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Summary In 12 years (1958–69) 38 patients with homozygous sickle‐cell anaemia (SS) were studied during the course of 61 pregnancies. Maternal prognosis was poor, with 7 deaths. The causes of mortality and morbidity were severe anaemia, acute sequestration, bacterial infections, bone pain crises, and bone marrow embolism. The proportion of these patients requiring operative deliveries was high chiefly because of fetopelvic disproportion from generally contracted pelvis. For obstetric operations various types of anaesthesia were used with excellent results, provided gross anaemia was corrected and hypoxia was avoided. When bone pain crises occurred during late pregnancy, labour and in the early puerperium, heparinization and blood transfusions were freely used. Fertility was reduced in these women, and both the spontaneous abortion rate and fetal wastage were at least twice as high as they were in the general population. The average birthweight of the babies was comparatively low, for no obvious reasons.

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The responses of a group of all unmarried, sexually active teenagers in a developing country to offers of contraceptive service were assessed in a prospective, 30-month study at a teaching hospital family planning center. Teenagers of this group constituted 7.2% of the clinic population. The default rate was very high (43.0%) and was most noticeable among users of oral contraceptives. The intrauterine device seemed more acceptable, as were injections of norethisterone enanthate. Possible reasons for this pattern of response are given, and the authors suggest giving new consideration to making the intrauterine device more suitable for and acceptable to teenagers of developing countries. The place of norethisterone enanthate in teenage contraception is also discussed.

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