersburg" 2000

2. Socis magazine No. 12 2003

The relevance of the chosen topic is the need to increase the birth rate in the Russian Federation to overcome the difficult demographic situation

Object is infertility.

Subject: the role of social workers in the prevention of infertility.

The purpose of the work is to study the causes of infertility in men and women and the role of social workers in the prevention of infertility.

INFERTILITY MARRIAGE.

Female infertility can be primary (in the absence of a history of pregnancy) and secondary (in the presence of a history of pregnancy). Distinguish between relative and absolute female infertility.

Relative- the possibility of pregnancy cannot be excluded.

Absolute - pregnancy is not possible.

According to the WHO classification, the main groups of causes of infertility are distinguished:

· ovulation disorder 40%
tubal factors associated with fallopian tube pathology 30%
· gynecological inflammatory and infectious diseases 25%
· unexplained infertility 5%

The primary incidence of infertility, according to official statistics, was in 1998. 134.3 per 100,000 women. In total, 47,322 women applied for infertility issues during the year.

The causes of infertility are socially determined, being a consequence of abortions, sexually transmitted diseases, gynecological diseases, and unsuccessful births. Prevention of infertility should be aimed at reducing gynecological morbidity in women, preventing abortions, promoting a healthy lifestyle and optimal sexual behavior.

Infertility is an important medical and social problem, as it leads to a decrease in the birth rate. Infertility is an important socio-psychological problem, as it leads to socio-psychological discomfort of spouses, conflict situations in the family, and an increase in the number of divorces. fertility infertility social

Social and psychological ill-being is manifested by a decrease in interest in current events, the development of an inferiority complex, and a decrease in overall activity and performance. In marriage, coarsening of morals, antisocial behavior (extramarital affairs, alcoholism), aggravation of selfish character traits, disturbances in the psycho-emotional sphere and sexual disorders in spouses can be observed. Long-term infertility creates great neuropsychic tension and leads to divorce. 70% of infertile marriages are dissolved.

The relevance of the chosen topic is the need to increase the birth rate in the Russian Federation to overcome the difficult demographic situation

Object is infertility.

Subject: the role of social workers in the prevention of infertility.

The purpose of the test is to study the causes of infertility in men and women and the role of social workers in the prevention of infertility.

Infertile marriage.

Consequently, a diagnosis of infertility in a woman can be made only after excluding infertility in a man (with positive tests confirming the compatibility of sperm and the cervix).

Female infertility can be primary (in the absence of a history of pregnancy) and secondary (in the presence of a history of pregnancy). There are relative and absolute female infertility. Relative- the possibility of pregnancy cannot be excluded. Absolute - pregnancy is not possible. According to the WHO classification, the main groups of causes of infertility are distinguished:

· ovulation disorder 40%

tubal factors associated with fallopian tube pathology 30%

· gynecological inflammatory and infectious diseases 25%

· unexplained infertility 5%

The primary incidence of infertility, according to official statistics, was in 1998. 134.3 per 100,000 women. In total, 47,322 women applied for infertility issues during the year. These are married women who want to have children and go to a medical facility, therefore, the real level of infertility is much higher. According to special studies, the number of infertile marriages in Russia is 19%, according to international experts 24-25%. Thus, every fifth married couple cannot have children.

The causes of infertility are socially determined, being a consequence of abortions, sexually transmitted diseases, gynecological diseases, and unsuccessful births. Infertility often develops in childhood. Prevention of infertility should be aimed at reducing gynecological morbidity in women, preventing abortions, promoting a healthy lifestyle and optimal sexual behavior.

Infertility is an important medical and social problem, as it leads to a decrease in the birth rate. By solving the problem of infertility, it would significantly improve population reproduction rates. Infertility is an important socio-psychological problem, as it leads to socio-psychological discomfort of spouses, conflict situations in the family, and an increase in the number of divorces.

Diagnosis of infertility is carried out by antenatal clinics and family planning services. And in some cases, inpatient treatment in gynecological departments is required.

Genetic factors as general biological constants. Genotype as a set of genes, healthy and pathologically altered, received from parents. Mutations are changes in genes that occur throughout an individual's life.

Groups of diseases caused by genetic risk.

Chromosomal and gene hereditary diseases(Down's disease, hemophilia and others).

· Hereditary diseases that arise under the influence of external factors (gout, mental disorders, etc.).

· Diseases with a hereditary predisposition (hypertension and peptic ulcers, eczema, tuberculosis, etc.).

6. Infertility as a social and medical problem. Infertile marriage. Female and male infertility. The role of social workers in the prevention of infertility.

Infertility can be male or female.

Causes of female infertility: impaired egg maturation, impaired patency or contractile activity of the fallopian tubes, gynecological diseases. Endocrine causes of female infertility.

Timely consultation with a doctor regarding menstrual irregularities, inflammatory processes of the genital organs how to prevent infertility.

Male infertility.

Factors influencing male infertility: malformations of the genital organs, surgeries on the genital organs, trauma, inflammation, chronic diseases, sexually transmitted diseases, alcoholism, drug addiction, substance abuse, endocrine factors.

The male factor accounts for 40-60% in a childless marriage. Consequently, a diagnosis of infertility in a woman can be made only after excluding infertility in a man (with positive tests confirming the compatibility of sperm and the cervix).

Female infertility can be primary (in the absence of a history of pregnancy) and secondary (in the presence of a history of pregnancy). There are relative and absolute female infertility.

Relative - the possibility of pregnancy cannot be excluded. Absolute - pregnancy is not possible. According to the WHO classification, the main groups of causes of infertility are distinguished:

· ovulation disorder 40%

tubal factors associated with fallopian tube pathology 30%

· gynecological inflammatory and infectious diseases 25%

· unexplained infertility 5%

In marriage, coarsening of morals, antisocial behavior (extramarital affairs, alcoholism), aggravation of selfish character traits, disturbances in the psycho-emotional sphere and sexual disorders in spouses can be observed. Long-term infertility creates great neuropsychic tension and leads to divorce. 70% of infertile marriages are dissolved.* Diagnosis of infertility is carried out by antenatal clinics and family planning services. And in some cases, inpatient treatment in gynecological departments is required.

Family planning- this is freedom in deciding the number of children, the timing of their birth, the birth of only desired children from parents who are ready for a family.

Family planning:

· helps a woman regulate the onset of pregnancy at the optimal time to preserve the health of the child, reduce the risk of infertility; reduce the risk of contracting sexually transmitted diseases;

· makes it possible to avoid conception while breastfeeding, reducing the number of conflicts between spouses;

· guarantees the birth of a healthy child in case of an unfavorable prognosis for the offspring;

· contributes to the decision about when and how many children a given family can have;

· increases the responsibility of spouses to future children, cultivates discipline, helps to avoid family conflicts

· provides the opportunity to have a sexual life without fear of an unwanted pregnancy, without exposing yourself to stress, to freely continue your studies, master a profession, and build a career;

Enables husbands to mature and prepare for future fatherhood, helps fathers provide for their family financially. Childbirth is regulated in three ways:

1. Contraception

2. sterilization

CONTRACEPTION.

Giving women the right to reproductive health care include family planning, is a fundamental condition for their full life and the realization of gender equality. The realization of this right is possible only with the development of the planning service, the expansion and implementation of the “Safe Motherhood” programs, the improvement of sex and hygiene education, and the provision of contraceptives to the population, especially young people. Only this approach will help solve the problem of abortion and STDs.

STERILIZATION.

In order to protect women's health, reduce the number of abortions and mortality from them, surgical sterilization of women and men has been allowed in Russia since 1990.

It is performed at the request of the patient if there are appropriate indications and contraindications for surgical sterilization. There are only three social indicators: 1. age over 40 years;

2. presence of 3 or more children

3. age over 30 years with 2 children

However, sterilization cannot be regarded as the optimal way to prevent pregnancy; it is not very popular among the population.

Abortion is the artificial termination of pregnancy. According to modern medical standards, abortion is usually performed up to 20 weeks of pregnancy or, if the gestational age is unknown, when the fetus weighs up to 400 g.

Abortion methods are divided into surgical, or instrumental, and medical. Surgical methods involve removing the fetus using special instruments, but do not necessarily involve surgery. Medical or pharmaceutical abortion is the provocation of spontaneous abortion with the help of medications.

Medical abortion

Medical abortion is performed up to 9-12 weeks of pregnancy, depending on the recommendations and regulations in a particular country. In Russia, the limit for medical abortion is usually lower: up to 42 or 49 days from the beginning of the last menstruation. The medication method is a safe method of abortion and is recommended by WHO for pregnancy up to 9 weeks. There are also schemes for conducting medical abortion for the second trimester of pregnancy.

Medical abortion is usually performed using a combination of two drugs: mifepristone and misoprostol. According to Russian standards, the patient can receive these drugs only from her doctor and takes them in his presence. The free sale of medical abortion products is prohibited. In regions where mifepristone is not readily available, medical abortion is performed using only misoprostol.

Medical abortion with a combination of mifepristone and misoprostol results in complete abortion in 95-98% of women. In other cases, abortion is completed using vacuum aspiration. In addition to incomplete abortion, the following complications may occur during a medical abortion: increased blood loss and bleeding (probability 0.3%-2.6%), hematometra (accumulation of blood in the uterine cavity, probability 2-4%). For their treatment, hemostatic and antispasmodic drugs are used, the duration of therapy is 1-5 days.

Surgical methods of abortion

Abortion by surgical methods, that is, using medical instruments, is carried out only by specially trained medical workers in medical institutions. The main instrumental methods of abortion are vacuum aspiration (“mini-abortion”), dilation and curettage (sharp curettage, “curettage”) and dilation and evacuation. The choice of one method or another depends on the duration of pregnancy and the capabilities of a particular medical institution. In Russia, surgical abortion is also often called the procedure of dilatation and curettage.

1.Vacuum aspiration

Vacuum aspiration, along with medical abortion, is safe method abortion according to WHO and is recommended as the main method of abortion for up to 12 weeks of pregnancy. During manual (that is, manual) vacuum aspiration, a syringe with a flexible plastic tube (cannula) at the end is inserted into the uterine cavity. Through this tube, the fertilized egg with the fetus inside it is sucked out. With electric vacuum aspiration, the fertilized egg is sucked out using an electric vacuum suction.

Vacuum aspiration leads to complete abortion in 95-100% of cases. This is an atraumatic method that virtually eliminates the risk of uterine perforation, endometrial damage and other complications that are possible during dilation and curettage. According to WHO, the incidence of serious complications requiring hospital treatment after vacuum aspiration is 0.1%.

2.Dilatation and curettage

Dilation and curettage (also acute curettage, commonly known as “curettage”) is a surgical procedure in which the doctor first widens the cervical canal (dilation) and then scrapes out the walls of the uterus using a curette (curettage). Dilatation of the cervix can be carried out using special surgical dilators or by taking special medications (in this case, the risk of tissue injury and the subsequent development of cervical insufficiency is greatly reduced). Before the procedure, the woman must be given pain relief and sedatives.

3.Dilatation and evacuation

Dilation and evacuation is an abortion method used in the second trimester of pregnancy. WHO recommends it as the safest method of abortion at this stage. However, second trimester abortions are generally more dangerous and more likely to cause complications than earlier abortions. The dilation and evacuation procedure begins with dilation of the cervix, which can take anywhere from a few hours to 1 day. An electric vacuum suction is then used to remove the fetus. In some cases, this is enough to complete the abortion; in other cases, surgical instruments are used to complete the procedure.

4.Artificial birth

Induced childbirth is an abortion method used in the later stages (starting from the second trimester of pregnancy) and is an artificial stimulation of labor.

"Infertility as a social and medical problem."

1. Infertile marriage.

2. Female and male infertility.

3. Abortion as a social phenomenon.

4. The role of social workers in the prevention of infertility.

The relevance of the chosen topic is the need to increase the birth rate in the Russian Federation to overcome the difficult demographic situation

The object is infertility.

Subject: the role of social workers in the prevention of infertility.

The purpose of the test is to study the causes of infertility in men and women and the role of social workers in the prevention of infertility.

Infertile marriage.

Infertility is the inability of people of working age to reproduce. A marriage is considered infertile if a woman does not become pregnant within a year of regular sexual activity without the use of contraception. Infertility can be male or female. The male factor accounts for 40-60% in a childless marriage.

Consequently, a diagnosis of infertility in a woman can be made only after excluding infertility in a man (with positive tests confirming the compatibility of sperm and the cervix).

Female infertility can be primary (in the absence of a history of pregnancy) and secondary (in the presence of a history of pregnancy). There are relative and absolute female infertility. Relative – the possibility of pregnancy cannot be excluded. Absolute – pregnancy is not possible. According to the WHO classification, the main groups of causes of infertility are distinguished:

· ovulation disorder 40%

tubal factors associated with fallopian tube pathology 30%

· gynecological inflammatory and infectious diseases 25%

· unexplained infertility 5%

The primary incidence of infertility, according to official statistics, was in 1998. 134.3 per 100,000 women. In total, 47,322 women applied for infertility issues during the year. These are married women who want to have children and go to a medical facility, therefore, the real level of infertility is much higher. According to special studies, the number of infertile marriages in Russia is 19%, according to international experts 24-25%. Thus, every fifth married couple cannot have children.

Infertility is an important medical and social problem, as it leads to a decrease in the birth rate. By solving the problem of infertility, it would significantly improve population reproduction rates. Infertility is an important socio-psychological problem, as it leads to socio-psychological discomfort of spouses, conflict situations in the family, and an increase in the number of divorces.

Diagnosis of infertility is carried out by antenatal clinics and family planning services. And in some cases, inpatient treatment in gynecological departments is required.

According to experts, from 36 to 53 million abortions are performed annually in the world, i.e. Every year, about 4% of women of fertile age undergo this operation. In Russia, abortion remains one of the methods of birth control. In 1998 1,293,053 abortions were performed, which is 61 per 1,000 women. If at the end of the 80s it was 1/3 of everyone in the world, then since the beginning of the 90s, thanks to the development of family planning services, the frequency of abortions has been gradually decreasing. However, in Russia compared to other countries they still remain high.

Abortion is legal in most countries around the world. For only 25% of women in the world, legal reproduction is not available (mostly these are residents with strong clerical influence or a small population). All European countries, with the exception of the Republic of Ireland, Northern Ireland and Malta, allow induced abortion. Different countries have different laws governing the procedure for terminating a pregnancy.

· L.V. Anokhin and O.E. Konovalov

UK and Sweden - after 16 years

Denmark and Spain - after 18 years

Austria - after 14 years.

2. Laws allowing abortion for social reasons. About 25% of women in the world have the right to abortion for social reasons.

3. Laws restricting the right to abortion. In a number of countries, abortion is allowed only if there is a threat to the woman’s physical or mental health: congenital deformities, rape. About 12% of the world's population lives in conditions where the right to abortion is restricted.

4. Laws prohibiting abortion under any circumstances.

The USSR legislation on abortion can be divided into three stages:

Stage 1 (1920-1936) - legalization of abortion.

Stage 2 (1936-1955) - prohibition of abortion.

Stage 3 (1955 to the present day) - permission for abortion.

Currently in Russia, any woman has the right to have an abortion up to 12 weeks of pregnancy. Artificial termination of pregnancy for medical reasons is carried out with the consent of the woman, regardless of the stage of pregnancy. The list of medical indications is determined by Order of the Ministry of Health No. 242 of December 12, 1996; artificial termination of pregnancy up to 22 weeks of pregnancy can be performed with the consent of the woman for social reasons.*

But even legal abortion has serious negative impacts ________________________________________________________________

*"Organization of the work of the antenatal clinic"

on the woman's body.

Abortion is the cause of secondary infertility in 41% of cases.

After an abortion, the frequency of spontaneous miscarriages increases 8-10 times.

The role of social workers in the prevention of infertility.

Within the competence of social services, it is possible to provide the population with specialized medical and psychological consultation on issues of regulating childbirth. Family planning is freedom in deciding the number of children, the timing of their birth, the birth of only wanted children from parents who are ready for a family.

Family planning:

· helps a woman regulate the onset of pregnancy at the optimal time to preserve the health of the child, reduce the risk of infertility; reduce the risk of contracting sexually transmitted diseases;

· makes it possible to avoid conception while breastfeeding, reducing the number of conflicts between spouses;

· guarantees the birth of a healthy child in case of an unfavorable prognosis for the offspring;

· contributes to the decision about when and how many children a given family can have;

· increases the responsibility of spouses to future children, cultivates discipline, and helps avoid family conflicts.

· Provides the opportunity to have a sexual life without fear of an unwanted pregnancy, without exposing yourself to stress, to freely continue your studies, master a profession, and build a career;

Enables husbands to mature and prepare for future fatherhood, helps fathers provide for their family financially.

Childbirth is regulated in three ways:

1. Contraception

2. sterilization

CONTRACEPTION.

In economically developed Western countries, more than 70% of married couples use contraceptives. About 400 million women in developed countries use various methods of contraception to prevent unwanted pregnancy. Over the 30 years of family planning services, more than 400 million births have been avoided around the world.

In Russia, the proportion of married couples who protect themselves from unwanted pregnancy is lower than in economically developed European countries, but there are no official statistics. Statistical records are kept only on the number of intrauterine devices and hormonal contraception. Thus, in 1998, 17.3% of women of fertile age with intrauterine devices were under observation, and 7.2% using hormonal contraception. It should be noted that while the number of women who have IUDs has not changed significantly since 1990, the number of women using hormonal contraception has increased 4.3 times. Special studies show that in Russia approximately 50-55% of married couples regularly use birth control.

The frequency of contraception use in certain countries is influenced by:

· social factors (in particular, the attitude of the country’s government towards contraception, economic situation)

cultural factors (in particular traditions)

attitude towards religion

· legal restrictions (limiting the types of contraception that can be used)

When deciding on a particular contraceptive, the following points must be taken into account:

· any method of protection is better than no protection at all;

· the most acceptable method is the one that suits both partners;

Basic requirements for methods of protection:

· reliability of the method;

· availability;

· hygiene;

· minimal impact on the sexual partner;

· ease of use;

· safety;

rapid restoration of fertility

STERILIZATION.

In order to protect women's health, reduce the number of abortions and mortality from them, surgical sterilization of women and men has been allowed in Russia since 1990. It is performed at the request of the patient if there are appropriate indications and contraindications for surgical sterilization. There are only three social indicators:

1. age over 40 years;

2. presence of 3 or more children

3. age over 30 years with 2 children

However, sterilization cannot be regarded as the optimal way to prevent pregnancy; it is not very popular among the population.

Literature:

1. V.K. Yuryev, G.I. Kutsenko “Public health and healthcare”

Publishing house "Petropolis" St. Petersburg" 2000

2. Socis magazine No. 12 2003

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