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AND ABORTIONS IN THE DISTRICT PLOVDIV
Shopov Dimitar Georgiev
MD, PhD, Chief Assistant Prof. Department of Social Medicine and Public Health Medical University - Plovdiv, Bulgaria
Mihaylova Vanina Krasteva
PhD, Assoc. Prof. Department of Preventive Medicine, Faculty of
Public Health, Sofia; Chief Assistant Department of Healthcare Management, Faculty of Public Health, Medical University, Plovdiv, Bulgaria
Stoeva Teodora Radeva
Senior health care University Hospital "Sv. George " - Plovdiv Bulgaria
ABSTRACT
The macroeconomics, the labour market and the standard of life of the population play a decisive role for the demographic processes in Bulgaria. The inflation and the inherent financial destabilization suppress the reproductive attitude of the population. The present article analyzes:
the tendencies of the geographic indices of the population in the district of Plovdiv birth rate
the dynamics of the registered abortions: by age, by type, at will for a 5-year period from 2010 to 2014 inclusive. The following facts have been established:
- The population in the distirct of Plovdiv decreases
- The highest number of abortions is performed by women in the age group 20-29, immediately followed by those aged 3039.
- A high relative share of the spontaneous abortions towards the total number of abortions
- A high relative share (49.7%) of desired abortions, performed by women who do not have children or have only 1 child. The possible reasons for the mass practice of abortion as a means of birth rate control are indicated.
Keywords: abortion, natural growth in population, demographic indices, population, birth rate, fertile age
DEMOGRAPHY, BIRTH RATE
OF
Introduction:
Reports and analyses of world and European official institutions point out that the demographic problem is an issue concerning all European countries. According to a study of the UN, the population of our continent is drastically decreasing and the tendencies are for deepening of the crisis. Bulgaria occupies 210th place according to birth rate in the world, with 8.92 births per 1000 people, states a report of the World Book of Facts as of March 2014. Our neighbouring countries are ahead of us: Macedonia - 171th place, Romania - 206th place and Serbia -208th place. After us is only Greece, occupying 213th place. By death rate index, Bulgaria occupies the sixth place in the world. Here the death rate is 14.3 per 1000 people. Ahead of us are South Africa - 17.49, Ukraine - 15.72, Lesoto - 14.91, Chad -14.56 and Guinea Bissau - 14.54. Our country occupies 229th place according to growth in the population, with a negative coefficient of minus 0.83%. The macroeconomics, the labour market and the standard of life of the population play a decisive role for the demographic processes in Bulgaria.[1;3] Our country occupies one of the last places in Europe by the index „gross domestic product per capita"[7;9]. The highest relative share in the category of poor people is occupied by people with
primary and lower education, unemployed, unmarried mothers, where the level of poverty is almost three times higher than the average for the country. Poverty is also widespread in families with children, especially with three and more children[11;12]. Inflation and the inherent financial destabilization suppress the reproductive attitudes of the population and motivate many young and educated people to look for their career development abroad. Despite the decreasing rate of unemployment and the tendency of opening more workplaces, the young people are still facing difficultie s in finding their first job after graduation[14;15]. There is still a controversy on the labour market - the preference for hiring young people and the simultaneous requirement for professional experience[16]. Such requirements disbalance the labour market and strain the relations between the generation. On the background of the European standards, the Bulgarian population demonstrates lower sexual and contracepive culture related to the use of low-efficient traditional contraceptive methods and mass practicing of abortion[17;19].
The objectives of our study are:
- the tendencies of the demographic indices of the population in the district of Plovdiv
- birth rate
- dynamics of the registered abortions: by age, by type, by desire
Material and method:
Subject of observation is the population of the district of Plovdiv. The study is retrospective, for a 5-year period (20102014 inclusive). Quantitative and qualitative indices have been used for the analysis. The primary information has been derived from the National Statistical Institute, the Ministry of Health, the Regional Health Institute - Plovdiv. The information has been processed using variational, alternative and non-parametric analysis. For the computer processing of the collected database
the statistical pack SPSS version 19 and Microsoft Excel have been used.
Results and discussions:
The district of Plovdiv is located in the central part of Southern Bulgaria and occupies an area of 5972.9 sq.m., which is equal to 5.4% of the territory of the Republic of Bulgaria.
As of 31 December 2014, the population of the district of Plovdiv was 675 586 people and constituted 9.4% of the population of the country. There is a tendency of decreasing the population in the district - from 696300 in 2010 to 675 586 in 2014. (Chart 1)
Population in the district of Plovdiv
/
2010year 2011year 2012year 2013year 2014year
□ Total men 334955 328759 327534 327127 325608
□ Total w omen 361345 352125 351326 351070 349978
□ Women aged 15-49 166002 155945 154149 152587 151596
Chart 1
The per cent ratio between men and women is in favour of the women, and in the analyzed period of time a progressive tendency in the direction of the female gender has been observed. The
collapse of the birth rate is a consequence of the sharp decrease in the number of women in reproductive age (15-49). (Table 1)
Table 1
2010 year 2011 year 2012 year 2013 year 2014 year
Total men 48,10% 48,20% 48,20% 48,20% 47,90%
Total women 51,90% 51,80% 51,80% 51,80% 52,10%
Women aged 15-49 45,90% 44,20% 43,80% 43,50% 43,30%
The natural growth in population in the district of Plovdiv (Chart 2) is in the direction of depopulation: - decreasing birth rate
increasing death rate
negative natural growth in population
Natural growth in population
11
1J
2010year 2011year 2012year 2013year 2014year
□ Birth rate 10,3 10 9,8 9,6 9,8
□ Death rate 13,9 13,8 14,3 13,6 14,1
□ Natural growth -3,6 -3,8 -4,5 -4,1 -4,3
Chart 2
Despite the unfavourable statistics, traditionally the birth rate in Sofia is the highest. The second place is occupied by the district of Plovdiv, followed by the district of Varna.
The ratio between the number of births and abortions per 1000 women in the district of Plovdiv is 1:0.4, which has not changed for the last ten years (Chart 3). The change in the model of cohabitation of young couples, most of which live together
without marriage, also plays an important role for the number of newborns. In the past one of the main reasons for concluding a marriage was unplanned pregnancy. Living together without marriage and the spreading of the methods of contraception even among the Roma population gives an opportunity for the couples to postpone the birth of their children for better times.
Births and in the district of Plovdiv
llllllllll.
2010year 2011year 2012year 2013year 2014year
□ Births 43,8 44,5 45,4 44,4 46,7
□ Abortions 16,4 17,4 16,5 16,9 17
Chart 3
The facts with respect to the registered abortions in the age group 20-29, immediately followed by the age group 30-39 have
been analyzed and graphically presented. This is an alarming fact, as those age groups have the highest fertility rate.
Registered abortions
□ 2012year
□ 2013year
□ 2014year
m
below 20years
9,10%
10,30%
9,70%
азэ
20-29years 30-39years ,„
40years
43,30% 42,40% 5,20% 43,60% 39,90% 6,20% 43,60% 41% 5,80%
/
Chart 4
The registered abortions by type have their dynamics during the observed period of time (Chart 5). The highest relative share in the regressive tendency is occupied by the spontaneous abortions. They are followed by the desired abortions. They mark a progressive tendency. The abortions by medical indications have a modest share (around 6%). The economic realities and the changing role of the women in the Bulgarian
society do not allow for the reversion to the model of simple reproduction, where the generations are replaced by the same number, without increasing the population. To this end a woman must have at least two children in her fertile age - between 15 and 49. Statistics shows that this number is below 1.5 on average and marks a downward trend on the background of the reducing number of women in reproductive age.
Registered abortions by type
i—i — i—i i—i i—i
2010year 2011year 2012year 2013year 2014year
□ Desired 40,60% 49,10% 39,90% 41,30% 42,20%
□ Under medical 6% 7% 5,60% 5,80% 5,80%
indications
□ Spontaneous 53,40% 43,90% 53,40% 52,90% 52%
Chart 5
The fact reported from the data on chart 6 for the distribution of desired abortions is also alarming. The highest per cent belongs to the mothers with two children, followed by mothers with one or without children, considering the fact that from all
Chart 6
Conclusions:
1. The number of the population in the district of Plovdiv decreases.
2. The analysis of the two events - childbirth and abortions in the district of Plovdiv reports a ratio of 1:0.4 between them, which has remained unchanged for the last five years.
3. The registered abortions in 2014 are 2 580 or 17.0 per 1000 women in reproductive age (15-49 years of age). The number of abortions of 1000 women in fertile age in the district of Plovdiv is equal to the average rate for Bulgaria in 2014 -17.6%o.
4. The highest number of abortions has been performed by women aged 20-29, followed by those aged 30-39.
5. A high relative share of the spontaneous abortions towards all abortions
6. A high relative share (49.7%) of desired abortions performed by women who have no children or have only 1 child.
7. The probable reasons for the mass abortions as a means of control of the birth rate can be explained with the following:
- insufficient sexual education of juveniles, necessary for the formation of healthy habits, communicational skills and responsible behaviour.
- decrease in the age of starting sexual life
- increase in the number of sexual partners
desired abortions in the district of Plovdiv in 2014, 49.7% have been performed by women who do not have children or have only 1 child (Chart 6).
- promiscuous sexual contacts and lack of knowledge of preservation of the reproductive health
- insufficient family planning in practice.
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Al
ocation of willful abortions
flL
withoutchild ren with 1child with 2children w ith3andmo rechildren
□ 2012year 23,40% 29,60% 35% 12%
□ 2013year 19% 30,70% 36,20% 14,10%
□ 2014year 21,20% 28,50% 36% 14,30%
w
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