The Tokelau Island Migrant Study is outlined. It is a multi-disciplinary study of health and social change in the Tokelau islanders, following up emigrants to New Zealand (NZ). In this paper fertility and related aspects are examined, comparing pre-migrants (persons subsequently known to have emigrated to NZ) with non-migrants. Pre-migrant females tended to be younger, to marry later, to be less often childless and to have suffered more miscarriages, than non-migrants. Tokelau parity lagged behind other Polynesian populations due to later marriages, and reached a level below that of the more westernized Rarotongans and NZ Maoris.

Tokelau life expectancy was estimated to be 62·2–62·6 years for males and 62·9–66·4 years for females.

This paper reports a pilot study of thirteen children with epilepsy and their families; the parents' efforts to obtain help for the child and the effect of the child's disability on the family relationships are described. About half of the parents did not consult the family doctor immediately after the first appearance of signs of epilepsy (patient delay). About a quarter of the family doctors delayed referral of the patient with epilepsy to the specialist (doctor's delay). Another 3 years passed, on average, before the patient reached a special centre or clinic for epilepsy (specialist delay); in three-quarters of all cases the first step to get there was taken by the parents and not by the specialist and chance plays an important role in determining how the entry into this third echelon is achieved. Reasons for the search for more specialized help were: dissatisfaction with the results of the treatment and the kind of rapport with the second echelon specialist. The out-patient clinic for epilepsy is generally favourably commented on because the expert medical advice is combined with the availability of a social worker, thus offering support with social problems also. As regards the influence of the illness on the family, there is evidence that family life is disrupted to a greater or less extent. The parents experience psychological stress and are generally apprehensive lest something will happen to their child. In a number of cases the relationships between siblings are rather disturbed. The parents, especially mothers, tend to (over-)protect the child with epilepsy. The child with epilepsy has a relatively isolated position in his social environment; he has few informal or formal social contacts with his peer group. The condition epilepsy contributes to a diminution of expectations for the future and curtailment of scholastic behaviour.

Frequently it is of interest to compare the distributions of birth intervals for two or more population subgroups. Such analysis can serve as a useful adjunct to conventional studies of differential fertility.

This paper discusses several statistical tests which can be used to test differences in the distributions of the length of birth order specific intervals when these distributions are obtained using life table techniques. Since such estimates involve incomplete or arbitrarily censored intervals, conventional statistical tests are not appropriate.

The tests are illustrated through application to data from the 1965 National Fertility Survey. Data on the occurrence and timing of third and fourth births are shown to be significantly different for black and white currently married women. Comparisons among income groups, however, fail to show significant differences.

Despite the great amount of resources invested in family planning programs around the world and the considerable attention given to appraising their effects, little has been written about the analysis of family planning costs. Indeed, costs often seem to be virtually ignored. In the likely event that the growth of resources available for financing family planning programs in the future ceases to be as high as the expansion in demand for family planning, pressures will develop for better ways of evaluating family planning costs. This paper considers two major methodological issues—what should be included in family planning costs and what is the most practically useful classification. First, we recommend the use of a complete, inclusive concept of economic costs, including the imputation of costs of ‘free’ or donated inputs. Second, a classification of costs into administrative, motivational and contraceptive is suggested. The location of the usual types of family planning in these categories is then indicated.

Both the concept of economic costs and their three-fold classification are illustrated with detailed data on the family program in Barbados from its inception in 1955 through 1974.

The fertility of Japanese agricultural immigrants settled in eastern Bolivia was studied in comparison with Japanese populations in South Brazil and in Japan. The fertility of the Japanese in Bolivia was found to be high compared with the contemporary Japanese living in Japan, and lay between the levels for South Brazil in 1952 and for Japan in 1970. It is supposed that the Japanese immigrant women in Bolivia maintained the high level of fertility which was prevailing in Japan at the time when they had emigrated, while the level of fertility in Japan had declined remarkably.

Questions concerning their attitudes towards induced abortion in six different circumstances were asked of 1254 rural Thai married women, aged 15–44, in a 1972 nationwide fertility survey. A positive response was given to one or more of the questions by nearly three-fifths of the women; the largest proportion of positive responses (42·0%) was given by women if the pregnancy resulted from rape, and 40·1 % responded affirmatively if the pregnancy might endanger the health of the woman. The lowest proportions, but still nearly one-fifth of the women, were in favour of abortion if the couple do not want another child or if they cannot support another child. Responses are analysed in relation to the demographic and socio-economic characteristics of the women and their husbands, to fertility and family planning experiences, and to the women's communication activities. Comparisons of the results are made with similar data from rural South Korea, rural US and suburban Thailand. The study suggests that positive attitudes towards induced abortion among Thai rural women reflect traditional values, not recent ‘modernization’ ones.

This paper compares the results of questions about the best number of children and the desire for more children from three Nigerian sample surveys of adult females: in the Lagos metropolis (1973), in West Nigeria (1973), and among the Ngwa Ibo in the East Central State (1974). In Lagos and West Nigeria support for the ‘small’ family (of four children or, rarely, less) is more prevalent amongst the younger, urban bred and educated women: when these achieve their preferred family size a decline in fertility may be implemented. Among the Ngwa Ibo four children are seen as too few and the desire to stop childbearing only receives majority support from wives with seven or more surviving children. Economic constraints on family size have less impact on the Ngwa Ibo but glimmerings of interest in family limitation, albeit at high parities, are apparent among the educated Ngwa wives.

Oestrogens as postcoital contraception have been prescribed for 282 women at the Brook Advisory Centre (Avon) since January 1973. A daily dose of 50 mg diethylstilboestrol for 5 days started within 72 hr of unprotected intercourse was used from January 1973. This was changed to 5 mg ethinyl oestradiol in May 1974. There were no pregnancies nor any serious side effects. Follow-up showed that most women had their next period at the expected time.

A study of MZ and DZ twins suggests that cultural differences are less important than individual environmental experiences in determining the age of first sexual intercourse. Certain personality factors are found to be correlated with this trait and there is also evidence that genetical differences may predispose individuals to cross this threshold at an earlier or a later age.

Of 50 women who were having their third or subsequent legal abortion, 23 were pregnant because their contraceptive method had failed, 24 because of erratic contraceptive use, and three had changed their mind about an initially welcome pregnancy. There was a significant relationship between erratic use and a history of medical consultation for psychiatric reasons, and a suggestion that unsettled relationships and low educational status are also related to erratic use.

Inappropriate contraceptive advice was an important factor in several cases. Since the perfect contraceptive does not exist, and since some people are more unlucky than others, repeated abortion cannot be eliminated, but it may be reduced by giving especially careful contraceptive advice to those who are clearly at risk.

There is no evidence that abortion is being deliberately used as a method of birth control.

The proposed method of bleeding pattern analysis avoids the problem of defining the menstrual cycle. The difficulty of maintaining a cyclical approach becomes acute when methods of fertility regulation are used which are known to disrupt seriously previously experienced bleeding patterns.

By using eight simple measures relating to the pattern of bleeding over a fixed period of time, it is possible to present sensitive indicators previously available but not used. These indicators will permit a more meaningful comparison of data obtained from different groups of women or for the same woman over time. The eight measures relate to the number, average duration and variability of bleeding episodes taking place within a defined period of time; the variability of the bleeding-free interval; the average duration and variability of the bleeding episode and its succeeding bleeding-free interval; and the number of days on which bleeding has occurred.

Agreement was reached by the Workshop participants regarding the terms to be used, the definition of these terms, the statistical approach to be adopted and the analytical procedures to be followed in the analysis of bleeding patterns. It is hoped that this alternative approach to bleeding pattern analysis will assist researchers, clinicians and other investigators in the collection, analysis and interpretation of menstrual bleeding patterns.

An example of this approach is given in the following paper by D. Mayes. This example is based on data in the form of diary cards made available to the Family Planning Research Unit, Exeter University, by John Guillebaud of the Churchill Hospital, Oxford.

The purpose of this paper is two-fold; first, it seeks to examine the differences in menstrual bleeding patterns between users of three IUD models and second, it presents the advantages and disadvantages of the methods of analysis recommended by the Exeter Workshop on Bleeding Pattern Analysis reported by Snowden (1977, see p. 107 of this issue). The principal feature of this means of comparison is that the pattern of menstrual bleeding is assumed to be complex and multivariate. Previous analysis has tended to concentrate on the length of menstrual cycles, where such cycles are denned as the interval between the onset of one period of menstrual bleeding and the next. In addition to this type of information, the present study also incorporates information on the length and variability of periods of bleeding and intervals between bleeding. This information is readily available and easily collected.