Portal de Periódicos da CAPES

[Chilean history of infant and maternal mortality, 1940 -1985].

1987; National Institutes of Health; Issue: Spec No Linguagem: Inglês

B Viel, Wagner de Campos,

Ethics and bioethics in healthcare

In 1940, Chile had a population of slightly over 5 million, a crude birth rate of 36.4/1000, a death rate of 21.3/1000, and a natural increase of 1.5%. Between 1940-65, birth rates remained stable and high while the death rate declined steadily, so that the rate of natural increase gradually rose to 2.6%. After 1965, the birth rate declined faster than the death rate, and the natural increase rate slowly returned to its 1940 level--this due to lower fertility rather than high mortality. A slight increase in fertility rates followed a pronatalist campaign launched in 1978, but another slight decline began in 1982. The natural increase rate in 1985 was 1.6%. A private family planning organization was started in chile in the early 1960s to respond to the problem of illegal abortion. Studies had shown that 80% of Chilean women seeking abortion were married or in stable unions with 3 or more living children. In 1965, Chile's new family planning organization reached an agreement with the Ministry of Health whereby free family planning information and services would be offered in Ministry of Health facilities facilities to all women seeking them. The association also became a member of the International Planned Parenthood Federation, enabling it to receive external aid in the form of modern contraceptives and gynecological equipment. In its 21 years of existence, the family planning associated has maintained its agreement with the Ministry of Health and initiated others. Between 1960-84, with availability of family planning services, age specific fertility rates declined slightly for women aged 15-19 and very greatly for older women. In 1960 and 1984 respectively, age specific rates were 72.6 and 64.0 for women aged 15-19, 211.1 and 141.1 for women 20-24, 240.9 and 127.6 for those 25-05.5 and 90.8 for those 30-34, 141.4 and 45.0 for those 35-39, and 62.2 and 14.4 for those 40-44. The total fertility rate was 4.7 in 1960 and 2.4 in 1984. The family planning program has greatly reduced health risks from multiparity, but adolescent pregnancy continues to pose a threat for mothers and children, especially since over half of births to women under 20 are illegitimate. Chile's infant mortality rates were 192.8 1940, 120.3 in 1960, and 19.7 in 1985. Between 1960-85, the neonatal rate declined from 35.2 to 10.4. It is possible that decline in late infant mortality was relative to the declining proportion of unwanted births made possible by availability of family planning services. It has been estimated that 30% of the decline in infant mortality between 1972-82 was due to the decline in high order births made possible by family planning. Maternal mortality has declined due to better care during pregnancy and delivery, decline in illegal abortions, and decreased fertility among women over 35.