The effects of four progestational drugs on the composition of human milk during the first year of lactation were studied in Egyptian women. In comparison with a group of non-medicated women, chlormadinone acetate, Depo-Provera and Deladroxone all caused a marked increase in protein content in the early stages of lactation; quingestanol acetate had little overall effect. The lipid and lactose content showed irregular changes in the medicated groups as compared with the controls.

Instead of divorce rates per 1000 married population, the actual divorce percentages expressed as the proportion of marriages contracted in successive years since 1911 are calculated from a random sample of 3392 first marriages in Amsterdam. The results show the highest divorce percentages for younger men, decreasing from 40% if they were married at 19 years of age to 12% if they were married at 30 years of age. Women attained these values if married at 17 and 28 years of age, respectively. The divorce percentage has increased from 10% for marriages contracted in 1911 to 20% for those contracted in the period 1941–45. The linear increase suggests that about 25% of marriages contracted in the period 1966–70 will end in divorce. This trend seems to depend on changes in the median age of marriage as well as on different divorce tendencies for men marrying at different ages.

It is hoped that the method of calculating divorce trends according to the year of marriage, and to specific age-groups, as used in this study, might yield more information about the range of the divorce problem than the more traditional methods of populations statistics.

The Griqua, a people of mixed ancestry living mainly in the northern part of the Cape Province, South Africa, bear surnames of British, non-British North Western European, Khoisan, Sotho/Tswana and other Negro origin, as well as a number indicating probable descent from slaves. Bearing in mind the historical circumstances of the formation of the Griqua nation and the relative importance of pater and genitor in the social system, it is possible so to analyse these surnames as to derive a quantitative estimate of the varieties of admixture in the people. The results accord closely with, and amplify, those of a sero-genetic study, which in turn furnishes explanations for some points not amenable to isonymic analysis. The combination of both types of investigation has both provided mutual corroboration and enabled more information to be extracted than would have been possible from either type of investigation on its own.

Sixty-seven GPs from a suburb of Copenhagen were interviewed regarding their experience with and opinion of induced abortion. The younger physicians in the sample were (a) significantly more experienced in areas of medical practice relating to abortion care, (b) significantly more positive in their attitude towards abortion, and (c) significantly more likely to emphasize the provision of contraceptive services to women undergoing pregnancy termination. Independent of the influence of age, a significant positive correlation was found between abortion attitude and the emphasis placed on providing contraception. A physician's self-perceived success in providing post-abortion contraception was found to relate in part to his/her view of the proper role to be played by a GP in abortion cases.

In 1968, a prospective study was started in collaboration with the Family Planning Association to try to provide a balanced view of the beneficial and harmful effects of different methods of contraception. This investigation is now in progress at seventeen clinics and over 17,000 women are under observation. At the time of recruitment, all these women were married white British subjects, aged 25–39 years, who voluntarily agreed to participate. Fifty-six per cent were using oral contraceptives, 25% were using a diaphragm and 19% were using an intrauterine device (IUD). During follow-up each woman is questioned at return visits to the clinic and a record of pregnancies and their outcome, hospital referrals (inpatient or outpatient), changes in contraceptive methods and the results of cervical smears, is accumulated. Women who default are sent a postal questionnaire and, if this is not returned, are telephoned or visited in their homes to collect the necessary information.

So far, data obtained during 56,000 woman-years of observation are available for analysis. Follow-up has been maintained with an annual lapse rate of about 0.3%due to withdrawal of co-operation or loss of contact; adherence to the method of contraception in use at recruitment has been reasonably good, and the reporting of pregnancies and hospital admissions appears to have been both reliable and unbiased.

The present data include only 24 deaths, so the mortality associated with different contraceptive methods cannot yet be estimated. With regard to morbidity, however, our preliminary results closely resemble those obtained in the prospective study carried out by the Royal College of General Practitioners (1974) and in the principal retrospective studies carried out in Britain and the United States. Women who used oral contraceptives at the start of the study experienced a deficiency of hospital referrals for cancer, benign lesions of the breast, menstrual disorders other than amenorrhoea, duodenal ulcer, and retention cysts of the ovary; they showed an excess of referrals for cerebrovascular disease, cervical erosion, skin disorders, self-poisoning, migraine, venous thrombosis and embolism, hayfever, gallbladder disease, amenorrhoea, and sterility. Women who used a diaphragm showed a deficiency of hospital referrals for carcinoma-in-situ and dysplastic lesions of the cervix uteri and accidental injury; and an excess of referrals for haemorrhoids and cystitis. Women who used an IUD experienced an excess of hospital referrals for anaemia, varicose veins and salpingitis. About half of these differences (12 out of 23) were predicted from other studies while some suggestive evidence already existed for a further five. Of the remaining six, some probably reflect the influence of selective factors or chance.

Multiple pregnancies, stillbirths, malformations, the sex ratio and birthweight showed no consistent relationship to method of contraception. The outcome of unplanned pregnancies occurring in women using an IUD, however, was remarkably unfavourable both in terms of ectopic gestation and miscarriage.

Clear evidence was found of impairment of fertility after discontinuation of oral contraceptives. Whether this is likely to lead to permanent sterility in some women is uncertain.

The study has provided data on the efficacy of a wide variety of contraceptive methods. In general the failure rates are in keeping with those obtained in other large-scale studies, save that those for the diaphragm and the sheath are much lower than those usually quoted.

The available evidence does not yet allow a final balance to be struck between the benefits and risks associated with the new methods of contraception that have become widely used during the last two decades. It seems clear, however, that there are no material risks associated with the use of the diaphragm apart from the risk of pregnancy and that there may be some unintended benefits.

A study has been made in a group of rural Oxfordshire villages of levels of similarity between husbands and wives for IQ, personality and some anthropometric characteristics. Significant levels of assortative marriage have been found in both verbal and performance IQ, personality ‘inconsistency’, stature, weight and some other bodily dimensions. Their nature has been analysed by time of marriage, birthplace and social class, all of which appear to have marked effects. On the other hand, length of courtship and distance apart of the partners' residences at marriage seem to be more or less inconsequential.

Based on survey data from rural Egypt, the effects of the wife's education on fertility and family planning were investigated and shown to be very important. In accordance with the results of most other studies, there is an inverse relationship with the number of live births. The wife's education is also shown to influence attitudes towards family size, spacing, and knowledge and approval of contraceptives, all of which lead to a high proportion of contraceptive use and help to achieve the desired family size. There was also a clear inverse association between the wife's education and pregnancy loss and infant mortality; these latter two variables showed positive correlations with the number of live births.

(Summary in Arabic on p. 60)

Contraceptive knowledge and behaviour of mothers of large (five of more children) and small (under three children) families in four subcu;tures were compared with white Protestants. Four hundred and forty-nine mothers aged 35–45 years were studied from black, Cuban, Indian, Chicano, and white groups. With social class, knowledge of birth control, and degree of religiosity held constant, the best predictors of family size were the mother's desited family size (expressed as desired minus actual children) age at childbirth, and age at mariage. Data suggest that family size is not purely a function of birth control knoeledge but related to early marrage and pregnancy and in keeping with attitudes about an ideal family size. In general, factors related to size were stronger in the white group than in the subcultures, and in a few instances certain cultures were not consostent with others in overall trends.

The physique of 1888 girls, all born in 1939 or later, who entered University College Swansea in the period 1959–70, was investigated to see whether variations in height, weight and ponderal index were correlated with various factors in their family environment. Analysis of variance, multiple regression, and covariance analysis showed that stature and ponderal index varied according to social class and year of birth. However, analysis of a local subsample of the data indicates that these effects are primarily due to the changing composition of the student intake over the years, and the regional heterogeneity of the sample.

An account is given of the patterns of pre-marital, marital, and post-marital movement and age of marriage according to social class among the present inhabitants of a group of Oxfordshire villages.

There is controversy extending beyond that of whether family planning or population control measures should be promoted among various populations. Even when the decision has been made to provide family planning advice, information and service, debate often arises as to the best method of administering a family planning programme—whether to integrate it with maternal and child health (MCH) services, offer it post-partum, or provide it independently of all other health activities.

The Danfa Comprehensive Rural Health and Family Planning Project, Ghana, is investigating the general problem of health service delivery, including family planning, and is doing so with a firm commitment to efficient management, staff training and supervisory maintenance. An established research design and ongoing evaluation efforts, including cost and functional analyses, are an integral part of the project. While it is believed that the integrated MCH/Family Planning approach will yield optimal results in family planning acceptance (as well as reduction in morbidity and mortality), other alternatives of health care and family planning service delivery are being evaluated.

The publication of a history* of that remarkable organisation, the Ciba Foundation, by an author working on the inside and having access to all relevant material, is something of an event and gives a welcome opportunity for a personal appreciation by one who was at the birth if not at the conception.